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Spain without the S: Man has tests positive to Covid, HIV and Monkeypox all at once

<p>A 36-year-old Italian man has simultaneously tested positive to COVID, HIV and monkeypox making this a world first event.</p> <p>The triple co-infection was recorded after the man holidayed for a week in Spain. Nine days following his trip, he developed a fever, rash and as subsequent testing went on it was evident he was in for a wild ride.</p> <p>The man spent five days in Spain from June 16-20 and enjoyed his holiday to the fullest, seemingly engaging in unprotected sex with other men during that time.</p> <p>Upon returning to Italy, he developed a 39C fever, sore throat, fatigue and headache. The party-goer tested positive to COVID on July 2, and the same afternoon began to develop a rash on his left arm.</p> <p>On July 3 small, painful blisters appeared on his torso, lower limbs, face and other parts of the body.</p> <p>“On physical examination his body was dotted, including the palm of the right hand and the perianal region, with skin lesions in various stages of progression,” the report said.</p> <p>The blisters spread all over the body until July 5, evolving into umbilicated pustules, before he was moved to the emergency department and then to the Infectious Diseases unit at a hospital in Catania.</p> <p>This was when he tested positive to monkeypox.</p> <p>“Complete STI screening is recommended after a diagnosis of monkeypox,” the report said.</p> <p>The STI screening found he also tested positive for HIV, given this diagnosis was not the patient's first brush with an STI. Previous reports noted: “On admission, the patient reported being treated for syphilis in 2019.”</p> <p>“This case highlights how monkeypox and COVID symptoms may overlap, and corroborates how in case of co-infection, anamnestic collection and sexual habits are crucial to perform the correct diagnosis,” the report said.</p> <p>“As this is the only reported case of monkeypox virus, SARS-CoV-2 and HIV co-infection, there is still not enough evidence supporting that this combination may aggravate patient’s condition.”</p> <p>The patient was treated and discharged to home isolation on July 11 as his symptoms resolved. He returned for a checkup on July 19, still testing positive with monkeypox but with the lesions having slowly improved, he is now to begin HIV treatment.</p> <p><em>Image: Getty</em></p>

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First local monkeypox case recorded in NSW

<p dir="ltr">The first case of locally-acquired monkeypox has been recorded in New South Wales, with authorities confirming that 42 people have been infected with the virus to date.</p> <p dir="ltr">Although most contracted monkeypox overseas, two people were infected in other parts of Australia.</p> <p dir="ltr">The announcement, made by NSW Health on Sunday, comes as a first for NSW a week after the JYNNEOS vaccination program was launched for those most at risk from the virus.</p> <p dir="ltr">“NSW Health is urging the community, particularly gay, bisexual and other men who have sex with men (GBMSM), to continue to be vigilant for the symptoms of monkeypox following local transmission of the virus in NSW,” NSW Health said.</p> <p dir="ltr">Symptoms - which include a rash or lesions around the genital area, headache, body aches and fever - commonly appear between seven to 14 days after prolonged skin-to-skin contact with an infected person.</p> <p dir="ltr">Illness generally lasts for two to four weeks, with most experiencing mild symptoms that can be lessened with regular over-the-counter pain medicines and oral fluids and monitored by their GP, according to <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/monkeypox.aspx" target="_blank" rel="noopener">NSW Health</a>. For those with severe illness, antiviral medications are also available.</p> <p dir="ltr">“It is important that people with these symptoms avoid close contact with others, including sexual activity, as condoms are not effective at preventing the transmission of monkeypox,” NSW Health Executive Director of Health Protection Richard Broome said in a <a href="https://www.health.nsw.gov.au/news/Pages/20220821_00.aspx" target="_blank" rel="noopener">statement</a>.</p> <p dir="ltr">NSW Health also warns that monkeypox can also be transmitted by respiratory droplets during the initial infectious period and from contact with contaminated clothing, linen and other items.</p> <p dir="ltr">The news comes after Victorian authorities reported monkeypox was spreading in Melbourne last week, which was the first widespread example of local transmission in Australia since the global outbreak began.</p> <p dir="ltr">Prior to the 2022 outbreak, cases of monkeypox have mostly been reported in Central and Western African countries, with the <a href="https://doi.org/10.1136/bmjgh-2022-009838" target="_blank" rel="noopener">first human case reported</a> in the Democratic Republic of Congo in 1970.</p> <p><span id="docs-internal-guid-15cbbb5d-7fff-9dfb-3b85-b2a7d35bfde2">According to the <a href="https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html" target="_blank" rel="noopener">CDC</a>, 41,358 confirmed cases of monkeypox have been recorded as of publication, with 40,971 reported in locations without any historical cases of the virus, with a total of 89 in Australia and four in New Zealand.</span></p> <p><em>Image: Getty Images</em></p>

