The World Health Organization (WHO) has declared monkeypox a public health emergency of international concern. It’s likely that up until about two months ago, many Canadians hadn’t even heard of this disease.
Since May, monkeypox has been in the news everywhere, including Canada, where the number of infections reached 681 on July 22. It has started to spread from big cities like Toronto and Montreal to regional centers like Hamilton, where the first case occurred. it was publicly reported on July 4.
The good news is this: monkeypox is still fairly isolated from the overall population. There is still time to recover and an effective vaccine is already available, although supplies are limited.
The bad news is that the window is short, a matter of weeks, not months, to vaccinate the most susceptible and to encourage and support self-isolation for those with symptoms. After that, monkeypox may spread beyond our ability to control it with the vaccine supply we now have available.
However, spurring individuals and governments to act may be challenging, given the degree to which COVID-19 fatigue has set in and the erosion of confidence in public health measures, including vaccines, due to misinformation.
Monkey pox
Monkeypox, a close relative of smallpox, first jumped to humans in 1958. It has become endemic to a group of countries in central and western Africa, but had been of little interest elsewhere until it also became a threat in North America and Europe. .
A health worker prepares a monkeypox vaccine in Montreal on July 23, 2022. THE CANADIAN PRESS/Graham Hughes
What we’re seeing right now in Canada is that monkeypox is mostly affecting men who have sex with men. It is not yet time to advise everyone to rush to get a vaccine, but it is certainly time to ensure that those in the most affected communities understand the risk of infection, recognize the symptoms and take steps to protect themselves and others.
Although it has so far mainly affected men in the 2SLGBTQ+ community, it is important to note that monkeypox is not a “gay disease” at all. It is simply transmitted through close personal contact, which may or may not involve sexual contact.
Read more: Frequently asked questions about Monkeypox: How is it spread? Where did it come from? What are the symptoms? Does the smallpox vaccine prevent it?
Given its current pattern of emergence in the 2SLGBTQ+ community, we must draw on the hard-earned lessons of the emergence of HIV/AIDS in the 1980s to avoid repeating the stigmatizing mistakes of that era, which were not only shameful in a social sense, but also harmful to public health.
Lessons from HIV
In the 1980s and 90s, many people were afraid to get tested because of the stigma associated with HIV, even within the health care system itself. The world has come a long way since then, both in its attitude towards 2SLGBTQ+ people and in its wider understanding of the infection.
Back then, however, many people did not want to know their HIV status because of the stigma. We cannot let this happen with monkey pox, as 2SLGBTQ+ advocates have pointed out.
Monkey pox is not as easily transmitted as COVID-19, but the fact is that we are all equally susceptible, and we all need to be aware and prioritize measures that extinguish this threat before it grows. The ongoing COVID-19 pandemic has demonstrated the value of vaccination and the need for infected people to isolate themselves to prevent spread, and we can apply these lessons to monkeypox outbreaks.
Symptoms of monkeypox are rarely life-threatening and include fever, chills, fatigue, and muscle pain, followed by a characteristic rash. It usually takes about 10 days to appear after exposure, but can happen anywhere from five to 21 days. The infection usually takes two to three weeks to subside after this. Infectiousness ends around the time the distinctive lesions of monkeypox finally end and go away.
It is important that anyone who has had close contact with someone who has monkeypox get vaccinated if they have not developed symptoms and isolate themselves if they do. (NIAID, cropped from original), CC BY
During the window between exposure and the onset of symptoms, there is a golden opportunity to prevent individual illnesses and stop the spread of infection in general by vaccinating exposed people as soon as possible. This way, we can build a wall around the bud.
Mobilization of resources
The HIV epidemic, tragic as it was, served to mobilize health resources for and by 2SLGBTQ+ communities, and today existing networks are being activated to educate and help those most at risk during this stage of the monkey pox outbreak.
The Gay Men’s Sexual Health Alliance, for example, is proving to be a valuable hub for current and useful information on monkeypox prevention, screening and vaccination, including information on vaccine clinics.
It is vitally important that anyone who has had close contact with someone who has monkeypox get vaccinated if they have not developed symptoms and isolate themselves if they do.
Self-isolation, as we’ve learned from COVID-19, is neither easy nor practical for many people. It is important that Canadian governments accelerate financial assistance that allows people with monkeypox to stay at home and limit the spread of the infection.
We have seen in both HIV and COVID-19 what happens when we do not act in time. We know how to limit and end this outbreak, and we need to take action now.