The Facts and Falsehoods Surrounding Monkeypox

An electron micrograph of the monkeypox virus (NIAID Integrated Research Facility/Flickr)

Since January of 2020, the COVID-19 virus has run rampant throughout 228 countries and territories worldwide. Flash forward to 2022 and most countries have loosened the reins on the practice of quarantine, lockdown policies, mask mandates, and other restrictions in light of the effectiveness of the COVID-19 vaccine, which reduced both the number and severity of cases. But just as life appeared to be going back to normal, on August 4, the U.S declared a public health emergency centered around the elusive monkeypox disease. But the U.S is not the only country seeing the effects of this outbreak: the Centers for Disease Control and Prevention (CDC) reports case discoveries in 82 new countries that have never previously seen monkeypox. Of the current 31,800 confirmed cases, an overwhelming majority are from these countries. And as the world has already seen, any health emergency carries with it an air of curiosity, facts, and falsehoods.

Background

As news of the recent monkeypox outbreak has reached Western households, it has become a lesser-known fact that monkeypox dates back to the 1950s. Though first discovered in a lab in Copenhagen, Denmark in 1958 among monkeys, the virus is transmissible to almost all mammals, including humans. The most common location for these outbreaks has been Central and West Africa. Researchers theorize that the reason behind the virus’ prevalence in Africa is a result of the abundance of tropical rainforests and proximity to disease-prone wildlife coupled with less accessible healthcare.

The most recognizable symptom of infection by monkeypox is a rash that takes its form as a skin lesion, typically with pus inside. Other symptoms include fever, aches, and swollen lymph nodes. With this in mind, monkeypox has often been called a cousin of the historic smallpox disease. Similar to monkeypox, symptoms of smallpox included fevers, rashes, and sores, most commonly in the mouth. However, the key difference between the two diseases is that smallpox was notably quite deadly, killing an estimated 300 million people between 1900 and 1977, the year in which the smallpox vaccine was widely distributed. Monkeypox, on the other hand, has a survival rate of over 99% among cases in the West. Despite this key difference, the aforementioned smallpox vaccine has proven relatively effective against monkeypox. However, due to smallpox now being considered an eradicated disease, the vaccine has not been utilized on a grand scale since the 1970s, leading to issues with access to this potential cure for the disease we are seeing more of today.

How to stop the spread

Fortunately, monkeypox isn’t necessarily considered a fatal disease. Again, those infected in the U.S are over 99% sure to survive the disease. But this doesn’t mean that we shouldn’t be worried. Those with compromised immune systems are at risk when it comes to this virus. And on this note, the U.S has already reported its first few cases in children in July 2022. Fortunately, the contraction rate of monkeypox is lower than that of other outbreaks like COVID. According to the CDC, infections typically occur through skin-to-skin contact, most commonly through sex. The virus can also spread through infected surfaces, but this is much less common. Contrary to popular belief, monkeypox can be airborne. A person may contract the virus through the respiratory droplets of an infected person, but similar to infected surfaces, this method of contraction is uncommon. Nevertheless, it is important to take necessary actions to stop the spread of monkeypox. Precautions to take when concerning monkeypox include avoiding crowded areas, especially those where skin-to-skin contact occurs, avoiding surfaces touched by those who have had either the virus or exposure to it, and isolating if such exposure occurs.

Monkeypox and misconceptions

Oftentimes, outbreaks of novel disease breeds disinformation among citizens. Such is the case concerning monkeypox. One of the most misleading pieces of information includes the statement that monkeypox is an “African virus”, even though, as discussed above, the virus is originally European. But despite this being the case, the issue of racism somehow finds itself in the discussion. The most obvious manifestation of this is the overuse of pictures of Black people in news stories covering the disease. Many notable news outlets have been called out for using stock images of Black people when covering Western outbreaks of monkeypox. For example, the Foreign Press Association, Africa, tweeted in May, “Shouldn’t it be logical that if you are talking about the outbreak of monkeypox in Europe or the Americas, you should use images from hospitals across Europe and the Americas? Or in the absence of such use a collection of electron micrographs with labelled subcellular structures? We condemn the perpetuation of this negative stereotype that assigns calamity to the African race and privilege or immunity to other races.” Commentary like this has pushed The World Health Organization to consider renaming the virus to prevent any association with a particular region of the world. We’ve actually seen this happen before, most famously with the recent coronavirus outbreak which was renamed SARS-COV-2 as a response to the widespread use of the term “Chinese virus” in reference to it.

Another rather widespread misconception regarding the virus has been its widespread presence among gay men. A study on infection of the virus conducted among 16 countries from April 27 through June 24, 2022, found that 98% of those who were infected were either gay or bisexual men. 95% of these infections were caused by sexual activity. As a result, information about the virus from public health organizations has been targeted toward members of this demographic. But this raises concerns about stigmatizing these groups. For example, the virus is now informally being referred to as a “gay virus” among people who view the virus’ prevalence in the LGBTQ community as a way to criticize them. Many compare this to the HIV/AIDS pandemic of the 1980s and 1990s. HIV was notably common among gay men and caused public backlash against the LGBTQ community. As a result, many people affected by the disease felt as though they could not come forward, and this caused a lingering prejudice against the community that many believe still exists today. Jason Cianciotto of Gay Men’s Health Crisis remarks, “We are not going to end HIV, and we're certainly not going to curtail the monkeypox epidemic, by trying to shame people into not having sex or only having certain types of sex with certain people.” In addition, many believe that it is important to inform all citizens that the virus is not, in fact, exclusive to men who have sex with men, especially since the virus can theoretically infect anyone, and it is important that the general public is aware of this.

The public health response

Since the U.S is among one of the top countries in the world in terms of monkeypox infections, it’s safe to assume that the government is doing everything they can to eradicate the disease. But what is shocking to some is that, despite the Global Health Security Index naming the United States as the country that is most prepared to handle a pandemic (on the basis of access to proper health facilities), monkeypox has been running rampant throughout the country. For all intents and purposes, people say, the outbreak should be easy to contain. Namely, a vaccine for monkeypox exists. The Jynneos vaccine, a two-dose shot approved in 2019 by the Food and Drug Administration (FDA), has been proven to protect against smallpox and its closely related virus: monkeypox. But the process involved with getting this vaccine may be the reason for the virus’ success in the States. Firstly, a person suspecting they might have monkeypox needs to get tested. But actually getting a test is often a lengthy endeavor as there is a shortage of tests, causing tests only to be issued to certain cases. And when one is confirmed for a test, a health provider must specifically request one, which can take time. Epidemiologist Jennifer Nuzzo attests to this, stating, “We need to cast a wider net with testing to find infections that we're missing. And that's really hard to do if we make it cumbersome and difficult for health care providers to request a test in the course of their busy days.” Now, let’s just say people are adequately able to get tested for monkeypox. The second step of the process, vaccination, still lies in the way. Despite receiving 600,000 doses of the vaccine from overseas, the U.S is still strapped for supplies. At the present moment, it is the government’s goal to vaccinate those at risk for the virus (namely: men who have sex with men). However, the current vaccine supply is making this a difficult task. Presently, the FDA is trying to devise methods of extracting more doses from a single vial of Jynneos. Nevertheless, streamlining of the administration of vaccines is still a major issue. And with about 7 million doses set to arrive in the U.S by 2023, it seems that the most pressing problem remains the here and now.