Monkeypox: WHO chief advises men who have sex with men to reduce partners to limit exposure to monkeypox

 By John Bonifield, CNN

Updated 0901 GMT (1701 HKT) July 28, 2022

https://edition.cnn.com/2022/07/27/health/who-monkeypox-msm-sex-partners/index.html

(CNN)The vast majority of cases in the growing monkeypox outbreak are among men who have sex with men, according to the World Health Organization. WHO Director-General Tedros Adhanom Ghebreyesus advised members of this community Wednesday to limit their exposure to the virus by reducing their number of sex partners and reconsidering sex with new partners.

"This is an outbreak that can be stopped if countries, communities and individuals inform themselves, take the risk seriously and take the steps needed to stop transmission and protect vulnerable groups. The best way to do that is to reduce the risk of exposure. That means making safe choices for yourself and others.

"For men who have sex with men, this includes, for the moment, reducing your number of sexual partners, reconsidering sex with new partners and exchanging contact details with any new partners to enable followup, if needed," Tedros said at a briefing.

WHO declares monkeypox a public health emergency of international concern

While Tedros said the focus for all countries must be on engaging and empowering communities of men who have sex with men to reduce the risk of infection and transmission, he also cautioned nations to safeguard human rights.

"The stigma and discrimination can be as dangerous as any virus," he said.

Monkeypox isn't considered a sexually transmitted disease, but most people who have gotten it in the US recently report some level of sexual activity, Dr. Demetre Daskalakis, a US Centers for Disease Control and Prevention official working on the monkeypox response, told CNN this month. That can include penetrative encounters as well as oral sex.

The virus spreads primarily though skin-on-skin physical contact, but it can also be transmitted by touching objects like sheets or towels that may have been used by somebody with monkeypox, as well as through close face-to-face interactions like kissing.

Researchers are investigating whether the virus can be spread by someone who has no symptoms or through semen, vaginal fluids and fecal matter, according to the CDC.

An additional 786,000 monkeypox vaccine doses will soon be available in the United States

The CDC says that wearing a condom may help, but alone, it probably will not protect against the spread of monkeypox. However, the agency still emphasizes that condoms can prevent other sexually transmitted infections.

Tedros' comments about reducing sex partners are among the strongest yet on the matter. Other WHO communications haven't been characterized so sharply.

"Reducing your number of sexual partners may reduce your risk," one WHO flyer reads.

"How can I protect myself?" another says. "To catch monkeypox, you need skin-to-skin contact, including during sex, with someone infectious or their contaminated belongings. To reduce the risk of contracting monkeypox: practice safer sex, keep your hands clean."

"Remember that close physical contact, including sex, may increase your risk of exposure. Having multiple and frequent sexual contacts, including with anonymous partners, may put you more at risk of infection of monkeypox. To protect yourself practice safer sex," a third WHO flyer advises.

Health officials in the US have also advised reducing sex partners but used softer language.

What is monkeypox, and how can you stay safe as it spreads?

"Avoid skin-to-skin contact, including intimate contact, with people who have a rash that looks like monkeypox. Other harm reduction actions include minimizing sexual activity with multiple or anonymous sexual partners," CDC Director Dr. Rochelle Walensky said in mid-July.

Daskalakis advised last week, "In line with our harm reduction guidance, thinking about reducing your number of partners, potentially trying to avoid anonymous contacts ends up being smart from the perspective of decreasing the risk of exposure."

The CDC also says people might want to reduce skin contact as much as possible by having sex with clothes on or after covering areas where the rash is present. If they choose to have sex with someone who has monkeypox or who might have been exposed to it, they should talk about the virus ahead of time.

Another thing people can do to protect themselves is avoid close face-to-face contact like kissing with those who are clearly infected.

Scientists are still studying how monkeypox is spreading in this outbreak, but they say people don't seem to be getting sick after, say, walking past someone or giving them a hug and brushing over a lesion on their skin.

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"If it's a hug that doesn't necessarily include a shirt, there's a theoretical risk of transmission there, but that's not what we're hearing in terms of what's happening with our cases, so it's lower risk. I can't say zero risk," Daskalakis said.

Rather, it's longer contact that seems to be responsible for most cases now. "If you were to ask me how long 'long' is, I can't answer that question, but it seems as if it's possible that this is not being transmitted by a light brush," Daskalaskis said. "Realistically speaking, skin-on-skin contact of any variety theoretically can transmit monkeypox, but what we're seeing is, you kind of have to work at it a bit."

