The 2022–2023 mpox outbreak in Spain is a part of the

outbreak In epidemiology, an outbreak is a sudden increase in occurrences of a disease when cases are in excess of normal expectancy for the location or season. It may affect a small and localized group or impact upon thousands of people across an entire ...

of human mpox caused by the West African clade of the

monkeypox virus ''Monkeypox virus'' (MPV, MPXV, or hMPXV) is a species of double-stranded DNA virus that causes monkeypox in humans and other mammals. Monkeypox virus is a zoonotic virus belonging to the '' orthopoxvirus'' genus, making it closely related to th ...

. Spain was the second country outside the African countries with endemic mpox, to experience an outbreak in 2022. The outbreak was first reported in

Spain , image_flag = Bandera de España.svg , image_coat = Escudo de España (mazonado).svg , national_motto = '' Plus ultra'' ( Latin)(English: "Further Beyond") , national_anthem = (English: "Royal March") , ...

on 18 May 2022.

Background

An ongoing

mpox Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and some other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild ...

was confirmed on 6 May 2022, beginning with a

British British may refer to: Peoples, culture, and language * British people, nationals or natives of the United Kingdom, British Overseas Territories, and Crown Dependencies. ** Britishness, the British identity and common culture * British English ...

resident who, after travelling to

Nigeria Nigeria ( ), , ig, Naìjíríyà, yo, Nàìjíríà, pcm, Naijá , ff, Naajeeriya, kcg, Naijeriya officially the Federal Republic of Nigeria, is a country in West Africa. It is situated between the Sahel to the north and the Gulf of G ...

(where the disease is

endemic Endemism is the state of a species being found in a single defined geographic location, such as an island, state, nation, country or other defined zone; organisms that are indigenous to a place are not endemic to it if they are also found els ...

), presented symptoms consistent with mpox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's

index case The index case or patient zero is the first documented patient in a disease epidemic within a population, or the first documented patient included in an epidemiological study. It can also refer to the first case of a condition or syndrome (not n ...

of the outbreak. The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw

community transmission In medicine, public health, and biology, transmission is the passing of a pathogen causing communicable disease from an infected host individual or group to a particular individual or group, regardless of whether the other individual was previous ...

taking place in the

London London is the capital and List of urban areas in the United Kingdom, largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary dow ...

area as of mid-May, but it has been suggested that cases were already spreading in Europe in the previous months.

Transmission

A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as

, the

Democratic Republic of the Congo The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...

as well as

central Central is an adjective usually referring to being in the center of some place or (mathematical) object. Central may also refer to: Directions and generalised locations * Central Africa, a region in the centre of Africa continent, also known a ...

and

western Africa West Africa or Western Africa is the westernmost region of Africa. The United Nations defines Western Africa as the 16 countries of Benin, Burkina Faso, Cape Verde, The Gambia, Ghana, Guinea, Guinea-Bissau, Ivory Coast, Liberia, Mali, Mauri ...

. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with

lesion A lesion is any damage or abnormal change in the tissue of an organism, usually caused by disease or trauma. ''Lesion'' is derived from the Latin "injury". Lesions may occur in plants as well as animals. Types There is no designated classif ...

s on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced

proctitis Proctitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum. Signs and symptoms A common symptom is a continual urge to have a bowel movement—the rectum could feel full or have const ...

, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis,

gonorrhea Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium '' Neisseria gonorrhoeae''. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with ...

chlamydia Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium '' Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several w ...

, and

herpes Herpes simplex is a viral infection caused by the herpes simplex virus. Infections are categorized based on the part of the body infected. Oral herpes involves the face or mouth. It may result in small blisters in groups often called cold ...

History

On 18 May 2022, the

Community of Madrid The Community of Madrid (; es, Comunidad de Madrid ) is one of the seventeen autonomous communities of Spain. It is located in the centre of the Iberian Peninsula, and of the Central Plateau (''Meseta Central''). Its capital and largest mun ...

regional government reported the first eight suspected cases of mpox, and seven of them were confirmed by the

Ministry of Health Ministry of Health may refer to: Note: Italics indicate now-defunct ministries. * Ministry of Health (Argentina) * Ministry of Health (Armenia) * Australia: ** Ministry of Health (New South Wales) * Ministry of Health (The Bahamas) * Ministry of ...

on 20 May. On 20 May, the health authorities of Madrid closed the

gay sauna A gay bathhouse, also known as a gay sauna or a gay steambath (uncommonly known as a gay spa), is a commercial space for gay, bisexual, and other men to have sex with men. In gay slang, a bathhouse may be called just "the baths", "the sauna", ...

Paraíso, which was under investigation as a possible high transmission point in Madrid. The sauna reopened again on 9 June after receiving an authorization from the regional health department.

Outbreak characteristics

According to the Community of Madrid regional government on 6 June 2022, all cases in the region were men, except one woman who is cohabitant with one of the infected men. The most likely contagion event for most was sexual relations with strangers, usually at parties in private residences, a sauna, or the gay pride event at Maspalomas, Canary Islands. 48% of cases were also

HIV The human immunodeficiency viruses (HIV) are two species of '' Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immu ...

-positive. On 10 June, the Ministry of Health disclosed that out of a sample of 78 cases, 21 had a previous

smallpox vaccine The smallpox vaccine is the first vaccine to be developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox ...

dose. On 26 August, the Ministry of Health published additional data about 6,459 cases. 6,334 of them were men, and 125 were women. Age ranged between 7 months and 88 years, with a median age of 37 years. Out of 5,198 cases with recorded data, 5,022 were

men who have sex with men Men who have sex with men (MSM) are male persons who engage in sexual activity with members of the same sex. The term was created in the 1990s by epidemiologists to study the spread of disease among all men who have sex with men, regardless of s ...

. Out of 3,700 cases with recorded data, 92,6% had prolonged intimate contact during sexual relation as the most likely transmission mechanism.

LGBT stigmatization

Several experts have raised concerns about stigmatization of

LGBT ' is an initialism that stands for lesbian, gay, bisexual, and transgender. In use since the 1990s, the initialism, as well as some of its common variants, functions as an umbrella term for sexuality and gender identity. The LGBT term i ...

people in connection to the mpox outbreak. In June 2022, the public prosecutor of

Valencia Valencia ( va, València) is the capital of the autonomous community of Valencia and the third-most populated municipality in Spain, with 791,413 inhabitants. It is also the capital of the province of the same name. The wider urban area al ...

opened an investigation of a publication about the mpox outbreak by the far-right political party

España 2000 España 2000 (E-2000) is a far-right political party in Spain which has never obtained national or regional parliamentary representation. The last time it ran for General elections was in 2011, where it obtained 9266 votes out of a total of 24,5 ...

, which could constitute hate speech against the

community.

Cases per region

Notes

References

External links

*
Ministry of Health information website
{{DEFAULTSORT:2022-2023 mpox outbreak in Spain

Mpox Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and some other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild ...

2022 disasters in Spain