"We now have a critical opportunity to act quickly, together, to rapidly investigate and control this fast-evolving situation," he said. Based on the case reports to date, the current outbreak is being transmitted through social networks connected largely through sexual activity, primarily involving men who have sex with men. Many -- but not all cases -- also report fleeting and/or multiple sexual partners, sometimes associated with large events or parties.

However, it isn't clear yet as to "whether the monkeypox virus can also spread from one person to another through semen or vaginal fluids". There is also no clarity on "whether the virus could persist in these bodily fluids for longer periods of time", Kluge said. While the first case was reported from the UK on May 7, he noted it may have been circulating since mid-April. "Even as new patients present every day, investigations into past cases show that the outbreak in our region was certainly underway as early as mid-April," Kluge said.

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This was also reiterated by WHO Director-General Tedros Adhanom Ghebreyesus who said the monkeypox virus may be spreading "undetected". "The sudden appearance of monkeypox in many countries at the same time suggests there may have been undetected transmission for some time," Ghebreyesus said. The virus may have been transmitted for months or years undetected though investigations are ongoing and there are clear no answers yet, he added.

In Europe, the transmission has been linked to recent raves, parties, and adult saunas. "The potential for further transmission in Europe and elsewhere over the summer is high," Kluge warned. "Over the coming months, many of the dozens of festivals and large parties planned provide further contexts where amplification may occur." He emphasised the need to actively engage community groups and leaders and civil society organisations to increase awareness on how people can reduce their risk of exposure, and also urged people to reduce the number of sexual partners they have. However, Kluge warned against stigmatising the LGBTQ+ community.

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