Monkeypox

[Jamesie]

A coincidental flash in the pan - or something more worrying / sinister and which may ultimately result in another 2000+ page thread?

[Onceinawhile]

Well, I'm on the first or second page of the coronavirus thread saying it is a load of nonsense and not to worry, so no comment!!

[Wilson]

It's a lot of nonsense. Don't worry.

[SaulGoodman]

It’ll be over by summer

[hibsbollah]

It’ll be over by summer

:agree: He’s bound to stop when he gets the Sudetenland back.

[Pretty Boy]

I read earlier that the smallpox vaccine (tested since 1796 for all you sceptics) offers decent protection against monkeypox.

No doubt Matt Hancocks local pub landlord is branching out into pharmaceuticals as we speak.

[JeMeSouviens]

Not another thread about the Huns! :rolleyes:

[hibsbollah]

Not another thread about the Huns! :rolleyes:

...Don't worry, its all been blown totally out of proportion. That Atilla guy clearly has no interest in invading western Europe.

[Smartie]

I read earlier that the smallpox vaccine (tested since 1796 for all you sceptics) offers decent protection against monkeypox.

No doubt Matt Hancocks local pub landlord is branching out into pharmaceuticals as we speak.

https://www.bbc.com/future/article/20200928-how-the-first-vaccine-was-born

I've always loved the story behind that vaccine.

Having known friends and colleague struggle to get "ethical approval" for certain clinical trials in the modern era, there's something quite comical about someone pummelling a load of cowpox into a child in the late 18th century.

Especially given that it ended well (providing much needed protection against arguably the grimmest disease to have ever affected the human race).

[SaulGoodman]

I read earlier that the smallpox vaccine (tested since 1796 for all you sceptics) offers decent protection against monkeypox.

No doubt Matt Hancocks local pub landlord is branching out into pharmaceuticals as we speak.

A vaccine?? Aye right I’ll no be putting that ***** in my body, come on sheeple.

Posted whilst outside having a fag.

[LewysGot2]

A plague on both their houses….oh, sorry, that’s tomorrow afternoon :rolleyes::greengrin

[Jamesie]

https://www.nti.org/wp-content/uploads/2021/11/NTI_Paper_BIO-TTX_Final.pdf

Take a look at page 12 of this document, which was prepared as part of a table top wargaming exercise during the 2021 Munich Security Conference. And which is based on a hypothetical outbreak of monkeypox. Which commences on 15 May 2022. A huge, ginormous coincidence, surely?

[SChibs]

https://www.nti.org/wp-content/uploads/2021/11/NTI_Paper_BIO-TTX_Final.pdf

Take a look at page 12 of this document, which was prepared as part of a table top wargaming exercise during the 2021 Munich Security Conference. And which is based on a hypothetical outbreak of monkeypox. Which commences on 15 May 2022. A huge, ginormous coincidence, surely?

Apparently a very similar table top exercise took place regarding a coronavirus months before the pandemic. I'm yet to make up my mind either way, there are probably countless mock ups done constantly to help us prepare for outbreaks

[Stairway 2 7]

Apparently a very similar table top exercise took place regarding a coronavirus months before the pandemic. I'm yet to make up my mind either way, there are probably countless mock ups done constantly to help us prepare for outbreaks

Most nations do it every year on most known diseases. This is nothing like covid19 ad monkey pox like chicken pox is fairly well known. Covid we knew next to nothing about before it quickly swept in

[Jamesie]

Apparently a very similar table top exercise took place regarding a coronavirus months before the pandemic. I'm yet to make up my mind either way, there are probably countless mock ups done constantly to help us prepare for outbreaks

It’s the date that I find quite remarkable. Most of us had likely never heard of monkeypox prior to 15 May…

[Stairway 2 7]

It’s the date that I find quite remarkable. Most of us had likely never heard of monkeypox prior to 15 May…

If covid wasn't what it was I'm sure we wouldn't have about a small outbreak. The scientists have known about it for decades

[Jamesie]

https://news.sky.com/story/monkeypox-is-a-concern-and-the-us-is-looking-into-treatments-and-vaccines-says-joe-biden-12618684

[Stairway 2 7]

It seems its the exact same strain that had an outbreak in 2018. Not many talking about covid now , so they need to fill the news.

