A new report states that a man in his 20s saw his first lesion 'after he attended a large, crowded outdoor event at which he had close contact with others.'
Which makes a recent case study out of the Stanford University School of Medicine important reading. The
, “Human Monkeypox without Viral Prodrome or Sexual Exposure, California, USA, 2022,” set to be published in the October issue of thejournal, describes a bisexual man in his 20s whose first monkeypox lesion appeared around 14 days “after he attended a large, crowded outdoor event at which he had close contact with others, including close dancing, for a few hours.” The subject had recently traveled to the U.K.
Of the event, which the study heavily suggests was the site of the subject’s transmission, the authors write: He said that many attendees were in sleeveless tops and shorts. He wore pants and a short-sleeved top. He did not notice any skin lesions on anyone present, nor did he notice anyone who seemed sick. He shared an e-cigarette with a woman that he met while there. The event was not a rave and was not attended specifically or mostly by persons identifying as gay or bisexual. He attended other similar outdoor events over 4 days. He reported consuming alcohol but no other drug use at these events.
His primary risk factor was close, nonsexual contact with numerous unknown persons at a crowded outdoor event. His case highlights the potential for spread at such gatherings, which may have implications for epidemic control. The lack of both sexual exposure and anogenital involvement indicates that mode of transmission may be associated with clinical symptoms; fomites may be alternative modes of transmission.
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