Marco, 40, lives with his partner in Edmonton, Alberta. Marco’s partner had been “feeling bad” for a couple of days: low-grade fever, some fatigue, and some small lumps on his hands, which he didn’t think much of because they didn’t seem serious.
Marco joked with him, suggesting that they could be monkeypox symptoms. “I mean, what are the chances? Like 1 in 6 billion? he told BuzzFeed News.
At the time, there was only one confirmed case of the monkeypox virus in all of Alberta.
The next day, Marco’s partner received a call from a public health nurse informing them that they had been in close contact with a person who had tested positive for monkeypox. Marco also talked to the nurse and told her that he felt fine, but that he had what appeared to be a canker sore under his tongue, only he wasn’t particularly sensitive.
“I just had tacos with Valentina sauce and it didn’t hurt at all,” she said. (Hot sauce would make most canker sores burn.) Assessing risk and symptoms, the nurse asked both of them to go get tested right away.
Two days after the tests were done, Marco and his partner received another call from the public health nurse. “I just got the call, we’re both positive for monkeypox,” he told BuzzFeed News on Wednesday.
Monkeypox remains relatively rare, but cases are on the rise
A new outbreak of monkeypox is spreading across the US, Canada and Europe, with many of the initial cases in gay men. According to the World Health Organization, as of June 8, there are now about 1,200 monkeypox cases worldwideincluding 321 in the UK, 100 in Canada, and 39 in the US. fifteen different states have had cases, including California, New York and Florida.
There is reason to worry, but this is not another COVID. The virus is not as contagious or as easy to spread, and there are already two vaccines against monkeypox. One is Jynneos (also known by the brand names Imvamune or Imvanex) and the other is ACAM2000. They can help prevent symptoms even after exposure or infection.
While about 3% to 6% of people with monkeypox may die from the infection, which is most dangerous in children and immunocompromised people, the strain of virus currently spreading appears to be milder, similar endemic to West Africa. A more dangerous strain of monkeypox is endemic to Central Africa.
The cases are occurring just as Pride events are clandestine in many cities. People travel and celebrate during what for many is the first summer since 2019 when they can finally gather without COVID restrictions. Mask mandates are no longer in place on public transport or in many cities. Because close contact is one way the virus can spread, health experts are vigilant and working quickly to spread the word about STIs to LGBTQ+ communities.
But to be clear, monkeypox is not technically an STI, although some people do report having lesions on their genitals or acquiring the virus during sexual contact. The disease can be spread through any type of close or bodily contact, including hugging and kissing, sharing towels or sheets, or even respiratory secretions from breathing or talking during prolonged face-to-face contact; therefore, wearing a mask can help stop the spread of the virus.
Monkeypox is not a new disease. It was first discovered in monkeys used for scientific research (hence the name) in 1958 and first observed in humans in 1970. In places where it is endemic, it circulates naturally in animals such as rodents, occasionally jumping to humans who handle infected animals or are begging or scratched by them.
Cases are rare outside of Africa or among people who have not recently traveled to an endemic area, although there has been an outbreak in the US Midwest and Dormouse.
Usually, monkeypox symptoms They include fever, headaches, muscle aches, backaches, swollen lymph nodes, chills, and exhaustion. Symptoms usually appear 7 to 14 days after exposure, but can appear anywhere from 5 to 21 days. About one to three days after symptoms begin, people usually develop rashes and raised lesions, which eventually scab over and fall off. In general, symptoms can persist for up to four weeks.
Marco has found that his symptoms and those of his partner are different from what he has read on public health agency websites.
“You know that when people start having symptoms, they will go to Dr. Google,” Marco said. “And you see the signs and symptoms, but no one is saying that the signs and symptoms can vary.”
People infected with monkeypox may have a rash that starts on the face before spreading to other parts of the body, according to the CDC.
Marco noticed that neither he nor his partner developed a rash. “The rash is supposed to turn into pustules all over the body,” Marco said. “That didn’t happen to us either, except maybe under my tongue.”
