From NBC News:
The claim that skin-to-skin contact during sex between men, not intercourse itself, drives most monkeypox transmission is likely backward, a growing group of experts say.
Aug. 17, 2022, 8:47 AM PDT
By Benjamin Ryan
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.
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.
In recent weeks, a growing body of scientific evidence — including a trio of studies published in peer-reviewed journals, as well as reports from national, regional and global health authorities — has suggested that experts may have framed monkeypox’s typical transmission route precisely backward. ...
“A growing body of evidence supports that sexual transmission, particularly through seminal fluids, is occurring with the current MPX outbreak,” said Dr. Aniruddha Hazra, medical director of the University of Chicago Sexual Wellness Clinic, referring to monkeypox and to recent studies that found the virus in semen.
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.
On Aug. 14, Dr. Jeffrey Klausner, an infectious disease physician at the University of Southern California, and Dr. Lao-Tzu Allan-Blitz, a resident physician in global health at Brigham and Women’s Hospital in Boston, published an essay on Medium in which they reviewed the science supporting the argument that during the current outbreak, monkeypox is largely transmitting through anal and oral intercourse between men.
“It looks very clear to us that this is an infection that is transmitting sexually the vast majority of the time,” Allan-Blitz said.
We were told, occasionally, by the more realistic advocates of the conventional wisdom, that, “Yeah, OK, blaming AIDS on Nancy Reagan or whatever was just cope. We admit, AIDS was due to Gay Liberation getting out of control in the 1970s. But now that’s over: gays learned their lessons. That’s why we have Gay Marriage now.”
But then along came PrEP medications for blocking infection by HIV, and now there’s AIDS 2: Monkeypox.
It’s also possible that monkeypox has mutated. The previous spread in the U.S. was completely different demographically, showing up in families that bought prairie dogs as pets for their children. From Slate:
BY EMMA WALLENBROCK
MAY 25, 2022 2:51 PM
… And the U.S. has faced monkeypox before, most notably in July 2003, when 47 individuals from six Midwestern states—Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin—were confirmed to have or suspected of having the West African strain of the monkeypox virus (the same strain that has broken out in the U.S. and Europe this year). The outbreak began in Illinois, where an exotic animal vendor received a shipment of Gambian pouched rats and briefly housed them next to a prairie dog enclosure. The Gambian pouched rats were infected with monkeypox—which, despite its name, is more common in rodents than in monkeys—and passed it along to their neighbors.
Before the prairie dogs showed any signs of infection, they were sold as pets to both individuals and to pet shops, where their rapid and widespread distribution led to 71 total confirmed cases. (That’s human and animal infections.) One unfortunate family, the Kautzers, had bought two during a Mother’s Day event. After they got sick, they were told to quarantine “until the scabs fall off the sores,” and while one of their prairie dogs eventually succumbed to the illness, they were happy to keep the second (named Chuckles!) after he recovered.
… But during the 2003 outbreak, all 35 confirmed cases in humans were caused by direct contact with the infected prairie dogs. In fact, at the time, the CDC said that “no instances of monkeypox infection were attributed exclusively to person-to-person contact.”