CNN's Jen Christensen contributed to this report.

https://edition.cnn.com/2022/07/27/health/who-monkeypox-msm-sex-partners/index.html

New studies suggest Covid-19 likely originated from Wuhan wet market

New studies agree that animals sold at Wuhan market are most likely what started Covid-19 pandemic

By Jen Christensen, CNN

Updated 1505 GMT (2305 HKT) July 27, 2022

https://edition.cnn.com/2022/07/26/health/wuhan-market-covid-19/index.html

(CNN)In June, the World Health Organization recommended that scientists continue to research all possible origins of the Covid-19 pandemic, including a lab leak. Two newly published studies take totally different approaches but arrive at the same conclusion: The Huanan Seafood Market in Wuhan, China, was most likely the epicenter for the coronavirus.

The studies were posted online as preprints in February but have now undergone peer review and were published Tuesday in the journal Science.

In one, scientists from around the world used mapping tools and social media reports to do a spatial and environmental analysis. They suggest that although the "exact circumstances remain obscure," the virus was probably present in live animals sold at the market in late 2019. The animals were held close together and could easily have exchanged germs. However, the study does not determine which animals may have been sick.

The researchers determined that the earliest Covid-19 cases were centered at the market among vendors who sold these live animals or people who shopped there. They believe that there were two separate viruses circulating in the animals that spilled over into people.

"All eight COVID-19 cases detected prior to 20 December were from the western side of the market, where mammal species were also sold," the study says. The proximity to five stalls that sold live or recently butchered animals was predictive of human cases.

A vital clue to where Covid-19 came from may sit in Wuhan hospital 03:28

"The clustering is very, very specific," study co-author Kristian Andersen, a professor in the Department of Immunology and Microbiology at Scripps Research, said Tuesday.

The "extraordinary" pattern that emerged from mapping these cases was very clear, said another co-author, Michael Worobey, department head of Ecology and Evolutionary Biology at the University of Arizona.

The researchers mapped the earliest cases that had no connection to the market, Worobey noted, and those people lived or worked in close proximity to the market.

"This is an indication that the virus started spreading in people who worked at the market but then started that spread ... into the surrounding local community as vendors went into local shops, infected people who worked in those shops," Worobey said.

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The other study takes a molecular approach and seems to determine when the first coronavirus infections crossed from animals to humans.

The earliest version of the coronavirus, this research shows, probably came in different forms that the scientists call A and B. The lineages were the result of at least two cross-species transmission events into humans.

The researchers suggest that the first animal-to-human transmission probably happened around November 18, 2019, and it came from lineage B. They found the lineage B type only in people who had a direct connection to the Huanan market.

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The authors believe that lineage A was introduced into humans from an animal within weeks or even days of the infection from lineage B. Lineage A was found in samples from humans who lived or stayed close to the market.

"These findings indicate that it is unlikely that SARS-CoV-2 circulated widely in humans prior to November 2019 and define the narrow window between when SARS-CoV-2 first jumped into humans and when the first cases of COVID-19 were reported," the study says. "As with other coronaviruses, SARS-CoV-2 emergence likely resulted from multiple zoonotic events."

The likelihood that such a virus would emerge from two different events is low, acknowledged co-author Joel Wertheim, an associate adjunct professor of medicine at the University of California, San Diego.

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"Now, I realize it sounds like I just said that a once-in-a-generation event happened twice in short succession, and pandemics are indeed rare, but once all the conditions are in place -- that is a zoonotic virus capable of both human infection and human transmission that is in close proximity to humans -- the barriers to spillover have been lowered such that multiple introductions, we believe, should actually be expected," Wertheim said.

Andersen said the studies don't definitively disprove the lab leak theory but are extremely persuasive, so much so that he changed his mind about the virus' origins.

"I was quite convinced of the lab leak myself, until we dove into this very carefully and looked at it much closer," Andersen said. "Based on data and analysis I've done over the last decade on many other viruses, I've convinced myself that actually the data points to this particular market."

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Worobey said he too thought the lab leak was possible, but the epidemiological preponderance of cases linked to the market is "not a mirage."

"It's a real thing," he said. "It's just not plausible that this virus was introduced any other way than through the wildlife trade."

To reduce the chances of future pandemics, the researchers hope they can determine exactly what animal may have first become infected and how.

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"The raw ingredients for a zoonotic virus with pandemic potential are still lurking in the wild," Wertheim said. He believes the world needs to do a much better job doing surveillance and monitoring animals and other potential threats to human health.

Andersen said that although we can't prevent outbreaks, collaboration between the world's scientists could be key to the difference between a disease with a small impact and one that kills millions.

