Although the restrictions related to Covid-19 have been relaxed, for many gay men an uninvited guest called monkeypox threatened to spoil the long-awaited festivities.
Of the 6,924 confirmed cases of monkeypox in the global outbreak, the vast majority have occurred among gay, bisexual and other men who have sex with men or MSM, various health authorities report. Skin-to-skin contact during sex, according to experts, is probably the main driver of the global spread of the virus so far.
“I feel like this is going to be a pretty big blow. It’s up to us to take care of our own.”
Epidemiologists have emphasized that monkeypox can still be transmitted among other groups of people, although the risk to non-MSM remains low at this time.
Monkeypox has been relatively mild during this outbreak and has not caused any deaths outside of the 11 African countries where the virus has become endemic since it was discovered in 1970. However, 18 gay men who contracted monkeypox told NBC News that it can cause ugly and in some cases debilitatingly painful skin lesions – and left them glumly stuck inside.
“The thought of a full three-week quarantine is pretty scary,” said John, 32, a tech worker from New York who believes he contracted monkeypox from a guy he met during a recent trip to Los Angeles for the city’s Pride. “I just feel disappointed and exhausted. It was hard to miss the Pride celebration” in New York.
John is among a rapidly growing group of 560 U.S. residents who have so far been diagnosed with monkeypox — a number that experts believe is far below the actual number of cases, given gross undertesting. California, New York, Illinois and Florida are the states with the highest number of confirmed cases.
Some of the men, like John, who shared their monkeypox stories with NBC News, asked that only their first names be used to protect their medical privacy. Most of the men interviewed expressed a strong sense of duty to draw attention to this new pathogen that is spreading so worryingly within their community. They also hope to combat the stigma against those who contract the virus by giving it a human face.
“I feel like this is going to be a pretty big hit,” John said. “It’s up to us to take care of our own.”
A worldwide outbreak likely fueled by sexual contact and travel
Epidemiologists believe that they have traced the global spread of monkeypox to the spring gatherings of homosexuals in Western Europe. These parties attracted many men from other cities, some of whom then apparently brought the virus home. The Centers for Disease Control and Prevention reported last month that of the first 17 cases in the US, 16 were in men who have sex with men and 14 were in people who had traveled to 11 different countries in the three weeks before their symptoms started.
Almost all of the men who spoke to NBC News about having monkeypox said they were pretty sure they could trace their infections back to intercourse. Many had traveled for weeks before symptoms of infection appeared.
Justin, 38, said after returning home from a two-week vacation in Europe on May 18, he became the 14th person in the US and the second in New York City to be diagnosed with monkeypox. He said his case started with a fever, which along with symptoms such as swollen lymph nodes, headache, body aches, chills and exhaustion are common signs of monkeypox. Soon after, telltale lesions appeared all over his body.
Monkey pox usually has an incubation period of six to 13 days, but the time between exposure to the virus and the appearance of symptoms can last up to three weeks. The researchers did not study whether the virus is transmitted asymptomatically; at least in theory, it could, experts say. The period of active lesions, when the virus is most definitely contagious, lasts about two to four weeks, according to the CDC.
Jeff, who is in his mid-30s and is a university administrator in a mid-Atlantic state, spent several weeks traveling through Europe until early June. He stopped in London, Paris, Amsterdam and Berlin, having sex with multiple partners along the way, he said, including at a bathhouse and sex club in the German capital.
“There are hundreds of men in this club,” Jeff said, recalling the considerable skin-to-skin contact among patrons. “Obviously, no one’s going to come down to wipe the belt.”
Anne Rimoin, an epidemiologist at the UCLA Fielding School of Public Health and a leading expert on monkeypox, said of the sharing of condoms: “Given the risk of transmission by fomites — contaminated objects — it is theoretically possible for monkeypox to be transmitted in this way. .”
Nine days after returning home, Jeff developed an intense fever and headache.
Peter, 28, said he went to a sex party June 14 at a house on Fire Island, a gay beach enclave about two hours from New York, and that of the roughly 15 attendees, he and at least six other men now have monkeypox. .
