The Gran Canarian pride festival attended by 80,000 from Britain and across Europe is being investigated after being linked to numerous monkeypox cases in Madrid, Italy and Tenerife.
Held between May 5 and May 15, Maspalomas Pride attracts visitors from across the continent.
It was attended by people who have tested positive for the monekypox virus afterwards, with public health services from the Canary Islands now investigating the any links between the cases and the LGBT+ celebrations.
'Among the 30 or so diagnosed in Madrid, there are several who attended the event, although it is not yet possible to know if one of them is patient zero of this outbreak or if they all got infected there,' a health source told El País.
The Gran Canarian pride festival attended by 80,000 from Britain and across Europe is being investigated after being linked to numerous monkeypox cases in Madrid, Italy and Tenerife. Pictured, attendees at the event this month
There are two suspected cases in men in the Canary Islands, one with links to the LGBT+ festival.
There is no conclusive evidence that the latest outbreak is being sexually transmitted, rather than simply being passed between people who were in close proximity to each other, experts said.
As such gay men are not believed to be more likely to contract the disease, however are potentially more likely to have been exposed to it due to the known incidences being at events and locations that attracted large numbers of people from across the LGBT+ community.
The development came after it emerged Spanish authorities are also investigating confirmed cases of monkeypox that have been linked to a 'sauna' - which in Spain is used to describe establishments popular with gay men looking for sex rather than just a bathhouse.
A spokesperson for the department confirmed that one of the Italian men who has the virus was in the Canary Islands, but denied knowing if the man from Tenerife had travelled there, according to a report from the Spanish news website.
A second Italian man who was also in the Canary Islands contracted the virus. All three Italian men with the virus are unknown to each other.
Earlier today, a top British doctor has predicted a 'significant rise' in monkeypox cases in the UK in the next few weeks, as the country recorded 20 cases — and more than 100 found in Europe.
The disease, which was first found in monkeys, can be transmitted from person to person through close physical contact - as well as sexual intercourse - and is caused by the monkeypox virus.
It was attended by people who have tested positive for the monekypox virus afterwards, with public health services from the Canary Islands now investigating the any links between the cases and the LGBT+ celebrations. Pictured, attendees at the event this month
Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, is worried about the rate the virus is spreading.
She told Sky News that she expects a 'significant' rise in infections next week.
'What worries me the most is there are infections across Europe, so this has already spread,' she said. 'It's already circulating in the general population... It could be really significant numbers over the next two or three weeks.'
She also warned that the virus could have a 'massive impact' on access to sexual health services in Britain.
The UK Health Security Agency has said a notable proportion of recent cases in Britain and Europe have been found in gay and bisexual men.
The virus is more common to west and central Africa but the number of cases confirmed in Britain has hit 20, with nine other countries including Spain, Portugal and Canada also reporting outbreaks.
Yesterday, health authorities in Spain reported 23 more confirmed cases of monkeypox, mainly in the Madrid region where the regional government closed a sauna linked to the majority of infections.
It is believed that there are 50 cases in Spain, 30 confirmed and 20 suspected, along with two confirmed cases in the Spanish Canary Islands.
'The Public Health Department will carry out an even more detailed analysis... to control contagion, cut the chains of transmission and try to mitigate the transmission of this virus as much as possible,' said regional health chief Enrique Ruiz Escudero.
Nurses and doctors are being advised to stay 'alert' to patients who present with a new rash or scabby lesions (like above)
Dr Dewsnap said she is concerned about how the infection could affect services because staff who come in contact with sufferers are forced to isolate.
She told the BBC that clinic staff were 'already under significant pressure' before monkeypox was identified, making the situation worse.
'It is already stretching the workforce and will have a massive impact if staff have to isolate if they are in close contact with someone who's infected,' Dr Dewsnap said.
'In terms of the infection and its consequences for individuals, I'm not that concerned,' she later told BBC Radio 4.
'But I am concerned about our ability to maintain good sexual health services and access for everyone while still managing this new infection.'
Dr Dewsnap also called for 'adequate funding' for sexual health services.
She told BBC Breakfast: 'Over the last 10 years, there's been a significant decrease in funding through the public health budget.
'And that has seen a direct effect on staffing level and that means we have less capacity to see people.
'We used to be able to see people within 48 hours of them contacting us - that's really important because it cuts down the window where people have an infection, they don't know they have an infection and therefore they can pass it on to the people.
'So the speed in which we see people is really critical and monkeypox coming along shows us that more than ever before.
