Chicago, Atlanta, Los Angeles, Philadelphia and New York now have initial or additional cases of monkeypox, suggesting the poxvirus is spreading in the United States, and experts are discussing how to communicate the risks without stigmatizing people. sexual minority groups.
New cases in several cities
New York City officials said today they have identified a fifth suspected case of monkeypox in a person who tested positive for orthopoxvirus. In Chicago, a man was self-isolating at home while awaiting confirmatory test results from the Centers for Disease Control and Prevention (CDC).
Los Angeles County officials have also identified a case in an adult resident.
“The patient … recently traveled and had known close contact with a case. Although the patient is symptomatic, he is doing well and is not hospitalized. He is isolated from others,” the county said in a statement. Press.
16 of the first 17 US cases among MSM
There are now 21 confirmed cases of monkeypox in the United States. Today in Morbidity and Mortality Weekly Report (MMWR), the CDC provided details of the first cases.
The MMWR report tracks the first 17 cases found in nine states through May 31. Sixteen of the 17 cases involved men who have sex with men (MSM). Fourteen of the 17 said they had recently traveled abroad. All but one patient developed a rash all over the body, with 8 patients reporting the rash beginning in the genital area.
It should be noted that the first two men (one in New York and one in Massachusetts) with monkeypox in the country described the onset of symptoms on May 4 after recent international travel. It was not until May 17, when increasing media coverage of monkeypox cases in the UK, that men were tested for poxviruses.
“Right now, the overwhelming majority of cases have a recent travel history prior to symptoms,” said Capt. Jennifer McQuiston, DVM, MS, CDC deputy director in the Division of Pathogens and Consequence Pathologies. high, during a press conference on the report.
Although many cases are described as mild, with patients self-isolating at home, McQuiston said she did not want to downplay the illness.
“It can be very painful and cause long-term scarring,” she said. “Some patients required painkillers.”
An expert highlights the clarity of the messages
The CDC has recommended that all patients self-isolate until their rashes have healed, with new skin emerging after the scabs have subsided. Skin-to-skin contact with the monkeypox rash can transmit the virus.
“The CDC urges health care providers in the United States to be alert to patients who have rashes consistent with monkeypox, regardless of the patient’s gender or sexual orientation or international travel history or specific risk factors for monkeypox. Clinicians should contact their local or state health department if they suspect a case of monkeypox,” the report said.
New Jersey-based risk communication expert Peter Sandman, PhD, said agencies such as the CDC and the European Center for Disease Prevention and Control (ECDC) are working to tackle stigma against MSM in their messages about monkeypox, but doing so could do a disservice to the communities most at risk of catching the virus.
Yesterday, the ECDC and the European office of the World Health Organization published new guidance on risk communication regarding the virus. Sandman said the guidance made several good points but lacked in some important respects.
“Strangely absent from every list of target audiences in this report: people who have sex with MSM. Bisexual people are an obvious route of transmission from the MSM community to everyone else,” he told CIDRAP News in an email. “There is nothing here to warn women (other than sex workers) of the risk that a bisexual male sexual partner may have monkeypox.”
Sandman said the legacy of HIV means most MSM are more likely than many others to seek medical attention when they see a new symptom.
“This will prove useful in efforts to control the spread of the disease,” he said.
Sandman calls the report’s advice to avoid stigmatizing language “all right.” But he adds: “I fear that the rest of this report exaggerates the risk of exacerbating stigma and reinforces what is already a dangerous trend in monkeypox risk communication: fear of accusations of stigma leading to headaches about which groups are most at risk and which behaviors are most risky.”
“Respectful language – absolutely. Vague, roundabout language – I hope not.”
Sandman also opposes authorities describing the cases as “mild.”
“In an effort to keep people calm, I think scary information is minimized,” he said. The West African clade, which is implicated in the global epidemic, causes a case fatality rate of 1%, and the long-term outcomes of patients with monkeypox are largely unknown.
Top 1,100 Global Cases
In 1 month, the epidemic has risen to 1,103 cases in at least 30 non-endemic countries, according to the Global.health database. The UK, Spain and Portugal continue to report the most cases.
The UK Health Security Agency (UKHSA) said 15 additional cases in England and 3 in Scotland brought the UK total to 225.
France has confirmed 33 cases, including 24 in Paris, and Latvia has reported its first case.