“I’m pretty sure I know who I got it from,” said Peter, who works in tech in a Rocky Mountain town but has been holed up in Seattle in isolation since he was diagnosed with monkeypox during what he hoped would be that it will be a fun visit to attend the city’s pride festivities. “Thinking about it,” he said, “I remember there was a little hard spot” on the man’s penis.
Peter said gay men should be careful looking for signs of monkeypox on their bodies and the bodies of their sexual partners.
“Don’t be afraid to say something,” he said.
Dealing with a chaotic public health system
Many men with monkeypox reported extremely frustrating experiences, plagued by dead ends and delays as they sought to be tested for the virus and worked with public health officials to provide the names of their recent close contacts. Some saw time running out for them or their partners as they tried to secure scarce doses of the Jynneos monkeypox vaccine, which research suggests can prevent symptoms of the disease if administered within four days of exposure and at least reduce symptoms if administered within five to 14 days. Using vaccines in this way is known as post-exposure prophylaxis or PEP.
Mark Hall, 41, a nurse from New York, said he got his first lesion on June 24 – the Friday of the city’s blockbuster Pride weekend – but thought it was an ingrown hair and only realized two days later that it was probably monkey pox later, after he had already been to several Pride events. Despite his urgent and determined efforts that began that Sunday, he was unable to get tested, confirmed as having the virus and finally begin providing names to the health department’s contact tracing service by Thursday, he said.
With a vaccine shortage hampering the nation’s response to the outbreak, only 40% of Hall’s close contacts, he reported, had been vaccinated by July 5, and another 6% had vaccination appointments booked for this week. But until now, much of the 14-day period for using the vaccine as PEP has been closed to his unvaccinated contacts. One of these men already has a suspected case of the virus.
Like Covid-19 and HIV before it, monkeypox has established an epicenter in New York, which had 111 confirmed cases by Tuesday, up from 87 on Friday.
Hall said he was dismayed to learn that the city’s health department can still only test 10 people a day for orthopoxvirus, the family of viruses that monkeypox belongs to.
“We knew Pride was coming,” he said. “Why didn’t we increase testing capacity earlier, knowing this would be a problem?”
Michael Lanza, a spokesman for the New York City Department of Health and Mental Hygiene, said the city is conducting as many tests as possible “given national resource constraints.”
“The sample testing process is time intensive and the current test was never designed to be highly efficient,” he told NBC News in an email. “We are working with our federal partners, NY state government and commercial labs to see how we can increase capacity, but beginning this week we will have one commercial lab assisting with testing requests.”
Rob Short, 29, expressed frustration that he never received a call from public health officials about receiving the vaccine as PEP after attending a specific rally in Washington, D.C., in early June. He said he’s sure local health authorities think it’s a spreading event because he’s aware of other attendees who received contact tracing alerts about it. Getting the vaccine quickly, he said, could have spared him the infection that sent him into isolation, leaving the personal trainer unable to make a living teaching group fitness classes.
For some, isolation is optional. Two weeks ago, the Los Angeles County Department of Public Health sent Matt Ford, 30, a court order, which the actor shared with NBC News, to remain in isolation until further notice.
“There is a conundrum,” said Jennifer Nuzzo, an epidemiologist at Brown University. “It is clear that we need to isolate people as long as they are contagious. That is the way to suppress this virus and prevent it from taking root. But we know from many past outbreaks that punitive approaches can backfire, driving cases underground. For this particular virus, because the isolation period is quite long, it is particularly difficult for people to isolate themselves.”
Nuzzo stressed that people with monkeypox may need various forms of support, including income and housing support, to help them overcome isolation.
Jeff, for example, questioned the wisdom behind such strict isolation of a virus that appears to mostly require significant physical contact for transmission. (Many experts have argued that if the virus is airborne, it probably takes hours of close contact for that to happen.) He said he had been in regular contact with a public health official in his home state who told him they were honestly not completely sure if it is safe for him to go out.
The monkeypox treatment
According to the CDC, there are no specific treatments for monkeypox, although there are antiviral medications that can still be used in medically sensitive populations, such as immunocompromised people.
