Mpox spreads to further groups of people in Berlin

The mpox virus is increasingly being transmitted in Berlin through sex between men and women. According to the State Office for Health and Social Affairs (Lageso), several cases have recently been reported in connection with sex-positive events for heterosexual and queer people, as stated in Lageso’s latest weekly report.

So far in August, two women with mpox have been reported to Lageso. According to the authority, a man also became infected during the same period, stating that he may have contracted the virus during sex with a woman. All three are thought to have become infected through anonymous sexual encounters in clubs or at home.

Significantly more cases than in some previous years

A total of four cases of mpox in women have been reported to Lageso so far this year. In fact, it is primarily men who have sex with men and frequently change sexual partners who become infected.

The total number of mpox cases reported in Berlin so far this year stands at 156. This is more than in the same period last year (144) and significantly more than in the whole of 2024 (38) or 2023 (13).

According to the Robert Koch Institute (RKI), the German public health agency, 375 cases of mpox have been reported across Germany so far this year (as of August 27).

A total of 98% of these were men, epidemiologist Klaus Jansen from the RKI told the dpa.

The men for whom the route of infection is known contracted the virus almost exclusively through sex with men. “Across Germany, we are not currently seeing a trend similar to the situation described by Lageso for Berlin.”

“It is a cause of great concern to us”

Infectious diseases epidemiologist Claudia Ruscher from Lageso said: “It is a cause of great concern to us that mpox is spreading to another group of people who previously appeared unaffected and who are therefore largely unvaccinated and poorly informed.”

Four women might initially seem like a small number, but there is a new dynamic at play here. The infections occurred within a short space of time.

In recent years, either no women at all or just one woman per year had been infected. Only during the major outbreak in 2022 were there a total of four cases among women. However, the total number of cases in that outbreak was around ten times higher than it is at present.

People who are unvaccinated and contracting mpox for the first time are more likely to experience a more severe course of the disease. “They are more likely to have a feverish illness and often develop skin lesions all over their body,” said Ruscher. “These are not just blisters, but itchy pustules, some of which are also pus-filled. They are really very painful.”

Mpox is transmitted through close physical contact

Mpox is a viral disease and is transmitted through close physical contact, particularly during sex. The risk of infection is greatest when coming into contact with the typical skin lesions (blisters or scabs) of people infected with Mpox, which can appear all over the body. Condoms therefore do not offer sufficient protection, Ruscher said. Transmission via respiratory droplets – that is, through saliva – is also possible. A vaccine is available.

In 2022, the disease spread particularly rapidly in Germany. It mainly affected men who have sex with men and who frequently change sexual partners. A targeted vaccination campaign was subsequently launched for this group, and uptake was high.

Shaving rash? Mosquito bites? Herpes?

Other groups of people, however, often do not even know that mpox exists, said Ruscher. If they become infected and the pustules appear, they do not initially associate them with mpox. “Instead, they might think they have razor rash, mosquito bites or cold sores, and may not go to the doctor straight away.”

One patient had visited four different doctors before receiving the correct diagnosis, he said.

Looking ahead, he said, “we must expect further infections among women, but it is difficult to give an exact figure.”

The Standing Committee on Vaccination recommends the mpox vaccine for, among others, men, transgender and non-binary people who have sex with men and frequently change partners, sex workers, and people who come into contact with infected individuals.

The vaccine is very effective and well tolerated, according to Jansen from the RKI. Those who become infected despite being vaccinated usually experience a significantly milder course of the disease.