The warning by Dr. Catherine Smallwood, a senior emergency officer at the WHO, comes after the United Nations health agency declared monkeypox a public health emergency of international concern—as it did with COVID-19.
It also comes after the Journal of New England Medicine on July 21 published a major peer-reviewed study that found that the virus is primarily being transmitted through the sexual activity of gay and bisexual men.
Smallwood noted that public health officials are paying attention to the progression of monkeypox as an emerging virus outbreak that began in the LGBT community among gay and bisexual men.
Until the spring of 2022, monkeypox was endemic to Africa, where it was mostly spread by animals. But for the first time, the virus is spreading among gay and bisexual men in over 75 countries and territories, with over 16,000 infections and five deaths.
“At the moment cases continue to be reported among men who have sex with men, for the most part. But we should not expect that to remain such,” Smallwood said in an interview with CNBC.
“It may be that this particular population group, as it is for any new disease spreading, it starts in one community or it starts in one setting, and then it might spread.”
Smallwood said the progression of monkeypox “really might be the canary in the mine” alerting the world to “a new disease threat that could spread” from the LGBT community to other population groups.
If that happens, she said that monkeypox could have an “increased public health impact,” particularly for groups that a prone to more severe illness.
Most recently, two cases have been reported in a toddler and an infant in the United States, both of whom come from households with adults who are part of the “gay men’s community,” according to an official from the U.S. Centers for Disease Control and Prevention (CDC).
WHO Declared Monkeypox a Global Health ‘Emergency’
WHO Director-General Tedros Adhanom Ghebreyesus declared the virus a global health “emergency” on July 23, prompted by the global growth in monkeypox cases.
“I have decided that the global monkeypox outbreak represents a public health emergency of international concern,” Ghebreyesus said in a statement.
Ghebreyesus announced his decision after a meeting of independent experts on the WHO’s Emergency Committee.
The WHO experts previously convened in June but did not reach a consensus on whether monkeypox met the criteria for a public health emergency of international concern. At the time, there were 3,040 cases in 47 countries.
At the reconvened meeting on July 21, the experts once again failed to reach a consensus, but Ghebreyesus made the final call, noting that the outbreak has spread rapidly around the world in a way that it has never before.
“I thank the Emergency Committee for its deliberations and advice. I know this has not been an easy or straightforward process, and that there are divergent views among the members,” he said.
Primarily Transmitted Sexually by Gay and Bisexual Men: Study
Although disease experts and officials from the CDC don’t consider monkeypox a sexually transmitted infection, a major peer-review study has found that it is primarily being transmitted through the sexual activity of men who have sex with men.
The Journal of New England Medicine’s study reported on 528 infections diagnosed between April 27 and June 24, of which 98 percent were in gay or bisexual men. Of these cases, 95 percent of the infections were suspected to have been transmitted through sexual activity. Of this group, 41 percent also had HIV.
The initial outbreak in Europe was linked to large-scale LGBT events in Spain and Belgium, with the leading theory among disease experts being that the monkeypox virus was sexually transmitted at those events.
An uptick in recent U.S. cases suggests transmission occurred at the tail end of Pride Month in late June and early July, based on the study finding that incubation is between three and 20 days (usually seven days).
The CDC acknowledged the possibility of spread during U.S. LGBT events in June, but was hesitant to recommend canceling them, opting instead to target messages to the population group via the health sector.
Dr. Paul Alexander, a former Trump administration health official and researcher, has said the CDC should have done more and sooner.
“All this needed was leadership saying no skin to skin contact, no anal sex, no sex, none for a few weeks and we would have helped this high risk group, but no, it’s political games and now the low-risk general heterosexual population is at risk especially from bisexual males,” Alexander wrote in a blog post.