[Hibby70]

The rash I can cope with but throwing your own **** at the window 🙈

[SHODAN]

It doesn't spread as easily as COVID and a vaccine is already in place, so I imagine this one can be contained relatively well.

[NORTHERNHIBBY]

Seems to be the antithesis of Covid. A virus that you can readily see rather than just suffer from and the powers that be have a handle on it already. A bit too handy maybe??

[overdrive]

I read something saying it was mainly affecting the male gay/ bi community in the UK.

I assume this is just because a gay/bi male happened to get it early on in the UK and socialises with other gay/bi men, so they’ve been the unfortunate ones to get it rather than any suggestion that it might be sexually transmitted?

[Pretty Boy]

I read something saying it was mainly affecting the male gay/ bi community in the UK.

I assume this is just because a gay/bi male happened to get it early on in the UK and socialises with other gay/bi men, so they’ve been the unfortunate ones to get it rather than any suggestion that it might be sexually transmitted?

There seems to be a suggestion the virus has been 'lucky' in the sense it found itself in the right place at the right time. A sauna in Madrid and a Pride festival in Gran Canaria, the latter with a transient crowd, are being investigated as potential superspreader events.

I suppose a virus which can spread by close, prolonged contact is as likely to be transmitted by sexual inteevourse as any other route without being exclusively sexually transmitted.

Fwiw I think there has to be some very careful reporting around the spread among gay men. If the superspreader link is proven it has to be clear this was wrong time, wrong place rather than some 80s throwback HIV hysteria.

[Pedantic_Hibee]

What’s the symptoms? I’ve just ripped the windscreen wipers off my car.

[Stairway 2 7]

As I read someone who has been studying this for decades say. This has been causing outbreaks since the 50s ,the difference now is its in rich countries. It seems its the same variant from the 2018 break out.

[Smartie]

Was this not roughly how HIV evolved though?

Cross species jump from fellow primates, spread through a few different immunocompromised individuals to allow the virus to evolve before eventually wreaking havoc amongst groups who spread it unknowingly via bodily fluids for a very long time before there was much of an understanding of what was going on?

[I'm_cabbaged]

What’s the symptoms? I’ve just ripped the windscreen wipers off my car.

Literally crying 😂😂

[Stairway 2 7]

Was this not roughly how HIV evolved though?

Cross species jump from fellow primates, spread through a few different immunocompromised individuals to allow the virus to evolve before eventually wreaking havoc amongst groups who spread it unknowingly via bodily fluids for a very long time before there was much of an understanding of what was going on?
This hasn't evolved though, it's just effecting a few white people after a worldwide pandemic. I never noticed it in the news when it was effecting Africans over the decades

[Hibbyradge]

What’s the symptoms? I’ve just ripped the windscreen wipers off my car.

I'm dead 😂😂😂😂

[hibsbollah]

What’s the symptoms? I’ve just ripped the windscreen wipers off my car.

Just dont accept a CurlyWurly from strange drivers and you'll be fine.

[lapsedhibee]

What’s the symptoms? I’ve just ripped the windscreen wipers off my car.

:greengrin

[SaulGoodman]

I'm dead 😂😂😂😂

That’s not a very good symptom

[degenerated]

What’s the symptoms? I’ve just ripped the windscreen wipers off my car.Maybe yer achimptomatic ?

[Sir David Gray]

Anyone know if I'm about to become quite busy again at 2pm every day?

[I'm_cabbaged]

Seems to be a bit of a panic over PPE in the RIE stores this morning. I don’t know why as they’ve still got a **** load of it!!

[nonshinyfinish]

Anyone know if I'm about to become quite busy again at 2pm every day?

https://www.theguardian.com/world/2022/may/24/why-are-monkeypox-cases-suddenly-emerging-across-the-world-and-could-the-virus-have-mutated


Many health experts have said the monkeypox cases in 12 countries are not cause for panic, given the virus is much less infectious than illnesses like Covid and rarely fatal

It's not airbourne like Covid – it requires close physical contact to spread.

[Sir David Gray]

https://www.theguardian.com/world/2022/may/24/why-are-monkeypox-cases-suddenly-emerging-across-the-world-and-could-the-virus-have-mutated



It's not airbourne like Covid – it requires close physical contact to spread.

