About three months after the first monkeypox detection in Germany, the Robert Koch Institute (RKI) speaks for the first time of known infections among minors. All cases, except for two adolescents, are adults, it says in the situation assessment of the RKI from Tuesday. Initially, the "Spiegel" had reported about two affected persons at the age of 15 and 17 years. According to an RKI database, the case reports come from Stuttgart and Erfurt, refer to the first half of July (reporting weeks 27 and 28) and to male adolescents.

A total of 2724 infections have now been transmitted to the RKI from all German states, almost all of them men. "According to current knowledge, the transmissions in this outbreak occur primarily in the context of sexual activities, currently particularly among men who have sexual contact with other men," the RKI explains.

"So far, only five female cases have been transmitted in Germany." By far, the incidence is highest in Berlin. "As far as is known, most of those affected do not fall seriously ill," the RKI writes.

The mortality rate in countries outside Africa remains "extremely low," Jürgen Rockstroh, head of the Outpatient Clinic for Infectious Diseases and Immunology at Bonn University Hospital, said in response to a query. Although several monkeypox deaths have become known in recent days in countries for which the disease is new - two of them in Spain. However, the expert sees several reasons for this: For example, the World Health Organization's (WHO) declaration of a public health emergency with international scope a few days ago may have led to improved surveillance. At the same time, there are now more than 20,000 cases worldwide, so that more cases are being evaluated.

Rockstroh also stressed the need to record illnesses of those affected to find factors that increase the risk of hospitalization and death. Severe immunosuppression appears to increase the risk for an unfavorable course, he said.

Image by Gerd Altmann