SRINAGAR: As monkey pox has been declared a global health emergency by World Health Organization (WHO), a growing body of research suggests that sex between men and not skin contact is fuelling monkeypox.

The sex between men itself – both anal as well as oral intercourse- is likely the main driver of global monkeypox transmission. However, this assertion has negated the earlier belief that the virus is largely transmitting through skin-to-skin contact during sex between men.

Earlier, the WHO’s public health advice had said that it is not just limited to LGBTQ’s after it was accused of demonizing the community. It had stated that monkeypox can spread from close physical contact regardless of any sexual orientation or race, and that LGBTQs are not ‘spreaders’ of monkeypox.

You can catch monkeypox if you have close physical contact with someone who is showing symptoms. This includes touching and being face-to-face,” it said.

However, in a research paper titled as Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series, confirms in its conclusion the on-going unprecedented community transmission among gay, bisexual, and other men who have sex with men seen in the UK and many other non-endemic countries.

“Rectal pain and penile oedema were the most common presentations requiring hospital admission,” the study reveals.

Experts have also framed monkeypox’s typical transmission route precisely backward according to 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.

In an essay published on Medium by 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 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 told NBC news.

The correlation may appear to be strong, but that does not explain the whole picture of disease caused by this virus, said Dr Rosamund Lewis, technical lead for monkeypox at the World Health Organization, reported NBC news.

“So we need to keep an open mind. It was “unfortunate but true” that “we don’t know yet” whether the virus is predominantly transmitted through intercourse,” she said.

Some experts in infectious disease see evidence supporting the argument that monkeypox at least transmits more readily through intercourse reported NBC news.

An infectious disease specialist at the UCLA School of Medicine, Dr Paul Adamson, said that “At this point, I’m not sure we can say it is primarily the sexual transmission and not the skin-to-skin contact that also occurs during sex that is contributing to the most transmission during this current outbreak. However, emerging data seem to suggest that monkeypox might be more efficiently transmitted sexually.”

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According to World Health Organization (WHO) cases jumped 20 percent last week to 35,000 across 92 countries.

The disease according to growing body of research is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus.

Human monkeypox was first identified in humans in 1970 in the Democratic Republic of the Congo in a 9-month-old boy, according to WHO, the virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.

Distilling the evidence in an interview with NBC news, Klausner, who has submitted a version of his and Allan-Blitz’s essay to a scientific journal for publication said the hypothesis that sex itself fuels the global outbreak into four major points.

“According to the WHO, more than three quarters of global monkeypox cases are among men 18 to 44 years old. This is a typical age breakdown for diagnoses of sexually transmitted infections among gay and bisexual men,” he noted first.

What’s more, in recent studies of pooled monkeypox cases among this demographic, 17 percent to 32 percent of those diagnosed with the virus received a sexually transmitted infection (STI) diagnosis at the same time.

Second, since first being identified in humans in 1970, monkeypox lesions have in the majority of cases occurred in men’s genital and anorectal areas.

This, experts told NBC News, suggests that these were the sites where the virus first passed into the body. In a study published July 21 in The New England Journal of Medicine, a global team of researchers pooled 538 monkeypox cases — also all in men — from around the world and found that 73 percent had lesions in the genital or anorectal areas.

Third, researchers have found monkeypox in semen and have been able to culture that virus, which suggests it could transmit through ejaculation. Also, the authors of two recent studies have detected the virus after taking anal swabs among men who had monkeypox but were asymptomatic, which indicates that the virus might transmit from the anorectal area during anal intercourse before people develop symptoms.

Experts say more research is needed on both these fronts.

Referring to bodily fluids such as semen, vaginal fluids and blood, the WHO’s Lewis said, “Research is underway to find out more about whether people can spread monkeypox through the exchange of these fluids during and after symptomatic infection.”

Finally, Klausner noted that scientists have identified an association between specific sexual acts and the location of monkeypox lesions.