Labeling monkeypox to sexually transmitted diseases / infections will stigmatize a community, experts say
The monkeypox virus can be spread through sexual contact, as shown by the initial presentation of genital or perianal rashes in many cases, the World Health Organization (WHO) said. And now a new study has found the virus in the semen.
Reports also show that the epidemic in several non-endemic countries is prevalent on a particular social network – men who have sex with men (MSM) – in addition to the theory of sexual transmission.
This route of transmission is uncharacteristic of the pathogen, just as the geographical extent of the current epidemic is, and most cases have no history of travel to endemic countries. The virus is usually spread through close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bed linen, the UN Health Agency said.
A report published on 2 June 2022 in Eurosurveillance – the European Journal of Infectious Disease Surveillance, Epidemiology, Prevention and Control – examines the epidemiological, clinical and virological characteristics of four cases of monkeypox in Italy.
Four men in their 30s, who belong to the MSM community, tested positive for the monkeypox virus after traveling in the first two weeks of May. Three went to a mass gathering on the island of Gran Canaria while one was traveling for sex work. All four have a history of STIs and two are HIV positive.
As observed worldwide, their lesions appear in the anal and genital areas. Among the key findings of this study was the presence of monkeypox virus in semen.
“Although these findings cannot be considered conclusive evidence of infectivity, they show viral excretion, the effectiveness of which in terms of transmission cannot be ruled out,” the authors note.
Although these findings are important, there is not enough evidence to suggest sexual transmission of monkeypox, said David Heyman, former head of the WHO Emergency Department, stressing that it is not a sexually transmitted disease. “We need to understand all the different ways of transmission. What we are sure of is that the virus is transmitted through physical contact. ”
The infection is called STIs when it is transmitted almost exclusively through sexual intercourse. “Based on our current understanding, monkeypox is not STIs. It is transmitted during sexual intercourse if there are lesions in the genital area, “he explained.
The monkeypox behaves very differently from the way it is understood to spread in African countries where it is endemic, said James O’Loyd-Smith, a professor of ecology and evolutionary biology at the University of California, Los Angeles.
He said Down to earth:
The virus seems to have penetrated some specific social networks and managed to spread through close contact at parties and apparently through sexual contact. From what is known so far, this seems to be the main driver for the spread of this outbreak outside Africa. These types of contact have never been identified as a major route of transmission in endemic countries.
Several experts fear that labeling monkeypox as sexually transmitted will stigmatize a community. According to them, the appropriate announcements are crucial, especially against the background of the current month of pride.
Boguma Kabisen Titanji, a virologist at Emory University, said otherwise. She explained on the microblogging platform Twitter:
Calling an infection a sexually transmitted infection (STI) is not intended to be stigmatizing. It allows people to understand how they can be exposed and potentially infected. It also helps in tracking partners by notifying them so that they are aware of their exposure in order to seek treatment.
The disease, which is spread through semen, vaginal secretions or skin-to-skin contact, is semantic, she added.
Not only is monkeypox infecting a certain population, but its symptoms are also not what is common in African countries. The overall progression of monkeypox symptoms begins with fever, chills, and swollen lymph nodes one to two weeks after exposure, followed by a rash a few days later that develops into blister-like lesions and turns into scabs, both of which continue. about one day each.
Healthy tissue usually appears two to four weeks after the onset of symptoms.
What we are witnessing now is a milder presentation of the symptoms leading to the rash and is therefore often overlooked, according to a report in the JAMA Network.
Another difference is the location of these lesions – it usually starts from the head and spreads to the arms and legs. But now the lesions appear for the first time in the genital or perianal area.
However, many still remain unclear. “Is it the actual close skin-to-skin contact, the respiratory secretions that are spread during sexual intercourse?” Or is it actually a sexually transmitted infection transmitted through body fluids that are exchanged during sex? Amesh Adalya, a senior scientist at the Johns Hopkins Health Security Center in Baltimore, was quoted as saying by Bloomberg.
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