Even as Covid-19 restrictions eased, for many gay men, an uninvited guest called the monkey pox threatened to spoil the much-anticipated festivities.
Of the 6,924 confirmed monkeypox cases 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. Experts claim that skin-to-skin contact during sex has probably been the main driver of the global spread of the virus so far.
“I feel like this is something that’s going to hit pretty hard. It’s up to us to look after 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 tended to be relatively mild during this outbreak and has not caused 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 unsightly and in some cases debilitatingly painful skin lesions – and left them darkly stuck inside.
“The thought of a full three-week quarantine is pretty scary,” said John, 32, a tech worker in New York who believes he contracted monkeypox from a guy he connected with during a recent trip to Los Angeles for the city’s Pride events. . “I just feel disappointed and annoyed. It was a shame to miss the Pride celebration” in New York.
John is among a rapidly growing group of 560 Americans who have so far been diagnosed with monkeypox — a figure experts believe is a vast undercount of the true number of cases, given the woeful 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 alarmingly within their community. They also hope to combat the stigma of those who contract the virus by giving it a human face.
“I feel like this is something that’s going to hit pretty hard,” 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 they have traced the global spread of monkeypox to a gathering of homosexuals in the middle of spring in Western Europe. These parties attracted many men from other cities, some of whom then apparently carried 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 symptoms began. .
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 sexual encounters. Many had traveled for weeks before developing signs of infection.
Justin, 38, said that after returning home on May 18 from a two-week European vacation, he became the 14th person in the US and the second in New York to be diagnosed with monkeypox. He said his case started with a high 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 crept across his body.
Monkey pox usually has an incubation period of about six to 13 days, but this period of 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 a bathhouse and a sex club in the German capital.
“There are hundreds of men in this club,” Jeff said, recalling the considerable skin-to-skin contact between patrons. “Apparently, no one will 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 sex toys: “Given the risk of transmission via fomites—contaminated objects—it is theoretically possible for monkeypox to be transmitted to 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 people present, 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 remained in isolation in Seattle since being diagnosed with monkeypox during what he hoped would 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 that particular man’s penis.
Peter said gay men should be on the lookout for signs of monkeypox on their bodies and those of their sexual partners.
“Don’t be afraid to say something,” he said.
Dealing with a chaotic public health system
Many of the men with monkeypox reported extremely frustrating experiences, plagued by dead ends and delays, as they tried to get tested for the virus and worked with public health officials to provide the names of their recent close contacts. Some saw the clock run out on them or their partners as they tried to secure meager doses of the Jynneos monkeypox vaccine, which research suggests can prevent symptoms of the disease if given within four days of exposure and at least reduce symptoms if given within from five to 14 days. Using the vaccine in this way is known as post-exposure prophylaxis or PEP.
Mark Hall, 41, a nurse from New York, said he developed his first lesion on June 24 – the Friday of the city’s hit Pride weekend – but thought it was an ingrown hair and didn’t realize it was likely monkeypox until two days later, after already attending several Pride events. Despite his urgent and determined efforts that began that Sunday, he wasn’t able to get tested, get confirmation that he had the virus and finally start providing names to the health department’s contact tracer until 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% have scheduled vaccination appointments this week. But until now, much of the 14-day window for using the vaccine as PEP was 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 as of Tuesday, up from 87 on Friday.
Hall said he was horrified to learn that the city’s health department can still test 10 people a day for the orthopoxvirus, a family of viruses to which monkeypox belongs.
“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 doing 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 high throughput,” 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 starting this week we will have one commercial lab to help test demand.”
Rob Short, 29, expressed frustration that he never received a call from public health officials that he had received the PEP vaccine after attending a specific rally in Washington, D.C., in early June. He said he’s sure local health authorities consider it a spreading event, as he’s aware of other attendees who have received contact tracing warnings about it. Getting the vaccine quickly, he said, could spare 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 not 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. “Obviously people need to be isolated as long as they are contagious. That is the way to contain this virus and prevent it from taking root. But we know from many past outbreaks that punitive approaches can backfire by 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 for a virus that appears to largely require a significant amount of physical contact to transmit. (Many experts argue that if the virus does become airborne, it probably requires hours of close contact.) He said he is in regular contact with a public health official in his home state, who told him that, frankly, they’re not entirely sure whether 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 vulnerable 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 out of a sense of obligation to alert public health authorities, they encountered a system that was completely unprepared for them. With no prior experience treating patients with a virus previously rarely seen in the United States, members of the emergency department were confused about what safety protocols to follow. The men reported being rushed into isolation rooms and left alone for hours, their imaginations conjuring dystopian scenes from movies like “Contagion” or “E.T.”, while PPE-clad staff were confused about best practices.
