Monkeypox, a disease that was once largely restricted to Africa, is gradually penetrating Europe and North America. Interestingly, the spread is not connected to Africa this time.

As the count of new cases of the virus increases in Europe with Germany being the latest of more than 100 cases, there is a rather strange pattern common with cases of Europeans who had contracted the disease.

Reuters reports that many of the cases are not linked to travel to the continent. As a result, the cause of this outbreak is unclear, although health authorities have said that there is potentially some degree of community spread.

In Britain, where 20 cases have been now confirmed, the UK Health Security Agency said the recent cases in the country were predominantly among men who self-identified as gay, bisexual or men who have sex with men.

The 14 cases in Portugal that were all detected in sexual health clinics are also in men who self-identify as gay, bisexual or men who have sex with men.

Spain is also not isolated, Health authorities in the country said 23 new cases were confirmed on Friday, mainly in the Madrid region where most infections were linked to an outbreak in an adult sauna.

According to Germany’s armed forces’ medical service, which detected its first case in the country on Friday, “With several confirmed cases in the United Kingdom, Spain, and Portugal, this is the largest and most widespread outbreak of monkeypox ever seen in Europe.”

A medical jury is called to task to ascertain if the new cases in Europe are enough to link the disease with Sexual Transmitted Disease (STI), time and science will tell.

Stuart Neil, professor of virology at Kings College London said “the idea that there’s some sort of sexual transmission in this, I think, is a little bit of a stretch,”

Meanwhile, the World Health Organization was due to hold an emergency meeting on Friday to discuss the recent outbreak.