Many of the men who spoke to NBC News said that when they visited health facilities just to ensure a proper diagnosis and because they felt obligated to alert public health authorities, they were met with a system that was completely unprepared for them. With no prior experience treating patients with a virus previously rarely seen in the United States, emergency department members were confused about what safety protocols to follow. The men reported being rushed into isolation rooms and left alone for hours as their imaginations wandered to dystopian scenes from movies like “Contagion” or “E.T.”, while PPE-clad staff pondered the best course of action.
Some men said they were sent home with incorrect diagnoses before finally finding a doctor who diagnosed them correctly.
“Now I know what it felt like to be the first to get HIV decades ago,” said Alex, 32, a biologist from Washington, D.C., who said he believes he contracted monkeypox from a gathering of several dozen OnlyFans creators at were filming each other’s sex scenes. He said he had heard that the event probably led to at least three more cases.
Alex said when he went to a DC hospital with “the worst pain of his life” the doctors “had no idea what to do — they were on Google, literally.”
Peter said the worst part of his trip to the emergency room at a Seattle hospital was when another man who was initially in the same room as Peter came into the hallway and started talking to the nurse about Peter’s condition. “She said loudly: ‘Are you screwing me?!'” Peter recalled the words of the nurse. “It was really horrible to feel that stigma, like I was a dirty patient.”
“The fact that these patients are not receiving appropriate and compassionate care shows a real need for better education and training of health care providers, especially those working in sexual health clinics, emergency departments and urgent care centers,” said Dr. Céline Gounder, MD. associate and managing editor for public health for Kaiser Health News. “Not knowing how to test for monkeypox is no excuse.”
Jeff, however, said he was blown away by the non-judgmental care he received when he visited the emergency room in his hometown.
“I’m so happy,” he said. “They were respectful. No one believed me or said, ‘Oh, you were a whore in Germany? Well, no wonder!'”
Outside of formal medical care, networks of men with monkeypox have sprung up, with men sharing advice on self-care through direct messages and social media posts. Ford, for example, recommended soaking in Epsom salt baths.
Some became amateur epidemiologists. Short said he and his friends noticed a pattern in which men who engage in receptive anal intercourse tend to get an initial outbreak of sores in the anal region, while insertive partners get them on their genitals. Meanwhile, epidemiologists have noted that some cases of monkeypox in this outbreak are atypical compared to cases in previous contexts in that they first appear as lesions in the genital or perianal area.
For some, severe pain
According to a recent report by the World Health Organization, perhaps 10% of documented monkeypox cases in an outbreak led to hospitalization, either for treatment or isolation. A recent study in the UK found that hospital admissions were caused by pain or infection of skin lesions.
Some of the men who spoke to NBC News said that while their skin lesions may have been fairly mild, they experienced extreme pain in the anorectal or genital area, particularly when urinating or defecating.
“It’s the most painful s— you’ll ever take in your life,” Short said. “To the point where I almost passed out.”
As for Hall, a lesion on his urethra caused him to fear urination. “It feels like 1,000 burning knives trying to come out of my urethra at the same time,” he said.
New Yorker Gerald Febles, 25, said monkeypox left him with excruciating pain all over his body, including lesions in his mouth and gums. Lymph nodes in his groin had swollen to the size of his fist, making it difficult for him to do anything but lie down, he said.
“The pain became so unbearable,” Febles said as he waited for hours at Lenox Hill Hospital in Manhattan last week. “Every joint in my body hurts.”
Eventually, Febles, who is an employee relations manager at urgent care company MedRite, was given antibiotics and one pill of oxycodone and sent home with a topical lidocaine solution. His discharge note, which he shared with NBC News, did not indicate the morphine prescription he was given. So he endured severe pain for another day before he realized that an opioid was waiting for him at the pharmacy.
Febles said that after giving an interview to the local NBC affiliate, he was called by the Columbia University infectious disease team, led by Dr. Jason Zucker, about receiving the antiviral tecovirimat based on the investigation. His lesions have since resolved — an effect he attributed to the antiviral drug. In an email to NBC News, Zucker confirmed that he had been prescribing the antiviral drug to people with monkeypox under what is known as an expanded access protocol developed by the CDC.