'So we need adequate funding so we can adequately staff with the experts that we need and the appropriately trained staff in clinics so that we can ensure people can get in quickly, and therefore we can reduce the risk of infection of other people.'
Meanwhile, Professor Sir Peter Horby, director of the Pandemic Sciences Institute at Oxford University, described the current monkeypox outbreak as 'an unusual situation', because the virus is being transmitted within communities outside of Central and West Africa.
Sir Peter told BBC Radio 4 on Saturday: 'It's transmitted by close person-to-person contact and, in the past, we have not seen it being very infectious.
'What's unusual about what we're seeing now is that we're seeing transmission occurring in the community in Europe and now in other countries, so it's an unusual situation where we seem to have had the virus introduced but now have ongoing transmission within certain communities.'
The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related
He added: 'It would appear that there is some element of sexual transmission perhaps with just the very close contact between people and the skin lesions, because a large proportion of the current cases are being detected in gay and bisexual men.
'So it's very important that we get the message across that if people have unusual skin lesions that they do seek attention quickly so that we can control this.
'The important thing is that we interrupt transmission and this doesn't become established in the human population in Europe.'
Monkeypox is a usually mild infection, with symptoms including fever, headaches and a distinctive bumpy rash.
In Britain, authorities are offering a smallpox vaccine to healthcare workers and others who may have been exposed.
Spain is assessing different therapeutic options, such as antivirals and vaccines, but so far all cases have mild symptoms and therefore no specific ad hoc treatment has been necessary, Spanish Health minister Carolina Darias told reporters on Friday.
The Portuguese cases remain under clinical follow-up but none have been hospitalized as they are all stable, the health authority said.
Portugal has 14 confirmed cases and 20 suspected infections. And across the Atlantic, there are two confirmed cases in Canada, with 20 suspected cases.
There are also cases in Italy, Sweden, Belgium, Germany, The Netherlands, France, Israel and Australia.
How DO you catch monkeypox and what are the symptoms? EVERYTHING you need to know about tropical virus spreading around the world
By Emily Craig, Health Reporter for MailOnline
Monkeypox is spreading globally for the first time, in an outbreak that has caught health officials off-guard.
Eleven countries including Australia have now detected the tropical virus, which is usually only spotted within Africa.
Two men from Sydney and Melbourne have both returned from Europe infected with the rare tropical disease.
The Victorian case is known to have been in the UK where there are currently 20 cases, which are all among men from the gay and bisexual community.
Germany and Belgium today became the latest nations to declare monkeypox cases, while and Australia announced patients had tested positive overnight.
A disproportionate number of cases are in gay and bisexual men, authorities have said. Health chiefs say the pattern of transmission is 'highly suggestive of spread in sexual networks'.
NSW chief health officer Dr Kerry Chant said: 'It is important to be particularly vigilant if you returned from overseas from large parties or sex on premises venues overseas.
'You can imagine that some settings, such as sex on premises venues or other events and gatherings may lead to sort of what we've seen as super spreading events.
'It is important that people who have recently returned from Europe who attended such parties be particularly alert given the worldwide case reports today.'
Here is everything we know about the monkeypox outbreak so far:
How do you catch monkeypox?
Until this worldwide outbreak, monkeypox was usually caught from infected animals in west and central Africa.
The tropical virus is thought to be spread by rodents, including rats, mice and even squirrels.
Humans can catch the illness — which comes from the same family as smallpox — if they're bitten by infected animals, or touch their blood, bodily fluids, or scabs.
Consuming contaminated wild game or bush meat can also spread the virus.
The orthopoxvirus can enter the body through broken skin — even if it's not visible, as well as the eyes, nose and mouth.
Despite being mainly spread by wild animals, it was known that monkeypox could be passed on between people.
However, health chiefs insist it is very rare.
Human-to-human spread can occur if someone touches clothing or bedding used by an infected person, or through direct contact with the virus' tell-tale scabs.
The virus can also spread through coughs and sneezes.
In the ongoing surge in cases, experts think the virus is passing through skin-to-skin contact during sex — even though this exact mechanism has never been seen until now.
There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox, including the drug tecovirimat, which was approved for monkeypox in the EU in January
How is it tested for?
It can be difficult to diagnose monkeypox as it is often confused with other infections such as chickenpox.
Monkeypox is confirmed by a clinical assessment by a health professional and a test in a specialist lab.
The test involves taking samples from skin lesions, such as part of the scab, fluid from the lesions or pieces of dry crusts.
What are the symptoms?
