NBC News: Monkeypox chiefly transmitted through sex between men, suggests CDC update communications strategy

Scientists say CDC should revamp monkeypox guidelines

Editor's Note: The following report contains graphic language about the sexual transmission of monkeypox.

NBC News poked a hole in the public health narrative that skin-to-skin contact, rather than sex between men, was the chief transmitter of monkeypox in a report on Wednesday, and quoted scientists urging the Centers for Disease Control to update its communications on the infectious disease.

NBC's Benjamin Ryan reported that growing evidence in recent weeks "has suggested that experts may have framed monkeypox’s typical transmission route precisely backward."

"Since the outset of the global monkeypox outbreak in May, public health and infectious disease experts have told the public that the virus is largely transmitting through skin-to-skin contact, in particular during sex between men," NBC reported. "Now, however, an expanding cadre of experts has come to believe that sex between men itself — both anal as well as oral intercourse — is likely the main driver of global monkeypox transmission. The skin contact that comes with sex, these experts say, is probably much less of a risk factor."

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Accurate information on the highest-risk behavior for transmission is crucial, as it plays into recommendations on isolation, infection risk and other factors. It cited studies finding the virus in semen, with one scientist remarking a "growing body of evidence supports that sexual transmission, particularly through seminal fluids, is occurring with the current MPX outbreak."

A staff member of the Westchester Medical Center applies a monkeypox vaccine to a person in a drive-through monkeypox vaccination point at the Westchester Medical Center in Valhalla, New York, U.S., July 28, 2022.  (REUTERS/Eduardo Munoz)

Among the other evidence cited for the claim was the disease's prevalence among men aged 18-44 (more than 75 percent of global cases), and the majority of cases occurring in the anorectal or genital areas, suggesting sexual transmission when the virus is first passed along.

"Consequently, scientists told NBC News that the Centers for Disease Control and Prevention and other public health authorities should update their monkeypox communication strategies to more strongly emphasize the centrality of intercourse among gay and bisexual men, who comprise nearly all U.S. cases, to the virus’ spread," NBC reported.

A Medium blog cited in NBC by Drs. Lao-Tzu Allan-Blitz and Jeffrey D. Klausner found strong evidence that monkeypox is a sexually transmitted disease. 

"…the temporal and anatomic association with various sex practices, the high prevalence of sexual risk behavior among patients with human monkeypox, and the in vitro infectivity of human monkeypox DNA isolated from semen strongly suggest that human monkeypox is transmitted through sexual activity," they wrote, while fretting over the potential "stigma" of labeling it an STI.

A greyhound has contracted monkeypox in the first confirmed case of human-to-pet infection.

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"Conversely, failure to appropriately identify and disseminate to the public the predominant mode of transmission will likely perpetuate behaviors that are driving transmission," they wrote.

The World Health Organization pushed back, though, with its technical director claiming "we don't know yet" how monkeypox chiefly transmits.

The CDC's guidelines on monkeypox currently state, "Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including, "Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox," "Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox," and "Contact with respiratory secretions."

A registered nurse prepares a dose of a monkeypox vaccine at the Salt Lake County Health Department Thursday, July 28, 2022, in Salt Lake City.  ((AP Photo/Rick Bowmer, File))

The report comes as the CDC, a public punching bag for more than two years over its controversial handling of the coronavirus pandemic, undergoes a reorganization ordered by director Dr. Rochelle Walensky.

"For 75 years, CDC and public health have been preparing for COVID-19, and in our big moment, our performance did not reliably meet expectations," she said in a statement obtained this week by The Washington Post. "My goal is a new, public health action-oriented culture at CDC that emphasizes accountability, collaboration, communication, and timeliness."

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Fox News' Stephen Sorace contributed to this report.

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