That's good, sure my manager will be relieved. :greengrin

[The dalmeny]

What’s the symptoms? I’ve just ripped the windscreen wipers off my car.

I just chucked some poo at someone who was staring at me

[degenerated]

I just chucked some poo at someone who was staring at meThink I might take the day off tomorrow :greengrinhttps://uploads.tapatalk-cdn.com/20220525/2e50874dd4ff94df5eb56fa3c3c2de3b.jpg

[Jamesie]

Friend of a friend tested positive for this in London this morning. Will be interesting to see if there’s a significant spike in the figures tomorrow.

[Stairway 2 7]

Friend of a friend tested positive for this in London this morning. Will be interesting to see if there’s a significant spike in the figures tomorrow.

The numbers get updated everyday. There is only 300 odd in the world in total and 30 something in the uk. No deaths. The media is trying it's best but I don't think they will manage to keep it near the front of the papers

[Santa Cruz]

The numbers get updated everyday. There is only 300 odd in the world in total and 30 something in the uk. No deaths. The media is trying it's best but I don't think they will manage to keep it near the front of the papers

106 confirmed cases in the UK 2 days ago. 3 in Scotland according to this article. Low risk to population.

https://news.sky.com/story/sixteen-further-monkeypox-cases-detected-in-england-uk-health-security-agency-confirms-12622587

[Sir David Gray]

The numbers get updated everyday. There is only 300 odd in the world in total and 30 something in the uk. No deaths. The media is trying it's best but I don't think they will manage to keep it near the front of the papers

Not too sure where your figures are from, there's over 100 cases been identified in the UK.

[Stairway 2 7]

Not too sure where your figures are from, there's over 100 cases been identified in the UK.

Just checked they were from 21st of May, slower rise that I thought. Especially since its usually mild and not reported but is now being checked

[Stairway 2 7]

Saw this last week of the daily deaths for Wednesday worldwide , I wish TB had a better publicist

25898

[Jamesie]

The numbers get updated everyday. There is only 300 odd in the world in total and 30 something in the uk. No deaths. The media is trying it's best but I don't think they will manage to keep it near the front of the papers

Haven’t seen any update on numbers since Friday - and it was 106 cases in the UK then. Currently 497 worldwide based on reported figures today: https://bnonews.com/monkeypox/

[Stairway 2 7]

Haven’t seen any update on numbers since Friday - and it was 106 cases in the UK then. Currently 497 worldwide based on reported figures today: https://bnonews.com/monkeypox/

So 200 cases worldwide in a week, with zero deaths, easily treatable, majority of cases passed through sex. 4000 tb deaths a day but no panic

[Jamesie]

So 200 cases worldwide in a week, with zero deaths, easily treatable, majority of cases passed through sex. 4000 tb deaths a day but no panic

Yes - or to look it another way, a 300% growth in numbers in the UK in the space of a week.

[Stairway 2 7]

Yes - or to look it another way, a 300% growth in numbers in the UK in the space of a week.

Isreal went from 1 case yesterday to 2 today, 100% in a day.

I'm not saying we shouldn't keep an eye on it and there is lack of defence as people don't get vaccinated against it anymore. But this has been affecting Africa for decades, its the same strain as an outbreak in 2018. There is a treatment that works and passes mostly from sex.

The only difference from every other outbreak is its affecting white people this time. Did Biden comment on the 2018 outbreak or the many dozen before that.

Probably the reason covid wasn't a big deal in many African countries. There is so many things that are preventable that are a risk to their lives there. I read they are pushing through a saliva test for monkeypox that will be a few weeks. Where the **** was it in 2018 when it was in Africa

[SaulGoodman]

If it’s spread by having sex I’m in luck.

[Keith_M]

If it’s spread by having sex I’m in luck.


I should be pretty safe as well, TBF.

[Sir David Gray]

World Health Organisation declare Monkeypox a global health emergency.

https://www.bbc.co.uk/news/health-62279436

[SaulGoodman]

I’m getting a bit sick of the 2020’s tbh

[Stairway 2 7]

Should really be classified as an std now that it's clear it doesn't really transmit in the general population, the fact women generally aren't getting it shows this. 99.4% of cases have been seen in gay males and over 95% of cases directly linked to sex.

