Why a single monkeypox case is raising transmission concerns for researchers

Researchers have raised concern over the potential for modes of monkeypox transmission beyond intimate contact after detailing the case of an infected man with no recent sexual contact whose highest-risk exposure was attending a crowded outdoor event that was not primarily attended by gay and bisexual people.

An early release article from researchers at Stanford (Calif.) School of Medicine was published Aug. 15 in the CDC's Emerging Infectious Diseases journal. They detailed the case of the patient, who returned to the U.S. after visiting the U.K. and sought care at a Stanford emergency department with a rash. Researchers said the man first noticed a lesion about two weeks after attending a crowded outdoor event where he reported close contact with others, including dancing. He attended a similar outdoor event over four days and did not report any sexual contact in the preceding three months. The individual developed lesions, though none on the anus or genitals. 

The monkeypox case is unusual, as most in the current outbreak have been tied to close, intimate contact among men who have sex with men. If the outbreak is not contained, health experts have said the virus will likely begin to spread more broadly among those who attend crowded nightclubs and bars. 

"His primary risk factor was close, nonsexual contact with numerous unknown persons at a crowded outdoor event," the report said. "His case highlights the potential for spread at such gatherings, which may have implications for epidemic control."

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