Some men said they were sent home with misdiagnoses before finally finding a health professional to diagnose them correctly.
“Now I know what it was like to be the first HIV patient decades ago,” said Alex, 32, a biologist in Washington, D.C., who said he believes he contracted monkeypox from a gathering of several dozen OnlyFans creators where were filming sex scenes with each other. He said he heard the event likely led to at least three more cases.
Alex said when he went to a hospital in DC with “the worst pain of my 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 out loud, ‘Are you screwing me?!'” Peter recalled the nurse saying. “It was really horrible to feel that stigma, like I was this dirty patient.”
“The fact that these patients are not receiving appropriate and compassionate care shows a real need for better education and training of healthcare professionals, especially those working in sexual health clinics, emergency departments and urgent care centers,” said Dr. Céline Gounder, c. contributor and editor-in-chief for public health for Kaiser Health News. “Not knowing how to test for monkeypox is no excuse.”
Jeff, however, said he was thrilled with the non-judgmental care he received when he visited his hometown emergency room.
“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 exchanging self-care tips 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 ulcers 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 present 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 epidemic led to hospitalization, either for treatment or isolation. A recent UK study found that hospital admissions were due to 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, especially 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.”
For Hall, a lesion on his urethra makes him afraid to urinate. “It feels like 1,000 burning knives are 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. His lymph nodes in his groin swelled to the size of his fist, making it excruciating 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.”
Ultimately, Febles, who is an employee relations manager for the urgent care company MedRite, was given antibiotics and one pill of oxycodone and sent home with a topical lidocaine solution. His discharge letter, which he shared with NBC News, did not indicate a prescription for morphine was written for him. So another day passed in extreme pain 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 got a call from an infectious disease team at Columbia University, led by Dr. Jason Zucker, regarding receiving the antiviral tecovirimate based on the investigation. His lesions have since cleared up – an effect he attributed to the antiviral medication. In an email to NBC News, Zucker confirmed that he was 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 spoke last week from hospital, in his case in London. He was unable to eat for days due to lesions in his mouth and swelling in the lymph nodes in his neck that was so intense that he could not swallow. His left nostril was covered with a purple-black lesion. Like Febles, he said he was experiencing extreme pain throughout his body, which doctors treated with opioids, including tecavirimat.
Tulunay, who is a training and volunteer co-ordinator at HIV not-for-profit organization Positively UK and is HIV positive, said he had heard of other Londoners with monkeypox refusing to self-isolate. He said he hopes that by sharing his ordeal, it will help convince people to be more careful.
“I just want to bring people to their senses,” said Tulunay, who was released from 10 days in the hospital on Monday. “I had the worst three weeks of my life.”
At the press conference on Wednesday, dr. Tedros Ghebreyesus, director-general of the World Health Organization, praised people who spoke about their experiences with monkeypox.
“This is a positive way to break the stigma about a virus that can affect anyone,” he said.
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What caused the foot and mouth outbreak?
Likely source. The consensus is that the FMD virus came from infected or contaminated meat that was part of the sewage that was fed to pigs at Burnside Farm in Heddon-on-the-Wall. The olive was not properly heat sterilized and the virus was therefore allowed to infect the pigs.
When did paw and mouth start? Cases of HFMD were first clinically described in Canada and New Zealand in 1957. The disease was named “hand and foot disease” by Thomas Henry Flewett after a similar outbreak in 1960.
What is the main cause of hand foot and mouth disease?
Viruses that cause hand, foot and mouth disease Hand, foot and mouth disease is caused by viruses belonging to the Enterovirus family. Common causes of hand, foot, and mouth disease are: Coxsackievirus A16 is typically the most common cause of hand, foot, and mouth disease in the United States.
What causes hand foot and mouth disease in adults?
HFMD is caused by a contagious virus that can be passed from one person to another through secretions from the nose and throat, including saliva or mucus, blister fluid, or feces. You can also be exposed to the virus: if you have close personal contact with an infected person.
Where does hand foot mouth disease come from?
Hand, foot and mouth disease (HFMD) is a highly contagious infection. It is caused by viruses from the genus Enterovirus, most often the Coxsackie virus. These viruses can spread from person to person through direct contact with unwashed hands or surfaces contaminated with feces.
How do you catch hand foot and mouth?
Hand, foot and mouth disease is easily transmitted to other people. It is spread by coughing, sneezing, faeces and blister fluid. You can start spreading it a few days before you have any symptoms, but you are most likely to spread it to others in the first 5 days after symptoms appear.