Shouldn't be used to stigmatise gay people, but inform and encourage vaccination. Luckily there is a readily available vaccine, cases aren't rising exponentially and almost all cases aren't serious to health

[He's here!]

54 cases confirmed in Scotland:

https://www.bbc.co.uk/news/uk-scotland-62279127

[Stairway 2 7]

54 cases confirmed in Scotland:

https://www.bbc.co.uk/news/uk-scotland-62279127

In over 2 months less than 1 a day

[CropleyWasGod]

Should really be classified as an std now that it's clear it doesn't really transmit in the general population, the fact women generally aren't getting it shows this. 99.4% of cases have been seen in gay males and over 95% of cases directly linked to sex.

Shouldn't be used to stigmatise gay people, but inform and encourage vaccination. Luckily there is a readily available vaccine, cases aren't rising exponentially and almost all cases aren't serious to health

What kind of sex is it being passed on by?

[Stairway 2 7]

What kind of sex is it being passed on by?
In the west its been pretty much male on male sex. Thankfully no deaths or icu in the 16,000, so not deadly really


https://mobile.twitter.com/whippletom/status/1535290131124477953

Tom Whipple
@whippletom

UKHSA technical briefing out on monkeypox, with demographics. Top lines:

99 per cent of cases male, over 99 per cent of those interviewed were men who had sex with men.

https://gov.uk/government/publications/monkeypox-outbreak-technical-briefings/investigation-into-monkeypox-outbreak-in-england-technical-briefing-1

Almost half of those who interviewed attended sex clubs in preceding period. A similar number had group sex during incubation period. 60% had an sti the previous year

[CropleyWasGod]

In the west its been pretty much male on male sex.


https://mobile.twitter.com/whippletom/status/1535290131124477953

Tom Whipple
@whippletom

UKHSA technical briefing out on monkeypox, with demographics. Top lines:

99 per cent of cases male, over 99 per cent of those interviewed were men who had sex with men.

https://gov.uk/government/publications/monkeypox-outbreak-technical-briefings/investigation-into-monkeypox-outbreak-in-england-technical-briefing-1

Almost half of those who interviewed attended sex clubs in preceding period. A similar number had group sex during incubation period. 60% had an sti the previous year

Sorry, wasn't very clear in my question.

Is there any detail on what type of sex is the riskiest, or is it an assumption that anal sex is the main cause?

[Stairway 2 7]

Sorry, wasn't very clear in my question.

Is there any detail on what type of sex is the riskiest, or is it an assumption that anal sex is the main cause?

The assumption is predominantly anal sex as many of the men are bisexual and its not passing to women. Things could change but just now it passing through sex between men. Shouldn't be any stigma its not the 80s, but there should be targeted vaccination and information ect

[CropleyWasGod]

The assumption is predominantly anal sex as many of the men are bisexual and its not passing to women. Things could change but just now it passing through sex between men. Shouldn't be any stigma its not the 80s, but there should be targeted vaccination and information ect

Thanks.

One wonders, then, about M-F anal sex, and also F-F anal practices. You say it's not passing to women, which is intriguing. (my 80's antennae are up, because that bit is similar to where we started with HIV.)

Is the virus blood-borne or through infected semen, or both?

I agree about the stigmatisation, of course, but one of the reasons HIV spread so rapidly in the 80's was because the non-gay population were slow to catch up on the safe-sex message; again, we started with most people being complacent because it was a "gay plague". The echoes are a bit concerning.

[Stairway 2 7]

Thanks.

One wonders, then, about M-F anal sex, and also F-F anal practices. You say it's not passing to women, which is intriguing. (my 80's antennae are up, because that bit is similar to where we started with HIV.)

Is the virus blood-borne or through infected semen, or both?

I agree about the stigmatisation, of course, but one of the reasons HIV spread so rapidly in the 80's was because the non-gay population were slow to catch up on the safe-sex message; again, we started with most people being complacent because it was a "gay plague". The echoes are a bit concerning.

Skin to skin rather than semen. I think the reason it's not passed yet is numbers. The majority will be just gay rather than bisexual. The bisexual ones by averages will predominantly be having vaginal sex. It seems improbable that it wouldn't spread by male female anal sex.

