Against the idea that this virus is more easily transmitted than earlier variants—say through smaller droplets or via the air—is that among the 89 cases being investigated for whom we know the gender, all 89 are males, a large number of whom are young and middle-aged adults. Public health agencies have reported that this monkeypox outbreak has been spreading in males who have had sexual contact with other infected males (or members of a shared sexual network). However, we do not know if that is true in some, many, most, or all of the cases.

Still, what we do know suggests strongly, to me at least, that monkeypox may still be primarily spreading through sexual contact, a known major mode of transmission. It could be that this virus has not gained any newfound stability in the air or in droplets—and that would certainly be welcome news—but that it is spreading with greater ease than usual (and therefore via more casual contact) in sexual networks, due to some genetic changes in the virus.