Harun Tulunay (35) also reported from the hospital last week, in his case in London. He couldn’t eat for days because of lesions in his mouth and swelling in the lymph nodes in his neck that was so bad he couldn’t swallow. His left nostril was covered with a purple-black lesion. Like Febles, he said he experienced severe pain throughout his body, which doctors treated with opioids while also giving him tecovirimate.
Tulunay, who is a training and volunteering co-ordinator at HIV not-for-profit organization Positively UK and is HIV positive, said he had heard of other Londoners with monkeypox refusing isolation. He said he hopes that by sharing his ordeal, he will help convince people to be more careful.
“I just want to make people aware,” said Tulunay, who was released from the hospital Monday after 10 days. “I had the worst three weeks of my life.”
At a press conference on Wednesday, Dr. Tedros Ghebreyesus, director-general of the World Health Organization, praised people who have spoken publicly about their experiences with monkeypox.
“This is a positive way to break the stigma about a virus that can affect anyone,” he said.
Follow NBC Out on Twitter, Facebook & Instagram.
Does the smallpox vaccine protect against monkeypox?
Because the monkeypox virus is closely related to the virus that causes measles, the measles vaccine can protect people from getting monkeypox. Data from Africa so far show that the smallpox vaccine is at least 85% effective in preventing monkeypox.
Does the measles vaccine stop monkeypox? In general, monkeypox is an extremely rare disease. Smallpox vaccines may provide protection if given before exposure; in some cases, they can prevent or alleviate severe disease if given within a certain time frame after exposure, according to the World Health Organization (WHO).
How do you protect against monkeypox?
Prevention steps
- Avoid close skin-to-skin contact with the monkeypox rash. …
- Do not touch or touch a sick person’s bedding, towels, or clothing.
- Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially after contact with sick people.
Is there a cure for human monkeypox?
There are no specific treatments for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox can be used to prevent and treat monkeypox virus infections.
How do you disinfect monkeypox?
Regularly clean and disinfect frequently touched surfaces and items, such as counters or light switches, using an EPA-registered disinfectant (such as List Q) according to the manufacturer’s instructions. Wear well-fitting source protection (eg medical mask) when in close contact with others at home.
Is monkeypox different from smallpox?
Monkeypox is a rare disease with symptoms that are similar to, but milder than, those of smallpox. Monkeypox can cause death. Monkeypox is an emerging infection in Africa and outbreaks of imported cases of monkeypox sometimes occur in other countries, including the United States.
Which disease is most confused with smallpox?
Clinically, the most common disease with a rash that can probably be confused with smallpox is varicella.
Is monkeypox chicken pox?
Monkeypox is not related to chickenpox. Monkey pox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Although it has been called “monkey pox”, the source of the disease remains unknown.
How closely related is monkeypox to smallpox?
The clinical disease closely resembles varicella or a mild case of smallpox with one major exception — there is generalized lymphadenopathy, which did not occur in varicella and is usually limited to the cervical nodes in varicella.
Is pox virus the same as smallpox?
While some smallpox viruses, such as smallpox (variola virus), no longer exist in nature, other smallpox viruses can still cause disease. Smallpox is a serious, contagious and sometimes fatal infectious disease. There is no specific treatment for smallpox, and the only prevention is vaccination.
What does the smallpox vaccine prevent?
The smallpox vaccine is the only way to prevent smallpox. The vaccine is made from a virus called vaccinia, which is another pox-type virus related to smallpox. The vaccine helps the body develop immunity to smallpox. It has been successfully used to eradicate smallpox from the human population.
Does the smallpox vaccine prevent you from getting it?
Historically, the vaccine has been effective in preventing smallpox infection in 95% of those vaccinated. In addition, the vaccine has been shown to prevent or significantly reduce infection when administered within a few days after a person has been exposed to the variola virus.
What did the smallpox vaccine replace?
Despite some opposition, vaccination soon replaced the riskier variolation and in 1853, 30 years after Jenner’s death, smallpox vaccination became standard practice for preventing smallpox. Today, people can be vaccinated against a whole host of infectious diseases, but measles is not one of them.
Who is the smallpox vaccine intended for?
