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Monkeypox patients should abstain from sex while symptomatic, U.K. says

Guidance comes as 179 cases have been confirmed in the country — the highest reported number worldwide

An employee works in a lab for vaccine maker Bavarian Nordic in Martinsried, Germany, on May 24. (Lukas Barth/Reuters)
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People with monkeypox symptoms should abstain from sex, British health authorities are recommending as the country reports 179 confirmed cases of the disease amid a rare global outbreak.

The guidance advises those who have been infected with monkeypox to use condoms for at least eight weeks after the infection abates as a “precautionary” measure, while public health experts learn more about how the virus spreads between people.

People who have monkeypox or think they could have it “should avoid contact with other people until their lesions have healed and the scabs have dried off,” the guidance says.

The World Health Organization has said it is unlikely that the outbreak of monkeypox could turn into a pandemic, but it warned that measures should be taken quickly to stop the spread.

The WHO said Sunday that nearly two dozen countries have reported a total of 257 confirmed cases and about 120 suspected cases of monkeypox. In Britain, which has the highest reported number of confirmed monkeypox cases in the world, according to the WHO, health authorities have suggested new measures for health-care workers and the public.

What is monkeypox, the rare virus now confirmed in the U.S. and Europe?

Rosamund Lewis, the WHO’s technical leader on monkeypox, said in a briefing Monday that most confirmed cases have been identified in gay, bisexual and other men who have sex with men, and that the risk to the wider population is “low.”

“This group of people [men who have sex with men] are those who are most affected by the cases at the present time, and the idea is to obviously stop further spread so that it doesn’t affect the more general population,” she said. “Having said that, anyone can be at risk.”

Lewis said “the world has an opportunity to stop this outbreak” by identifying confirmed or potential cases, isolating them and tracing their close contacts, and keeping an eye on those who have been exposed, who under WHO guidelines do not need to stay home if they are not exhibiting symptoms.

“At the moment, we are not concerned about a global pandemic,” she added. “We are concerned that individuals may acquire this infection through high-risk exposure if they don’t have the information they need to protect themselves.”

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The British government’s new guidance is designed in part to help those who have the disease or are exposed to it, in addition to being a summary of what is known and not known about the virus. The document states that most infections so far have occurred through close, direct contact.

People with monkeypox can isolate at home, as long as they are monitored by local health authorities, the guidance states. Their close contacts don’t have to quarantine if they are asymptomatic but will be monitored and may be “told to isolate for 21 days if necessary.”

People with confirmed or suspected monkeypox should “abstain from sex while symptomatic, including the period of early symptom onset, and while lesions are present,” it says.

It adds that “there is currently no available evidence of monkeypox in genital excretions” but recommends “as a precaution” that those who have had monkeypox “use condoms for 8 weeks after infection,” noting that the guidance could change.

The British Health Security Agency, one of the departments behind the guidance, has started offering a smallpox vaccine, a new version of which has been approved in the United States for use against monkeypox, to close contacts of confirmed cases “to reduce the risk of symptomatic infection and severe illness.”

Studies suggest that the smallpox vaccine is at least 85 percent effective against monkeypox, according to the U.S. Centers for Disease Control and Prevention. The United States stopped vaccinating people against smallpox — which was eradicated globally in 1980 — as a matter of routine in the 1970s.

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The WHO has not recommended universal monkeypox vaccination, though it says countries may want to vaccinate close contacts after they have been exposed to the virus or health-care workers who may be exposed in the future.

In the briefing Monday, the WHO’s Lewis said “it would be unfortunate” if monkeypox were to be allowed to “establish itself as … an infection capable of human-to-human transmission, and exploit the immunity gap left by smallpox 40 years ago.”

“So the WHO is very keen, upon the history of smallpox eradication, to also stop this outbreak as soon as possible,” she said.

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