Anyone can get monkeypox, but the virus is currently disproportionately affecting the gay community. Photo: BlurryMe/Shutterstock

Monkeypox cases are on the rise.

Reported cases of monkeypox have increased to more than 5,100 in the U.S., compared with several hundred in late June, the Centers for Disease Control said. Worldwide, the number of reported cases is more than 18,000.

In this outbreak, so far, monkeypox has disproportionately impacted gay, bisexual, queer and other men who have sex with men.

The World Health Organization has raised alarms about monkeypox and declared it a global health emergency July 23. Issuing its public health emergency of international concern enhances coordination and sharing of resources and information among nations.

New York City and San Francisco recently declared states of emergency. Those notifications allow cities to mobilize resources, accelerate emergency planning, streamline staffing, coordinate agencies across the city, allow for future reimbursement by the state and federal governments, and raise awareness among the public.

Here’s what we know.

What is monkeypox?

Monkeypox is a member of the orthopoxvirus family. Smallpox is also an orthopoxvirus. Epidemiologists and public health officials have known about monkeypox since 1958. It’s generally spread through human contact with infected rodents in Central and West Africa.

The first known case of monkeypox in the U.S. occurred in 2003 and infected 43 people. That outbreak originated in infected rodents that had been imported from Africa. This latest outbreak of monkeypox is more widespread and occurring in countries that typically have had very few cases or no reported cases.

How is it transmitted?

“In this current outbreak, the highest risk of transmission is very close, skin-to-skin contact, including kissing and sex, with the lesions someone has on their skin,” Dr. Erica Pan told Q Voice News. “It can appear almost anywhere, but what’s been noted in many of the recent cases is that it appeared in the genital and anal area.”

“One thing that makes monkeypox different from other rashes is that it can appear on the palms, soles of your feet, the chest, the face. Monkeypox could appear on one part of the body or all over the body,” Pan said.

“But,” she stressed, “monkeypox is not a sexually transmitted disease.”

“There is some potential risk with prolonged, intimate face-to-face contact with someone. But monkeypox is very different from COVID, which is a respiratory disease and highly infectious,” Pan said

“We have seen rare cases where the virus can be transmitted if someone shares clothing, bed linens, or towels from someone with lesions,” she said.

Some individuals may be at higher risk for monkeypox, highlighted here in the Los Angles Blade.

What are signs and symptoms?

Some of the initial symptoms of monkeypox are high fever, swollen lymph nodes and muscle aches, which are similar to coronavirus or flu. However, a rash with painful bumps or pimple-like lesions also will appear.

These sores can appear anywhere on the skin, from hands and face to the genitals and anus. Some monkeypox patients even report sores inside their mouths. Not all patients exhibit the same type and severity of symptoms, The Cleveland Clinic said.

No monkeypox hospitalizations or deaths have been reported.

“The rash or blisters can be painful,” Pan said. “They can be infectious for a very long time. The lesions heal, but they can take days to weeks. They will scab over and heal.”

Monkeypox and the LGBTQ+ community

At present, more than 90% of monkeypox cases are attributed to transmission between gay and bisexual men. Unfortunately, some people have used this situation to spread flash information and create a backlash against gay and bisexual men that is reminiscent of the early days of the AIDS epidemic in the 1980s, when some media and politicians villainized queer men.

Recently on Twitter, the hashtag #groomers trended alongside an ABC7 report that two young children have been diagnosed with monkeypox. Lack of information about how monkeypox is spread plus new anti-LGBTQ+ fervor has people like U.S. Rep. Marjorie Taylor Greene suggesting monkeypox is a sexually transmitted disease, stirring up her base of 1 million followers. The video in Taylor Greene’s tweet includes a snippet of a Washington Post interview with the head of the CDC, Dr. Rochelle Walensky. In the interview, Dr. Walensky remarks that the two children with monkeypox came into contact with gay men. She does not explain the method of transmission, a key piece of information that has led to much alarming speculation on social media.

Health officials have stressed that monkeypox is not a gay disease.