It can take up to three weeks for monkeypox-infected patients to develop any of its tell-tale symptoms.
Early signs of the virus include a fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion — meaning it could, theoretically, be mistaken for other common illnesses.
But its most unusual feature is a rash that often begins on the face, then spreads to other parts of the body, commonly the hands and feet.
The rash changes and goes through different stages before finally forming a scab, which later falls off.
How long is someone contagious?
An individual is contagious from the point their rash appears until all the scabs have fallen off and there is intact skin underneath.
The scabs may also contain infectious virus material.
The infectious period is thought to last for three weeks but may vary between individuals.
What even is monkeypox?
Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research in 1958.
The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.
Only a handful of cases have been reported outside of Africa and they were confined to people with travel links to the continent.
The UK, US, Israel and Singapore are the only countries which had detected the virus before May 2022.
Is it related to chickenpox?
Despite causing a similar rash, chickenpox is not related to monkeypox.
The infection, which usually strikes children, is caused by the varicella-zoster virus.
For comparison, monkeypox — like smallpox — is an orthopoxvirus. Because of this link, smallpox vaccines also provide protection against monkeypox.
Are young people more vulnerable?
Britons aged under 50 may be more susceptible to monkeypox, according to the World Health Organization.
This is because children in the UK were routinely offered the smallpox jab, which protects against monkeypox, until 1971.
The WHO also warns that the fatality rate has been higher among young children.
Does it spread as easily as Covid?
Leading experts insist we won't be seeing Covid-style levels of transmission in the monkeypox outbreak.
A World Health Organization report last year suggested the natural R rate of the virus – the number of people each patient would infect if they lived normally while sick – is two.
This is lower than the original Wuhan variant of Covid and about a third of the R rate of the Indian 'Delta' strain.
But the real rate is likely much lower because 'distinctive symptoms greatly aid in its early detection and containment,' the team said, meaning it's easy to spot cases and isolate them.
Covid is mainly spread through droplets an infected person releases whenever they breathe, speak, cough or sneeze.
What other countries have spotted cases?
Twelve countries — including the US, Spain and Italy — have now detected cases of monkeypox.
Spain this morning reported 14 new confirmed cases, bringing the nation's total to 21.
And Belgium detected two cases, one in Antwerp and the other in Flemish Brabant.
Germany subsequently confirmed its first ever monkeypox case in a patient who had 'characteristic skin lesions' — a tell-tale sign of the illness.
France last night confirmed a 29-year-old man in Paris had contracted the virus. He had not recently travelled, suggesting the virus is spreading in the community.
Meanwhile, Australia last night confirmed two cases, including one man in his thirties who had travelled from Britain to Melbourne with symptoms earlier this week.
The Netherlands Portugal, Sweden and Canada have also detected cases.
How deadly is it?
Monkeypox is usually mild, with most patients recovering within a few weeks without treatment.
Yet, the disease kills up to 10 per cent of people it infects.
However, with milder strains the fatality rate is closer to one in 100 — similar to when Covid first hit.
The UK cases all had the West African version of the virus, which is mild compared to the Central African strain.
It is thought that cases in Portugal and Spain also have the milder version, though tests are underway.
Is there a vaccine for it?
The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related.
Data shows it prevents around 85 per cent of cases, and has been used 'off-label' in the UK since 2018.
The jab, thought to cost £20 per dose, contains a modified vaccinia virus, which is similar to both smallpox and monkeypox, but does not cause disease in people.
Because of its similarity to the pox viruses, antibodies produced against this virus offer cross protection.
Are there any drugs?
There are also a handful of antivirals and therapies for smallpox that appear to work on monkeypox.
This includes the drug tecovirimat, which was approved for monkeypox in the EU in January.
Tecovirimat prevents the virus from leaving an infected cell, hindering the spread of the virus within the body.
An injectable antiviral used to treat AIDS called cidofovir can be used to manage the infection, according to the US Centers for Disease Control and Prevention (CDC).
It also works by stopping the growth of the virus.
What is the situation with the UK outbreak?
Twenty cases were confirmed in the UK between May 6 and 20.
No details about the eleven confirmed on May 20 have been released yet.
But six of the previous nine confirmed cases were in men who have sex with men — which officials say is 'highly suggestive of spread in sexual networks'.
How worrying is it?
UK health chiefs say the risk of a major outbreak is low.
What do I do if I have symptoms?
Anyone worried that they could be infected with monkeypox is advised to make contact with clinics ahead of their visit.
Health chiefs say their call or discussion will be treated sensitively and confidentially.