The World Health Organization (WHO) announced the spread of monkeypox in countries where the virus is typically not endemic. Some 92 confirmed cases and 28 suspected cases have been reported as of May 21.
The WHO noted that most cases, though not exclusively, have been identified among men who have sex with men (MSM). This has led to concern that these communities could face stigma or discrimination similar to their experience with regard to the HIV/AIDS epidemic during the 1980s hampering testing and vaccination efforts. Monkeypox will require vaccine strategy and outreach.
Many healthcare officials worry that the outbreak’s association with the MSM community, the unfamiliarity many (even in a healthcare setting) may have with the disease, and the general shame around STIs could lead to a stigmatic perception of a “gay disease.” Officials noted the need to be careful not to paint monkeypox as an issue only for the gay community.
At a press conference, the WHO made this statement: “This is not a gay disease as some people on social media have attempted to label it. That's just not the case. Anybody can contract monkeypox through close contact.”
The available evidence suggests those who are most at risk are people who have had close physical contact with someone with monkeypox, and that risk is not limited to MSM.
While COVID-19 has defined many people’s understanding of outbreaks, monkeypox is vastly different and less dangerous. Monkeypox traditionally spreads by direct contact with infectious lesions or infected material (such as blankets used by someone with monkeypox). It can also spread via respiratory droplets, but only through prolonged or intimate exposure.
According to the US Centers for Disease Control and Prevention (CDC), monkeypox is caused by a virus of the same name that can infect people by entering the body through broken skin, the respiratory tract, or mucous membranes like the eyes, nose, or mouth. People can also catch it through direct contact with bodily fluids or lesion material.
The repercussions of labeling HIV/AIDS a homosexual disease include untold suffering in gay communities in the 1980s. Gays were blamed for their own suffering and ostracized as purveyors of disease. As a result, cases were under-reported in the early days of the epidemic as those who contracted the virus went underground instead of seeking care. This led to missed opportunities to learn about the infection, understand its transmission and provide public health interventions to curb its spread.
Today, the danger of misinformation about monkeypox is amplified by social media and sensational news outlets. It is critical that reports on health should always lead with facts. As we learned with HIV/AIDS and with COVID, misinformation spreads infection among groups that incorrectly believed that they were not at risk, leads to dangerous silencing and shaming, and harms public health.
Monkeypox is a zoonotic disease: a viral infection that is transmitted from animals to humans. Its name isn’t due to monkeys being the primary vector for human infections, but rather because it was first identified in lab monkeys in Denmark enlisted for polio vaccine research. The first human cases weren’t identified until 1970 in the Democratic Republic of the Congo.
The disease has a typical incubation period of six to 13 days, after which it can cause flu-like symptoms, such as fever, headache, chills, exhaustion, lymph node swelling, back pain and muscle aches. Within three days of the onset of these symptoms, patients could witness the spread of pox-like lesions lasting 2-3 weeks. Among the two major strains, or clades, of the virus, the Congo Basin variant has the most severe symptoms and a mortality rate of between 5% and 10%. Outbreaks of the West African clade, the one responsible for all of the current cases outside Africa, have a 3.6% mortality rate with most deaths occurring in immunocompromised individuals.
Please read the following CDC articles to help you make informed decisions regarding monkeypox and sexual activity:
CDC: Social Gatherings, Safer Sex, and Monkeypox
CDC: Guidance - Monkeypox Outbreak