"The big question we need to ask ourselves is -- the next time this happens, because it will happen -- how do we go from detecting that outbreak early and preventing that outbreak so it doesn't become a pandemic?"

https://edition.cnn.com/2022/07/26/health/wuhan-market-covid-19/index.html

BBC: Coronavirus variant fear sparks Africa travel curbs

Travellers arriving in England from several southern African countries will have to quarantine amid warnings over a new coronavirus variant.

Published

1 hour ago   26 November 2021   BBC

Related Topics

• Coronavirus pandemic

IMAGE SOURCE,PA MEDIA

Travellers arriving in England from several southern African countries will have to quarantine amid warnings over a new coronavirus variant.

UK Health Secretary Sajid Javid said from 12:00 GMT on Friday six countries would be added to the red list, with flights being temporarily banned.

One expert described the variant, known as B.1.1.529, as "the worst one we've seen so far", and there is concern it has the potential to evade immunity.

No cases have been confirmed in the UK.

Only 59 confirmed cases have been identified in South Africa, Hong Kong and Botswana so far.

• What do we know about this new variant?
• What are the latest changes to UK travel rules?

All flights from South Africa, Namibia, Zimbabwe, Botswana, Lesotho and Eswatini are being suspended.

Mr Javid said that scientists were "deeply concerned" about the new variant but more needed to be learned about it.

But he said the variant has a significant number of mutations, "perhaps double the number of mutations that we have seen in the Delta variant".

He added: "And that would suggest that it may well be more transmissible and the current vaccines that we have may well be less effective."

He said adding the six countries to the red list was about "being cautious and taking action and trying to protect. as best we can, our borders".

From 12:00 on Friday non-UK and Irish residents will be banned from entering England if they have been in the six countries in the past 10 days.

Any British or Irish resident arriving from the countries after 04:00 on Sunday will have to quarantine in a hotel, with those returning before that being asked to isolate at home.

Those who have returned in the last 10 days are being asked to take a PCR test by the UK Health Security Agency (UKHSA).

The flight ban will remain in place until the hotel quarantine system is up and running.

One scientist told me this was the worst variant they'd seen - look at it on paper and it's not hard to see why.

It is the most heavily mutated variant so far and is now radically different to the form that emerged in Wuhan, China.

That means vaccines, which were designed using the original, may not be as effective.

And some of its mutations are known to increase the ability of coronaviruses to spread.

But there have been many variants that looked bad on paper before, but haven't taken off.

There are early signs this virus is spreading in South Africa and may already be in every province in the country.

But the big questions - how much does it evade vaccines, is it more severe, does it spread faster that Delta - are unanswerable for now.

• Read more from James.

BBC Africa correspondent Andrew Harding said scientists in South Africa were trying to understand the mutations of the new variant.

He said there was unhappiness at the new red listing by other countries, with scientists saying the country needed more support and more reward for spotting the new variant.

Experts from the World Health Organization (WHO) are meeting South African officials on Friday to assess the evolving situation in the country.

The new variant, which has been designated a new variant under investigation by the UKHSA, is heavily mutated and the confirmed cases are mostly concentrated in one province in South Africa.

Scientists say the variant has 50 mutations overall and more than 30 on the spike protein, which is the target of most vaccines and the key the virus uses to unlock the doorway into our body's cells.

Experts in South Africa have said the variant is "very different" to others that have circulated, with concerns that it could be more transmissible but also able to get around parts of the immune system.

Prof Ravi Gupta, from the University of Cambridge, said the new variant had the potential to escape immunity and have increased infectivity.

Imperial College London's Prof Neil Ferguson said it was concerning the new variant appeared to be "driving a rapid increase in case numbers in South Africa" and said the move to restrict travel was "prudent".

But he said it was not clear if the variant was more transmissible or resistant to vaccines and therefore it was too early to judge the risk it poses.

At the moment around 500 and 700 people are travelling to the UK from South Africa each day, but this figure was likely to have increased as the festive period began.

British Airways said it was contacting affected customers and Virgin Atlantic said it would be reviewing its schedule for South Africa for the coming week, with flights from Johannesburg to Heathrow cancelled between 12:00 on Friday and 04:00 on Sunday.

All the countries that remained on the UK's red travel list were removed in October.

Each UK nation sets its own policy but they have generally followed the same rules for past announcements.

Scotland is following the UK government's decision, with anyone arriving from the six countries having to self-isolate and take two PCR tests, while hotel quarantine will be in place from 04:00 GMT on Saturday.

Currently people travelling to the UK who are fully vaccinated do not need to take a Covid test before setting off but do need to take a lateral flow test two days after arrival and fill out a passenger locator form.

Those who are not fully vaccinated and are over 18 must self-isolate at home for 10 days and take a Covid test in the three days before travelling as well as on day two and day eight of their return.

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