When there is NO smallpox outbreak, you should get the smallpox vaccine if you are a laboratory worker who works with the virus that causes smallpox or other viruses that are similar to it. If you need long-term protection, you may need to receive regular booster shots.
Where did the 2003 outbreak of monkeypox take place?
The outbreak spanned Wisconsin, Indiana, Illinois, Ohio, Kansas and Missouri, as well as an additional case in eastern New Jersey.
Where are the outbreaks of monkeypox? Monkey pox is a zoonotic infection, caused by the monkey pox virus, which mainly occurs in West and Central Africa. Previous cases in the UK were either imported from countries where monkeypox is endemic or contacts with a documented epidemiological link to imported cases.
Where is the monkeypox from?
There are two known types (clades) of monkeypox virus — one originating in Central Africa and one originating in West Africa. The current world epidemic (2022) is caused by the less vicious West African class.
Where does monkey pox come from?
Monkey pox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Although it has been called “monkey pox”, the source of the disease remains unknown. However, African rodents and primates (such as monkeys) can carry the virus and infect humans.
When was the first monkeypox case?
Epidemiology of the disease The first human case was identified in a small child in the Democratic Republic of Congo in 1970. The monkeypox virus is transmitted from one person to another through close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.
How did the first person get monkeypox?
In humans, the disease remained confined to the rain forests of West and Central Africa until 2003, when there was an outbreak of monkeypox in the United States. All cases are linked to diseased rodents imported from Ghana. Local prairie dogs caught the infection and passed it on to their owners.
Where is monkeypox most common?
Human monkeypox was first identified in humans in 1970 in the DRC. It is called monkeypox because it was first identified in colonies of monkeys kept for research in 1958. The virus is most common in remote parts of central and western Africa.
How many cases of monkeypox are there in the world?
As of 10 June 2022, 185 cases of monkeypox have been reported from 9 non-EU/EEA countries: United Kingdom (104), United States (32), Canada (31), Switzerland (8), Mexico (4), Brazil (3) ) ), Argentina (1), Israel (1) and Venezuela (1).
How did the first person get monkeypox?
In humans, the disease remained confined to the rain forests of West and Central Africa until 2003, when there was an outbreak of monkeypox in the United States. All cases are linked to diseased rodents imported from Ghana. Local prairie dogs caught the infection and passed it on to their owners.
How common is monkeypox in the US?
Cases of monkeypox in the US are very rare. Monkeypox does not occur naturally in the United States, but cases have occurred that have been associated with international travel or the importation of animals from areas where the disease is more common.
Where do you get monkeypox from?
People can get monkeypox from animals, either through bites or scratches or by cooking game meat, according to the CDC. Exposure also occurs through close contact with bodily fluids, respiratory droplets, lesions that form during infection, or contaminated items such as clothing or bedding.
Where is the first case of monkeypox?
Monkey pox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Although it has been called “monkey pox”, the source of the disease remains unknown. However, African rodents and primates (such as monkeys) can carry the virus and infect humans.
Is monkeypox in New York City?
As of July 1, 2022, a total of 96 confirmed cases of orthopoxvirus/monkey pox – a designation established by the Centers for Disease Control and Prevention (CDC) – have been identified, of which 87 are in New York City, 5 in Westchester County, 1 in Sullivan County, 1 in Chemung County, 1 in Rockland County and 1 in Suffolk County.
Are there monkeypox in New York? “In New York State, we have seen a disproportionate number of cases of monkeypox, particularly within our LGBTQ communities who are particularly hard hit.
How many cases of monkeypox are there in the US?
| state | Number of cases |
|---|---|
| District of Columbia | 31 |
| Florida | 51 |
| Georgia | 11 |
| Hawaii | 6 |
How common is monkeypox in the US?
Cases of monkeypox in the US are very rare. Monkeypox does not occur naturally in the United States, but cases have occurred that have been associated with international travel or the importation of animals from areas where the disease is more common.
How many cases of monkey pox are there in the US?
The US reported 72 cases of monkeypox in 18 states last month, the country’s largest monkeypox outbreak ever. That total has risen significantly since early June, when only 19 cases were confirmed.