Thankfully unlike aids it isn't in the same world in mortality. But it's still very nasty so money on safe sex advertising and vaccination would be well spent

[lapsedhibee]

The assumption is predominantly anal sex as many of the men are bisexual and its not passing to women. Things could change but just now it passing through sex between men. Shouldn't be any stigma its not the 80s, but there should be targeted vaccination and information ect

If Sunak gets Johnson's Leader Of The Free World gig and does his full-on channeling Thatcher, we'll all get leaflets through the door telling us not to die of ignorance.

[Stairway 2 7]

If Sunak gets Johnson's Leader Of The Free World gig and does his full-on channeling Thatcher, we'll all get leaflets through the door telling us not to die of ignorance.

Thatcher was against the campaign and adverts, she thought if young people knew you could have gay sex more would find out about it and do it. Bafoon of a woman was thankfully overruled. How to survive a plague is a great documentary showing how vile the US establishment was, people were left to rot

[Hibby Bairn]

In the west its been pretty much male on male sex. Thankfully no deaths or icu in the 16,000, so not deadly really


https://mobile.twitter.com/whippletom/status/1535290131124477953

Tom Whipple
@whippletom

UKHSA technical briefing out on monkeypox, with demographics. Top lines:

99 per cent of cases male, over 99 per cent of those interviewed were men who had sex with men.

https://gov.uk/government/publications/monkeypox-outbreak-technical-briefings/investigation-into-monkeypox-outbreak-in-england-technical-briefing-1

Almost half of those who interviewed attended sex clubs in preceding period. A similar number had group sex during incubation period. 60% had an sti the previous year

You wouldn't know much of this from the main BBC report. Failing to mention a 99% male on male impact so far.

[Colr]

You wouldn't know much of this from the main BBC report. Failing to mention a 99% male on male impact so far.

You are aware that some men who have sex with men also have sex with women and don’t consider themselves gay?

[CropleyWasGod]

You are aware that some men who have sex with men also have sex with women and don’t consider themselves gay?

That particular group was always the most difficult group to reach in HIV prevention. MWSWM was a tricky thing to say, and an even trickier thing to deal with.

[He's here!]

Thanks.

One wonders, then, about M-F anal sex, and also F-F anal practices. You say it's not passing to women, which is intriguing. (my 80's antennae are up, because that bit is similar to where we started with HIV.)

Is the virus blood-borne or through infected semen, or both?

I agree about the stigmatisation, of course, but one of the reasons HIV spread so rapidly in the 80's was because the non-gay population were slow to catch up on the safe-sex message; again, we started with most people being complacent because it was a "gay plague". The echoes are a bit concerning.

Indeed. The WHO doesn't declare global health emergencies when there's little to be concerned by.

[Stairway 2 7]

https://mobile.twitter.com/mugecevik/status/1549858584548212736

Great thread from a virologist who has been dealing with this for years. Some points

We will see infections beyond the gay community, but they should be self limiting.

Theoretically it can be passed without intimate contact but it's clear that is how it's most likely spread

It's the same strain as was seen in 2018. It's been spreading in Africa in all that time but largely under investigated


While we will observe infections in the non-MSM population, the risk of significant transmission in the broader public continues to be low.

In theory, anyone can get MPX, but the risk is not the same for every person/ exposure. The narrative that MPX can affect everyone equally diverts attention away from addressing unmet needs. It’s a good PH practice to focus resources where it’s needed the most

[Stairway 2 7]

I think the comparison to aids is very poor to be honest. Yes it's starting in the gay community. But the differences make it another planet never mind ballpark and downplays the aids epidemic. Two fundamental reasons

Aids was a death sentence for the poor people that got it and still is in some places. The chance of death from monkeypox is miniscule.

There was no known treatments for aids, monkeypox has a treatment and even better it can be given post infection.

[Hibby Bairn]

You are aware that some men who have sex with men also have sex with women and don’t consider themselves gay?

I get that. But the risk to the general population is extremely low. Why not point that out?

This is an extract from the BBC report and guidance pages...

"Although some of the cases have been seen in gay and bisexual men, anyone who comes into close contact with someone who has monkeypox could potentially get the virus."

