Monkeypox is driving us bananas
Monkeypox is now turning up in ways and parts of the body we didn’t expect. (Photo: Marco Verch via Flickr)
As of Tuesday, the Centers for Disease Control and Prevention (CDC) have reported 1,088 confirmed and suspected cases of monkeypox in 29 countries. The data is displayed in their outbreak map here.
This has prompted the organization to raise alert to level 2. “Enhanced precautions” include avoiding close contact with sick animals and people, especially those with skin lesions.
The UK, which has the most cases recorded at present, recently promoted monkeypox to “notifiable disease” status. This means doctors now have to notify local authorities when they suspect a patient has it. In two studies published last week, it showed monkeypox spread undetected in the UK and Portugal mainly because the patients, the places they’ve been, and their activities were not related to each other.
So health officials are clueless as to where people are really getting it. Many cases are going undiagnosed this way. On Week 4 of the outbreak, this conclusive data arguably drives experts—and us common folk—bananas too.
Same sh-t, different symptoms
This gap may be explained by something we thought we knew enough about, but apparently didn’t: symptoms. Right now, symptoms are much more subtle and varied than in past cases.
"You can see how these patients can be missed. But they are still contagious and may propagate the disease,” said Dr. Donald Vinh, an infectious disease specialist at McGill University.
"In the classic monkeypox, described in textbooks, you're supposed to have two phases," he added. First you may expect a fever, tiredness and a single swollen lymph node, followed by the tell-tale rash that can cover the whole body.
Now, experts say many of the people's symptoms didn’t fit this profile at all. Sometimes the flu or swollen nodes appear, sometimes they don’t. Lesions begin and stay on one part of the body, typically the genitals or anus. In some patients, only one or two small lesions appear, which is different from the pus-filled blisters commonly shown. Lesions now look like craters or ulcers and are more similar to those caused by several sexually transmitted diseases (STDs), such as herpes and syphilis.
Subtler symptoms don’t equate to a milder illness though. The rashes can still be painful enough to require painkillers and cause long-term scarring on the skin.
Some reported inflammation of the rectum, and another, one tiny, not painful lesion on his penis. Again, still as contagious.
This is why health officials are calling sus over almost anything these days, even if that means watching out for any type of rash.
Dr. Sébastien Poulin, another infectious diseases specialist, tweeted that there’s “a spectrum of disease manifestations” and that we should “keep a high index of suspicion.”
Same stigma, different disease
With Pride Month celebrations coming up, it’s worth being extra careful anywhere there’s large numbers of people, especially in countries with reported cases—not because these events attract a certain kind of crowd with a certain kind of sexual orientation, but because a crowd’s a crowd, and there is still a pandemic going on.
While COVID-19 and monkeypox are both airborne, monkeypox still spreads slower and more effectively if paired with prolonged physical contact. And in any area with local transmission lies the greater risk of catching it in the sheets, rather than in the streets.
This is where sexual networks come in. To avoid replicating an unnecessary stigma born 40 years ago, this is your weekly reminder that monkeypox’s spread, just like HIV’s, is "less about sexual identity and more about sexual networks."
Again, Happy Pride Month, everybody!
