Yesterday, the U.S. Centers for Disease Control and Prevention (CDC) released a new guide called “Social Gatherings, Safe Sex, and Smallpox of the Monkey,” highlighting the risks of transmission in higher-risk situations.
“Enclosed spaces, such as back rooms, saunas or sex clubs, where there is minimal or no clothing and where intimate sexual contact occurs, are more likely to spread monkeypox,” says the guide. “A radish, a party or a club where there is little clothing and where there is direct, personal contact, often skin-to-skin, is at risk. Avoid rashes or sores you see in others and consider minimizing skin-to-skin contact. whenever possible”.
Although it is still unknown whether monkeypox can be transmitted through semen or vaginal fluids, the genital rash that occurs suggests that intimate contact is a key to transmission. The CDC’s site is also clear that the issue of asymptomatic transmission is still unknown.
Because most, but not all, cases of smallpox in the current outbreak have been in men who have sex with men (MSM), public health agencies face their first major challenge in the post-war era. -COVID: How to communicate the risk to MSM without stigmatizing. ?
Don’t avoid warning people
Jeff Duchin, MD, Seattle-King County Public Health Health Officer, said the CDC is doing a good job along the lines of alerting MSM groups to the real risks of monkeypox and avoiding stigma. .
Duchin said that in the wake of the COVID-19 pandemic, public health officials have been very careful about admitting what they don’t know about a virus or trying to predict how it will act.
“COVID-19 has demonstrated the importance of recognizing areas of uncertainty when describing what is known and when making predictions about emerging pathogens,” Duchin said.
“Monkeypox, on the other hand, has not been discovered recently and there is considerable knowledge, but it is probably good to keep an open mind about the extent to which the current outbreak may indicate differences in how the virus behaves in compared to the virus.
Although monkeypox was first described in humans in the Democratic Republic of the Congo in 1970, infection outside of West and Central Africa has been extremely rare until last month. And cases in endemic African countries are often related to the consumption of contaminated beef or households. The sexually transmitted component of the current outbreak is new.
Duchin said a confirmed case in Seattle has been closely monitored, with close contacts under surveillance. So far, smallpox in the area has been limited to one resident. In King County, the smallpox information website is called “Monkeypox in Men Who Have Sex with Men,” which Duchin said was a deliberate choice.
“We don’t let people stop us from warning people and providing them with the best information to protect their health,” Duchin said. “From the outset, we were clear about the risk to MSM.”
Be clear, don’t ‘pussyfoot’
Being aware of this risk is one of the most important messages about monkeypox, according to New Jersey-based risk communication expert Peter Sandman, PhD.
“In the current outbreak, most patients so far are taking it for MSM. But it will almost inevitably spread to HSH, to others who have close contact (especially sexual contact) with MSM, to others who have close contact ( especially sexual contact).) with these others, “Sandman said in an email.
“I urge risk communicators to say all this, and I urge them specifically not to let the fear of stigmatization stop them from doing so. The fear of stigmatization is an unacceptable reason to hold back or even slow down this. information.
“The stigmatization of MSM is still a real social evil, but sincere communication about the risk of smallpox will not aggravate this disease, and cat’s foot will not improve this disease. Stigma is really the fear of being accused of stigmatization — and this is an unacceptable reason to suppress or downplay important health information. “
The world total reaches 1,100
The CDC said the United States now has 40 cases of smallpox.
The European Center for Disease Prevention and Control (ECDC) today released an epidemiological update on monkeypox, citing the world total as 1,176 confirmed cases from 24 countries as of June 8.
The ECDC said: “EU outbreak sequences are part of a different 2022 cluster within the West African clade. There are two US 2022 sequences that are not part of this cluster, but which still belong to the West African clade. “
The outbreak is concentrated in Europe, where 704 cases have been reported in 18 countries, mainly in the United Kingdom, Spain and Portugal.
So far there have been no deaths, and most cases occur in young MSM.