The World Health Organization (WHO) has convened a meeting on June 23 to assess whether the monkeypox outbreak now affecting dozens of countries represents a public health emergency of international concern (PHEIC), the highest level. high world alert.
It is a formal WHO statement of “an extraordinary event that is determined to pose a risk to public health for other states through the international spread of disease and potentially requires a coordinated international response.” , when a situation occurs that is “serious, sudden, unusual, or unexpected,” and that “may require immediate international action.”
So far this year, more than 1,600 confirmed cases and almost 1,500 suspected cases of monkeypox have been reported to the WHO from seven countries where the disease has been known for years and from 32 recently affected countries. , according to UN News.
Dr Hans Kluge, WHO Regional Director for Europe, said today in a briefing that Europe remains the epicenter of this growing outbreak and said its magnitude poses a real risk. The longer the virus has been circulating, the wider its spread and the stronger the disease will be in non-endemic countries.
Kluge urged governments, health partners and civil society to act urgently, through improved surveillance, contact monitoring and infection prevention and control, as well as effective communications with the general public and doctors, and intensive community participation.
In Europe, the majority of reported patients have been men who have sex with men. Kluge warned that stigmatization of particular populations undermines the public health response, as has been repeatedly seen, in contexts as diverse as HIV / AIDS, tuberculosis, and VOCID.
Meanwhile, Matthew Vaughan, Acting Director of ACON’s Sexual Health and HIV Division, writes below that preparations are being made for an increase in cases in Australia, and stresses the importance of a clear message and the involvement of the community that does not contribute to fear and prejudice.
Matthew Vaughan writes:
As I write this, there have been over 1,600 confirmed cases of MPXV – I prefer to use this term to reduce stigma – worldwide, mostly in Europe, the UK and North America.
So far, Australia has only six cases, most of them among returning travelers, but with the summer holiday season beginning in the Northern Hemisphere, we are gearing up for another viral outbreak.
Early media reports on MPXV cases highlighted the association with gays, bisexuals and men who have sex with men. Especially among those who had attended major dance parties or sex parties in Europe.
Anyone who lived in the early 1980s could remember similar headlines in the media about an unpublished illness; “a rare cancer,” which we would later call the human immunodeficiency virus (HIV).
There were so many things we didn’t know about HIV in the early years. We didn’t know what caused it, we weren’t sure how it was transmitted, we didn’t know how to test it, and unfortunately we didn’t know how to treat it.
The multitude of unknowns caused immense fear and anxiety in the community. The media vilified those most affected by it, and conservative groups blamed it for immoral behavior, claiming that the suffering of the people was a punishment from God. There were public calls to close bars, nightclubs and other places frequented by gay men. At the height of the HIV epidemic, there were even moves to cancel Sydney’s annual Mardi Gras celebrations.
As the leading Australian HIV researcher, Edwina Wright of the Burnett Institute, pointed out, in the absence of the acquaintance, we are looking for someone or something to blame. In the case of HIV, it was those people who were affected. This was even in the clinical name given by doctors when they identified the first cases: Gay-Related Immunity Deficiency (GRID).
Some 40 years after the first HIV cases were identified, people living with HIV still experience the stigma associated with life-threatening illness. A scary campaign with the Grim Reaper was launched on national television, telling people to be careful, because we could all be devastated by it.
We only need to turn to recent events to understand how to blame groups of people for virus outbreaks, especially those historically discriminated against, feeds stigma, and affects communities beyond the virus itself. At the onset of the coronavirus pandemic, widespread racial attacks on Asian-Australians increased dramatically and Asian-Australians had to deal simultaneously with the impact of coronavirus and racial abuse.
Unfortunately, the arrival of MPXV in developed environments and in the networks of gay and bisexual men poses similar threats to human dignity.
However, the circumstances are very different. Unlike the early years of HIV, we already know a lot about this virus; we have a reasonably good idea of how it is transmitted, we know how to test it, there are treatment options available and we have vaccines.
A completely different situation.
Matthew Vaughan
Get ready now
However, we must not be complacent. We should, and are, preparing for an increase in MPXV cases in Australia. We need to learn from the past, be prepared, and act quickly to contain future outbreaks when they occur.
We can achieve this if governments work together with affected communities to inform specific communications and pragmatic responses. Collaborative efforts between governments and affected communities build trust, community engagement, and prevent unintended consequences of fear and prejudice.
It is important to note that we must recognize that the risk of MPXV is not limited to gays, bisexuals, and other men who have sex with men. Anyone who shares close contact with someone who is contagious is at risk, regardless of gender or sexuality. Reporting cases of MPXV as a disease that only, or largely affects, gay and bisexual men prevents people with symptoms from taking the test.
Even in 2022, homophobia affects the way people relate to health services. Homophobia not only affects gay and bisexual men, even if a person does not identify as gay. Fear of being misperceived or labeled as gay in the media or by family friends prevents people from accessing the evidence and engaging in important contact-seeking efforts.
The critical critical components of an early response to a viral outbreak are isolating sick people and close quarantine contacts. To do this effectively, health departments use vigorous contract monitoring methods, which allow them to identify and report potential cases and alert people who self-isolate or monitor symptoms.
For this to be effective, people should be encouraged to notice and remember their sexual partners and to disclose them in a complete and open manner to the health authorities, without fear of reactions or moral judgments.
MPXV is not currently classified as a sexually transmitted infection. It is still unknown whether it is transmitted through vaginal fluid, seminal fluid and ejaculate and requires further research. We know that it can be transmitted through close contact, which is inevitable during sex. Transmission can also be caused by contact with clothing or bedding of a person with MPXV.
So while it’s not an STI, it does have the potential to spread through the sexual networks, causing organizations like ACON (and many other LGBTQ organizations around the world) to respond quickly with sensitive messages. for our communities.
Currently, a large number of MPXV appearances appear to be among gay, bisexual, and other men who have sex with men. One possible reason for this is the proactive health-seeking behaviors of these communities, especially when it comes to caring for their own sexual health and that of others.
Once again, we are in another “unprecedented” situation. However, we know that our communities are strong and resilient, and time and time again gay and bisexual men have responded and adapted our behavior to protect ourselves, our partners, and our communities.
For reliable sources of information about MPXV, we recommend government sources such as the NSW Health Fact Sheet or resources published by the Australian Department of Health.
• Matthew Vaughan is the Director of Sexual Health for HIV and ACON’s lead campaign planner, where he leads the strategy and development of the multi-award winning campaign, Ending HIV, which aims to end HIV transmission in NSW. Matthew has been working in the community services industry for the past 15 years working in various roles within governmental, non-governmental and community-based organizations at the state, national and international levels.
Resources and reading
Related WHO Updates WHO Publication: Clinical Management and Prevention and Control of Monkeypox Infections: Provisional Rapid Response Guidance, June 10, 2022
From the United States, messaging tips: experts aim to thread needle monkeypox messages to MSM
Check out Croakey’s previous articles on monkeypox