Monkeypox is not a “gay disease” and the potential for stigma is a concern
Marco asked us to use his first name only to avoid possible stigma of the diagnosis for him or his partner, but he also wanted to share his experiences to prevent further spread of the virus.
Stigma is embedded in the LGBTQ+ experience.
HIV/AIDS has been closely associated with gay men since the rise of the epidemic in the 1980s. Some worry that monkeypox is going the same way. This year, UNAIDS, the international organization against HIV/AIDS, published a declaration about the stigmatizing effects of referencing LGBTQ+ people, as well as Africans, in public communications about monkeypox.
In addition to causing social harm, UNAIDS also warned that such associations could lead to further public health problems. The program’s deputy executive director, Dr. Matthew Kavanagh, said in the statement: “Stigma hurts everyone. Shared science and social solidarity help everyone.”
Others say concerns about stigma are less important when public health is at stake. Historian Jim Downs recently wrote an article for the Atlantic entitled “Gay men need a specific warning about monkeypox.” In that article, Downs writes, “Giving gay men carefully crafted warnings about the risk of monkeypox may be a form of education, not a form of stigma.”
peter staley, one of the original members of the HIV/AIDS activist organization ACT UP, agrees. He said queer men will always experience stigma, whether through the rhetoric surrounding monkeypox or otherwise.
“The right is going to attack us for everything and for what it can. They always have and they always will,” he told BuzzFeed News. “We should never let that dictate how gay men talk to each other about health and risks.”
Staley fully acknowledges that communicating the risk of monkeypox carries with it the possibility that the general public will associate the virus with gay men, thus creating a stigma.
“You have to fight two battles at once. We need to get the word out to gay men through targeted messaging. And we must be prepared to fight the resulting stigma by delivering tailored messages to the general public.”
Just weeks after the first US case was reported on May 19, targeted messages about monkeypox are already reaching gay men across the country. Such agile communications are possible through existing infrastructures paved through campaigns to reach LGBTQ+ people for the prevention of HIV/AIDS and other STIs.
With June being Pride Month, the CDC moved quickly to dispatch its Director of HIV/AIDS Prevention, Dr. Demetre Daskalakis, to engage with organizations and health groups to spread the word about monkeypox. He and his team have plans to talk to several Pride organizers this week. Daskalakis said this summer’s meetings can be seen as more of an opportunity than a risk.
“I think Pride is a great opportunity to educate people. And when I think about our advice, it’s really about giving people the knowledge they need to navigate the events that can happen throughout the summer, whether they’re going to Pride or not,” he told BuzzFeed News. “I tend not to think of places as risky environments, because it’s really about mitigating your own risk, having the right information so you can navigate what you’re willing to do.”
Daskalakis believes this rise in monkeypox has more similarities to a 2008 outbreak of MRSA, an antibiotic-resistant staph infection, than to the HIV/AIDS pandemic that began in the 1980s. So-called flesh-eating bacteria initially spread among groups of queer men before jumping into the general population.
“It is so similar in that it is spread by very close contact. Sex could be one of the reasons there is close contact, of course, or other intimacy,” Daskalakis said.
Then, as now, agencies issued similar warnings through health care providers, specifically those focused on HIV/AIDS, who had more gay clients. That was before the advent of smartphones and location-based dating apps. Now the conversation has widened.
Grindr, the most popular of these apps, has issued multiple informational warnings about monkeypox. The app filled the inbox of all users in the US, Canada, and most European countries with a message written by a local health agency and a link to get more official information from a source in their country. .
“We’re not a public health authority, but we’re great connective tissue,” said Patrick Lenihan, vice president of communications for Grindr. “Our users want this information and these groups want to distribute it to keep this population safe.”
In the US, Grindr is working with a group called Building healthy online communities, which aims to provide specific sexual health messages by bringing together public health professionals and dating apps. The app has connected with the Public Health Agency of Canada to send warning messages to your users.