Is hand foot and mouth caused by poor hygiene?
Observational studies have strongly shown an association between poor hand hygiene and HFMD.
What causes foot-and-mouth disease in cattle?
FMD is caused by a virus. The virus survives in living tissue and in the breath, saliva, urine and other secretions of infected animals. It can also survive in contaminated materials and the environment for several months under the right conditions. 7 types and more than 60 subtypes of the FMD virus are known.
How contagious is foot, and mouth disease in cattle?
Foot-and-mouth disease (FMD) is a highly contagious viral disease of livestock that causes fever followed by the development of vesicles (blisters) mainly in the mouth and feet. FMD is generally not fatal to adult animals, but it can kill young animals and cause serious production losses.
How do you prevent foot and mouth in cattle?
Preventing the introduction and spread of FMD
- keep everything clean – materials such as mud or bedding on clothing, boot equipment or vehicles can spread the virus from farm to farm or between different groups of livestock on a farm.
- do not wear work clothes to sales or exhibitions.
How do cattle get foot, and mouth disease?
Foot-and-mouth disease is one of the most contagious viruses and is spread by discharge from blisters and saliva of infected animals. Animals can become infected through contact with an infected animal, contaminated animal parts, or contaminated objects, such as farm equipment.
What virus causes hoof and mouth disease in cattle?
Abstract. Foot-and-mouth disease virus (FMDV) is a picornavirus that causes acute vesicular disease of ungulates. This virus continues to pose a threat to livestock worldwide with outbreaks causing severe economic losses.
How do humans get foot-and-mouth disease?
Hand, foot and mouth disease is easily transmitted to other people. It is spread by coughing, sneezing, faeces and blister fluid. You can start spreading it a few days before you have any symptoms, but you are most likely to spread it to others in the first 5 days after symptoms appear.
How do adults get hand, foot and mouth disease?
HFMD is caused by a contagious virus that can be passed from one person to another through secretions from the nose and throat, including saliva or mucus, blister fluid, or feces. You can also be exposed to the virus: if you have close personal contact with an infected person.
Can humans transmit foot and mouth disease?
No person-to-person transmission has been reported in humans. The incubation period in humans is two to six days. Symptoms are generally mild and self-limiting, including burning blisters on the hands, feet and mouth, sore throat and fever. Recovery usually occurs within a week of the last blisters forming.
What agent causes hand, foot and mouth disease?
CAUSE OF INFECTION In the United States, coxsackievirus A16 is an important cause of hand, foot, and mouth disease (HFMD). More recently, coxsackievirus A6 has been implicated as the cause of outbreaks and sporadic cases in the United States and internationally.
How is monkeypox prevented?
Monkey pox
- Avoid close physical contact with sick people.
- Do not kiss, hug or share cutlery or cups with others.
- Wash your hands often with soap and water.
- Keep your hands away from your eyes, nose and mouth.
How does a person get infected with 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.
Is there an antidote for monkeypox?
There is currently no specific treatment approved for monkeypox infection.
Can you survive monkeypox?
Monkey pox is usually mild and most people recover within a few weeks without treatment. But as the infection can spread through close contact, it’s important to isolate yourself if you’ve been diagnosed. You may be asked to self-isolate at home if your symptoms are mild.
What does monkeypox do to humans?
Monkeypox is a rare smallpox-like disease caused by the monkeypox virus. It is found mainly in areas of Africa, but has also been seen in other parts of the world. It causes flu-like symptoms such as fever and chills, as well as a rash that may take several weeks to clear up.
What is the cure for monkeypox?
There are no specific treatments for monkeypox virus infections. However, the monkeypox and measles viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against measles can be used to prevent and treat monkeypox virus infections.
How long does it take to get over monkeypox?
Monkeypox is not related to chickenpox. A rash that may look like pimples or blisters that appears on the face, inside the mouth, and on 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 I get rid of monkeypox?
There are no specific treatments for monkeypox virus infections. However, the monkeypox and measles viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against measles can be used to prevent and treat monkeypox virus infections.
Can you survive monkeypox?
Monkey pox is usually mild and most people recover within a few weeks without treatment. But as the infection can spread through close contact, it’s important to isolate yourself if you’ve been diagnosed. You may be asked to self-isolate at home if your symptoms are mild.
Do the bumps from monkeypox go away?
Monkey pox causes fever, headache, body aches, swollen lymph nodes and a rash. The rash starts as flat spots that turn into bumps, which then fill with fluid. The bumps crust over and fall off as they heal. Some people develop spots that look like pimples or blisters before they have any other symptoms.
How long does it take to get rid of monkeypox?
