Dr. Derval Igoe:

Yes. What we are finding in Ireland is that the number of cases in August was higher than the number of cases in September. We are on a slight downward trajectory. That is similar to what has been found in the United States, in Canada and in Europe overall. As to why that is happening, the view is that it is a combination of approaches. It is a combination of vaccination and changes in behaviour. If it is the case that there are smallish dense networks, people might have developed some natural immunity. Those are the three theories as to why it is decreasing. That is not to say that this will continue in the future. Our understanding is that this is overwhelmingly within the gbMSM community. If that continues within the community and there is no spread outside it - and there is no evidence of that - then we would not see cases in other populations.

In America they had the opportunity to look at people's behaviours systematically and they found that 50% of people had changed their behaviour as a result of monkeypox. Behaviour change is also a factor. If behaviour change is sustained, if the vaccination programme progresses and goes well and if the outbreak stays within the gbMSM community, I do not see a big escalation.