It's not some of the cases. It's 99% of the cases.

[CropleyWasGod]

Interesting blog from SWARM.

https://www.swarmcollective.org/blog/2022/7/4/monkeypox-what-do-sex-workers-need-to-know-july-4th-2022

[Stairway 2 7]

Prof Francois Balloux

There is a lot of discussion on twitter whether monkeypox (MPX) - outside endemic areas in Western/Central Africa - is a sexually transmitted disease (STD), or not. Let's have a look.
1/
The global outbreak of MPX is essentially exclusively circulating in men who have sex with men (MSM). There have been a few cases outside MSM but with no onward transmission so far, This is not due to lack of testing outside MSM.
2/
cdn.who.int/media/docs/def…

MPX cases are rising, but not exponentially so. The global MPX strain is not particularly transmissible. It requires close, intimate contact to pass from person to person. It can only maintain itself in demographics where people have many sexual partners

In its current form, MPX is most unlikely to become an STD outside some MSM circles. STDs are defined by their primary route of transmission (sex), but even more so, by their ability to cause long-term infections with the host remaining infectious to others for decades.
4/
MPX is not a pathogen that has the potential to become an STD in the heterosexual population. The reason is that those infected can pass it on effectively to others for no longer than ~4 weeks, and afterwards clear it, and become essentially immune for life.
5/
Some rough math, conservatively assuming:
Infected people infectious for ~four weeks.
~50% too unwell to engage in sex when infected
~50% attack rate (transmission upon exposure)
-> MPX only spreads in networks where people have >1 sexual partner / week

Unprotected sex with more than one different partner per month is fairly exceptional outside some MSM communities. As such, MPX is unlikely to become an STD within the heterosexual population. It is even more unlikely to spread to the community as a non-STD pathogen.
7/
This being said, this is the life history of the global MPX strain now. The longer it circulates, the higher the risk it becomes more transmissible and may evolve different transmission routes. As such, it is important to curtail this global MPX outbreak as soon as possible.

[Sir David Gray]

Monkeypox: First deaths outside Africa in Brazil and Spain.

https://www.bbc.co.uk/news/health-62350022

[CropleyWasGod]

Not good.

BBC News - Monkeypox: Lack of vaccines sparks pause in UK rollout
https://www.bbc.co.uk/news/uk-62551821

[Sir David Gray]

A dog has been infected with monkeypox after catching the virus from its owner, the World Health Organisation (WHO) has said.

It's the first case of its kind, and health leaders say isolating from pets when infected is important.

The WHO also warned of the need to get rid of rubbish carefully to reduce the risk of infecting other animals.

There is no evidence that dogs can transmit the disease to other dogs or humans, an expert said.

https://www.bbc.co.uk/news/health-62577472

[Stairway 2 7]

Probably why cases aren't really taking off and no exponential growth

https://www.nbcnews.com/nbc-out/out-health-and-wellness/sex-men-not-skin-contact-fueling-monkeypox-new-research-suggests-rcna43484

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.

[lapsedhibee]

A dog has been infected with monkeypox after catching the virus from its owner, the World Health Organisation (WHO) has said.

It's the first case of its kind, and health leaders say isolating from pets when infected is important.

The WHO also warned of the need to get rid of rubbish carefully to reduce the risk of infecting other animals.

There is no evidence that dogs can transmit the disease to other dogs or humans, an expert said.

https://www.bbc.co.uk/news/health-62577472

Not really explained how that would stop other dogs getting it from their owners.

[CropleyWasGod]

Probably why cases aren't really taking off and no exponential growth

https://www.nbcnews.com/nbc-out/out-health-and-wellness/sex-men-not-skin-contact-fueling-monkeypox-new-research-suggests-rcna43484

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.

I'm a bit puzzled by this. Women have anal and oral sex as well.

[Stairway 2 7]

I'm a bit puzzled by this. Women have anal and oral sex as well.

In a thread I read its due to the amount of partners. Something like a third of cases had group sex in the past few months. This creates paths for onward transmission. Most heterosexual couples aren't lucky enough.. so there is no path for onward transmission and it dies out. Epidemiologists I posted before says its highly unlikely to be community spread in heterosexual groups.