Monkey pox is usually mild and clears up within 2 to 4 weeks. The rash goes through several stages, ending with pustules that crust over and fall off. Treatment is aimed at relieving symptoms with simple painkillers and staying hydrated.
What animal causes 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.
What types of animals transmit monkeypox? Various animal species have been identified as susceptible to monkeypox virus. This includes chipmunks, tree squirrels, Gambian pouch rats, puffins, non-human primates, and other species.
How did the first human get 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 non-human primates (such as monkeys) can carry the virus and infect humans.
Is smallpox related to monkeypox?
Monkeypox is closely related to smallpox. Both are in the same virus family. The smallpox infection – or smallpox vaccine – offers really good protection against smallpox as well as monkeypox. Perhaps about 85% protection, one study estimated.
Where does monkey pox come from?
Well, for one thing, monkeypox does not come from monkeys. It is called monkeypox because it was first isolated from monkeys in Africa, but the reservoir for it is rodents, especially rodents in central and western Africa.
How did monkeypox get to humans?
Monkey pox was discovered in 1958 when two outbreaks of a pox-like disease occurred in groups of monkeys used for research. It is spread mainly through human contact with infected rodents, but can sometimes be transmitted through skin-to-skin contact with an infected person.
Where does monkeypox virus come from?
The final source of infection was determined to be imported Gambian rats that transmitted the infection to prairie dogs. There were no human deaths, although three children experienced serious illness.
How do monkeypox start?
Monkey pox causes fever, headache, body aches, swollen lymph nodes and a rash. The rash starts as flat spots that turn into bumps, which then fill with fluid. The bumps crust over and fall off as they heal. Some people develop spots that look like pimples or blisters before they have any other symptoms.
What causes monkeypox virus?
Although it has been called “monkey pox”, the source of the disease remains unknown. However, African rodents and non-human primates (such as monkeys) can carry the virus and infect humans. The first case of monkeypox in humans was recorded in 1970.
What animals Can you get monkeypox from?
Monkeypox virus can infect a wide range of mammalian species, including monkeys, anteaters, hedgehogs, prairie dogs, squirrels and shrews. We are still learning what types of animals can get monkeypox.
How did monkeypox get to humans?
Monkey pox was discovered in 1958 when two outbreaks of a pox-like disease occurred in groups of monkeys used for research. It is spread mainly through human contact with infected rodents, but can sometimes be transmitted through skin-to-skin contact with an infected person.
What does monkeypox do to the body?
A rash that may look like pimples or blisters that appears on the face, inside the mouth, and on 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.
What does monkeypox do to the body? Monkeypox is a rare smallpox-like disease caused by the monkeypox virus. It is found mainly in areas of Africa, but has also been seen in other parts of the world. It causes flu-like symptoms such as fever and chills, as well as a rash that may take several weeks to clear up.
Can monkeypox be treated?
There are no specific treatments for monkeypox virus infections. However, the monkeypox and measles viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against measles can be used to prevent and treat monkeypox virus infections.
How long does it take to get rid of monkeypox?
Monkey pox is usually mild and clears up within 2 to 4 weeks. The rash goes through several stages, ending with pustules that crust over and fall off. Treatment is aimed at relieving symptoms with simple painkillers and staying hydrated.
What happens when you get monkeypox?
A rash that may look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, such as the hands, feet, chest, genitals, or anus.
How do humans get monkeypox?
Monkeypox does not spread easily between people. Human-to-human transmission occurs through close contact with infectious material from the skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through fomites.
Can you survive monkeypox?
Monkey pox is usually mild and most people recover within a few weeks without treatment. But as the infection can spread through close contact, it’s important to isolate yourself if you’ve been diagnosed. You may be asked to self-isolate at home if your symptoms are mild.
How did monkeypox get to humans?
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 non-human primates (such as monkeys) can carry the virus and infect humans.
Where does monkeypox virus come from?
The final source of infection was determined to be imported Gambian rats that transmitted the infection to prairie dogs. There were no human deaths, although three children experienced serious illness.
Does monkeypox cause death?
According to the CDC, 1 out of every 10 cases of monkeypox will result in death. Severe cases are more likely to cause death. Risk factors for severe cases include: being younger.
Can you survive monkeypox?
Monkey pox is usually mild and most people recover within a few weeks without treatment. But as the infection can spread through close contact, it’s important to isolate yourself if you’ve been diagnosed. You may be asked to self-isolate at home if your symptoms are mild.
Is monkeypox fatal in humans?
Monkeypox can occasionally be fatal, especially in poor places with inadequate health care, and is closely related to smallpox, which has plagued humans for millennia.