“It’s not that queer people are any more likely to get monkeypox. Nothing about monkeypox makes it a uniquely queer disease. Anybody can get monkeypox,” Dr. James Simmons, a hospitalist nurse practitioner in Los Angeles, told Q Voice News.

“It’s purely coincidental that the spread started at queer events in Europe,” Simmons said. “Queer people historically travel within queer communities and attend queer events. So because this outbreak likely, and coincidentally, started at queer events, it’s important we make sure the LGBTQ+ community is educated regarding their potential risk.”

On Twitter, health officials caution against calling this a “gay disease.” Purdue Health Equity Director Jerome Adams tweeted, “#Monkeypox is NOT a sexually transmitted disease or a ‘gay’ disease, but a disease spread by close personal contact. Condoms or calling for a halt to ‘gay sex’ will not stop this outbreak. Education, vaccination, and testing will.”

At a recent monkeypox town hall hosted by Washington Blade and the D.C. Department of Health, moderator N. Adam Brown, an emergency department physician, cautioned the audience that monkeypox can affect anyone, not just those in the LGBTQ+ community.

“Viruses don’t discriminate. Humans discriminate. But this virus doesn’t. The fact is this is a skin-to-skin transmission disease. Any type of person who has direct contact with the skin with a person who has an infectious rash can get this disease.”

Dr. Eric B., a doctor and TikTok creator, shares the dangers of blaming one community for the spread of a disease or virus. Responding to a comment from a user, Dr. B. shares what he believes are common misconceptions about monkeypox, made worse by “abysmal” messaging. He said, “When you label a disease as being exclusive to just one specific group, you make that group a lightning rod for the ire of the general public, especially when that disease starts to spread to the general public. We saw the same thing with HIV in the early eighties, and we saw the same thing with covid in the Asian American community. You think we would have learned our lesson by now.”

What measures can be taken to avoid monkeypox?

“Talk with your sexual partner about any recent illnesses,” Pan said. “Be aware of any new sores or rashes on your body or your partner’s body, including the genital and anal area. Avoid close or sexual contact with someone who does have sores or rashes.”

“If someone does have a case, it’s important to cover the rash and avoid contact with people,” Pan said.

The CDC also offers a guide for people attending large social gatherings or planning to be in skin-to-skin contact with someone else.

  • Avoid large gatherings where skin-to-skin contact is unavoidable, like festivals and parties.
  • Wash your hands thoroughly and avoid touching skin rashes or lesions.

Vaccine shortage raises concerns

Right now, two monkeypox vaccines — JYNNEOS (Imvamune or Imvanex) and ACAM2000 — are available. Availability and eligibility of the vaccines varies in cities across the U.S. People who want to be vaccinated should contact their health care provider or local health department for details about appointments. Like the early days of the COVID-19 pandemic, there is an issue with supply versus demand. The supply and availability of ACAM2000 is greater than JYNNEOS, but the CDC cautions the former vaccine should not be used for all patients, especially those with a “weakened immune system, skin conditions like atopic dermatitis/eczema, or pregnancy.”

LGBTQ+ advocates and health officials have been protesting the lack of vaccines and testing, especially in metropolitan areas like San Francisco, Los Angeles and New York.

The San Francisco Department of Public Health has been criticized for its response to monkeypox, including long lines at vaccination sites and confusion over when follow-up doses will be available.

In Philadelphia, five clinics offer the vaccine, but have a limited supply and patients must match certain eligibility requirements.

There is good news, however, about vaccines. The Food and Drug Administration has approved Danish pharmaceutical company Bavarian Nordic to fill and finish an additional 786,000 doses of the JYNNEOS vaccine.

Here’s additional information about monkeypox.

City announces targeted vaccine response to monkeypox – Philadelphia Gay News

Is Long Beach ignoring gay men in its monkeypox response? – Q Voice News

New HHS reg seeks non-discrimination in health care as monkeypox spreads – Washington Blade

Local experts offer Monkeypox update; D.C. has only 10% of vaccine doses needed – Washington Blade

San Francisco health officials come under criticism over monkeypox response – Bay Area Reporter

Signs and symptoms – CDC