Monkeypox cases in Spain have been linked to a superspreader event at an adult sauna in Madrid.
Enrique Ruiz Escudero, the region’s cabinet minister for health of the community, said on Friday that health officials had traced many of Spain’s 30 monkeypox cases to a single sauna in the capital.
Britain’s monkeypox tally now stands at 20 after 11 fresh cases were announced on Friday, and contact tracing and quarantine of close contacts is under way.
A “notable proportion” of the UK and European cases are in gay and bisexual men, health officials have said.
Three cases in Belgium have also been linked to a large-scale fetish festival in Antwerp, according to organisers. The Darklands Festival warned people who attended four days of parties, starting on May 5, that authorities had linked the event to the country’s three confirmed cases.
“There’s reason to assume that the virus has been brought in by visitors from abroad to the festival after recent cases in other countries,” the festival said on its website.
Darklands is a ticketed event that describes itself as a place where “various tribes in the gay fetish community (leather, rubber, army, skinhead, puppies...) come together to create a unique spectacle of fetish brotherhood”.
Sources have told The Telegraph that an internationally advertised gay party in Spain is also being investigated as the root cause of the global monkeypox cases.
In the UK, a link was first drawn between gay men and monkeypox earlier in the week, with the UK Health Security Agency (UKHSA) urging men who have sex with men to be alert to any new rashes or lesions on their body, including their genitalia.
“The Public Health Department will carry out an even more detailed analysis...to control contagion, cut the chains of transmission and try to mitigate the transmission of this virus as much as possible,” Mr Escudero said, Reuters reported.
The Telegraph also understands that experts are concerned about the outbreak in LGBTQ communities because gay pride events are due to begin soon, with the potential for further spread.
Experts are trying to trace and isolate any close contacts of known cases to prevent the outbreak growing further. However, they warned that because cases are being seen around the world, the virus may have been circulating for some time before being detected at the start of May.
Dr Hans Kluge, the World Health Organisation (WHO) regional director for Europe, said: “As we enter the summer season in the European region, with mass gatherings, festivals and parties, I am concerned that transmission could accelerate, as the cases currently being detected are among those engaging in sexual activity and the symptoms are unfamiliar to many.
“I would like to emphasise that individuals contracting monkeypox must not be stigmatised or discriminated against in any way.
“Timely risk communication with the general public is important, and public health bodies should widely disseminate accurate and practical advice on prevention, diagnosis and treatment.”
Monkeypox is normally a virus that is hard to spread from one person to another, and this is the first time there has been sustained human to human transmission outside Africa.
“Monkeypox can be spread through close contact with an infected animal or human,” Anne Rimoin, professor of epidemiology at UCLA, told The Telegraph. “This includes contact with respiratory droplets, lesions or bodily fluids. It can also be spread through contact with contaminated materials such as bed linens, clothing or towels.”
UKHSA scientists said earlier this week that the virus is likely to be spreading through sexual networks because of skin-on-skin contact, with exposed lesions laced with virus in a similar way to syphilis.
This is the first time this link has ever been seen for monkeypox, and is challenging what scientists know about the transmission of the virus.
Dr Susan Hopkins, the chief medical adviser at UKHSA, said: “Because the virus spreads through close contact, we are urging everyone to be aware of any unusual rashes or lesions and to contact NHS 111 or a sexual health service if they have any concerns.
“Please contact clinics ahead of your visit and avoid close contact with others until you have been seen by a clinician. A notable proportion of recent cases in the UK and Europe have been found in gay and bisexual men, so we are particularly encouraging them to be alert to the symptoms and seek help if concerned.”
On Friday, The Telegraph revealed that the WHO convened a group of experts in an emergency meeting to discuss the monkeypox outbreak. Dr Mike Ryan, the executive director of the WHO health emergencies programme, is believed to be in attendance at the meeting.
The UK is thought to have tens of thousands of doses of stockpiled vaccine ready to deliver in the event of a pox virus outbreak.
Bavarian Nordic, a biotechnology company, this week announced that “an undisclosed European country” has placed a fresh order for more doses in response to the current outbreak.
On Friday, Health Secretary Sajid Javid confirmed the UK had “procured further doses of vaccine that are effective against monkeypox”.
Bernard Hoet, VP of medical strategy at Bavarian Nordic, told The Telegraph: “The reason why this vaccine was developed was to have a safe vaccine for stockpiling in case of outbreaks of smallpox. We are in contact with the UK authorities about the use of the vaccine. At the moment, I don't know exactly who is receiving the vaccine in the UK.”