How many people are infected with monkeypox?
From 1 January to 22 June 2022, 3413 laboratory-confirmed cases and one death were reported to WHO from 50 countries/territories in five WHO regions. Since the previous news of the outbreak on June 17, 1,310 new cases have been reported, with eight new countries reporting cases.
How many cases of monkeypox are there in Texas?
News. June 30, 2022 The Texas Department of State Health Services and local health departments have identified multiple cases of monkeypox in Texas in people who have not traveled out of state. Public health testing has found a total of 12 cases of monkeypox in Texas residents.
How to get monkeypox vaccine in NYC?
There are currently no monkey pox vaccination appointments or visits available. We expect to receive more vaccine doses soon and will schedule appointments when we have them.
Is monkeypox like chicken pox?
Monkeypox is not related to chickenpox. A rash that may look like pimples or blisters that appears on the face, mouth, and other parts of the body, such as the hands, feet, chest, genitals, or anus. The rash goes through different stages before it heals completely. The illness usually lasts 2-4 weeks.
How do you contract monkeypox?
Monkeypox is spread in different ways. The virus can spread from person to person through: direct contact with an infectious rash, scabs or body fluids. respiratory secretions during prolonged face-to-face contact or during intimate physical contact, such as kissing, caressing or sex.
How do you prevent monkeypox?
Take the following steps to prevent contracting monkeypox:
- Avoid close skin-to-skin contact with the monkeypox rash. …
- Do not touch or touch a sick person’s bedding, towels, or clothing.
- Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially after contact with sick people.
Where can you catch monkeypox?
How to get monkeypox. Monkeypox can be contracted from infected rodents (such as rats, mice and squirrels) in parts of West and Central Africa. You can get monkeypox from an infected animal if you are bitten or touch its blood, body fluids, spots, blisters or scabs.
Where are the cases of monkeypox?
California has the most cases in the country, with 95, followed by New York with 90 cases. Illinois has 53 cases.
Where is monkey pox in the US?
The monkeypox virus is spreading around the world The latest cases have been confirmed in the last few days in Florida, Georgia, Pennsylvania and New York. At least two other cases, one in California and one in Illinois, are suspected, but confirmation through testing is awaited.
When was the last case of monkeypox in the United States?
On July 15, 2021, CDC and the Texas Department of State Health Services confirmed a human case of monkeypox in a US citizen who traveled from Nigeria to the United States on two commercial flights.
Where is monkeypox most common?
Anyone can get monkeypox. In Africa, most cases are among children under the age of 15. Outside of Africa, the disease appears to be more common in men who have sex with men, but there are numerous cases in people who do not fall into that category.
How many cases of monkeypox in the us right now?
The US reported 72 cases of monkeypox in 18 states last month, the country’s largest monkeypox outbreak ever. That total has risen significantly since early June, when only 19 cases were confirmed.
Where did chickenpox first emerge?
The virus that causes chickenpox does not have a well-documented history. However, there is an early appearance that can be seen as far back as the ancient Greeks. The Greeks named the disease zoster after the word for girdle.
Where did chickenpox originally come from? Abstract. Varicella zoster virus (VZV) is the causative agent of chicken pox and herpes. The geographic distribution of VZV classes was taken as evidence that VZV migrated from Africa with the human population. We have shown that existing strains of VZV most likely originate from Europe, not Africa.
When did chicken pox first appear?
There is evidence of chicken pox dating back to ancient times, with the earliest known use of the term “chicken pox” dating back to 1691 – although it is not clear how it got its name. European explorers and settlers are believed to have brought the disease to America in the 15th century.
When did chickenpox evolve?
Such analyzes show that the viruses that eventually led to varicella-zoster and its relatives existed 200 million years ago in the Triassic/Jurassic period—the age of the dinosaurs! Varicella-zoster’s closest extant relative infects Old World monkeys.
How did chickenpox first start?
The first chickenpox viruses probably appeared 70 million years ago, around the time the dinosaurs went extinct, and infected our distant ancestors – probably small furry mammals that lived in family groups in trees. Since that time, chickenpox viruses have evolved with us.
