Eurosurv. Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022

[sharon sanders]

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• Jesús Iñigo Martínez¹ , Elisa Gil Montalbán¹ , Susana Jiménez Bueno¹ , Fernando Martín Martínez¹ , Alba Nieto Juliá¹ , Jesús Sánchez Díaz¹ , Natividad García Marín¹ , Esther Córdoba Deorador¹ , Antonio Nunziata Forte¹ , Marcos Alonso García¹ , Ana María Humanes Navarro¹ , Laura Montero Morales¹ , María José Domínguez Rodríguez¹ , Manuel Carbajo Ariza¹ , Luis Miguel Díaz García¹ , Nelva Mata Pariente¹ , Mercedes Rumayor Zarzuelo¹ , Manuel José Velasco Rodríguez¹ , Andrés Aragón Peña¹ , Elena Rodríguez Baena¹ , Ángel Miguel Benito¹ , Ana Pérez Meixeira¹ , María Ordobás Gavín¹ , María Ángeles Lopaz Pérez¹ , Araceli Arce Arnáez¹

Up to 22 June 2022, 508 confirmed cases of monkeypox (MPX) have been reported in the Madrid region of Spain, 99% are men (n = 503) with a median age of 35 years (range: 18–67). In this ongoing outbreak, 427 cases (84.1%) reported condomless sex or sex with multiple partners within the 21 days before onset of symptoms, who were predominantly men who have sex with men (MSM) (n = 397; 93%). Both the location of the rash, mainly in the anogenital and perineal area, as well as the presence of inguinal lymphadenopathy suggest that close physical contact during sexual activity played a key role in transmission. Several cases reported being at a sauna in the city of Madrid (n = 34) or a mass event held on the Spanish island of Gran Canaria (n = 27), activities which may represent a conducive environment for MPX virus spread, with many private parties also playing an important role. Because of the rapid implementation of MPX surveillance in Madrid, one of the largest outbreaks reported outside Africa was identified. To minimise transmission, we continue to actively work with LGBTIQ+ groups and associations, with the aim of raising awareness among people at risk and encouraging them to adopt preventive measures.

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.27.2200471