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Poxy McPoxface, TRUMP-22, Mpox: Public called on to rename monkeypox virus

<p>The World Health Organisation has called on the expertise of the public to help them rename the monkeypox virus after claiming the name is "misleading".</p> <p>Names for viruses are usually chosen by a committee behind closed doors, but the WHO has decided to open up the process to allow submissions from all over the world. </p> <p>Names such as Poxy McPoxface, TRUMP-22 or Mpox have been put forward so far, prompting the WHO to say they will choosing a serious name. </p> <p>WHO spokesperson Fadela Chaib said, "I am sure we will not come up with a ridiculous name."</p> <p>Dozens of submissions have now been made from a range of contributors including academics, doctors, and a gay community activist.</p> <p>One more technical submission came from Harvard Medical School emergency physician Jeremy Faust, who said the virus should simply be called OPOXID-22.</p> <p>Another proposal, TRUMP-22, appeared to be refer to former US President Donald Trump who used the controversial term "Chinese virus" for the new coronavirus, although its author said it stood for "Toxic Rash of Unrecognized Mysterious Provenance of 2022".</p> <p>Pressure is growing for a new name for the disease, largely because critics say it is misleading, since the virus did not originate in monkeys. </p> <p>A group of leading scientists wrote a position paper in June calling for a name that was "neutral, non-discriminatory and non-stigmatizing" amid fears the name can be used in a racist way.</p> <p>"It's very important we find a new name for monkeypox because this is best practice not to create any offence to an ethical group, a region, a country, an animal etc," Miss Chaib said.</p> <p>"The WHO is very concerned by this issue and we want to find a name that is not stigmatising," she added without giving a timeline of when the new name may be decided. </p> <p>Monkeypox was first discovered in 1958 and named after the first animal to show symptoms.</p> <p>The WHO declared the current outbreak a public health emergency in July having reported more than 32,000 cases from over 80 countries.</p> <p><em>Image credits: Getty Images</em></p>

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We need to talk about monkeypox without shame and blame

<p>The recent global outbreak of <a href="https://www.health.gov.au/diseases/monkeypox-mpx">monkeypox</a> largely among <a href="https://www.npr.org/2022/07/26/1113713684/monkeypox-stigma-gay-community">men who have sex with men</a> has raised concerns homophobia will undermine effective prevention efforts. There are also fears the disease will fuel homophobic stigma and discrimination.</p> <p>Even the name monkeypox <a href="https://theconversation.com/whats-in-a-name-why-giving-monkeypox-a-new-one-is-a-good-idea-185307">is stigmatising</a> due to long-held <a href="https://www.npr.org/sections/goatsandsoda/2022/08/01/1113908154/critics-say-monkeypox-is-a-racist-name-but-its-not-going-away-anytime-soon">racist appropriation of the term monkey</a> and the false implication the virus is transmitted by monkeys.</p> <p>The <a href="https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-covid-19-media-briefing--14-june-2022">World Health Organization</a> has said the name needs to change, but has not agreed on or announced a new one. Currently, <a href="https://www.aconhealth.org.au/monkeypox">advocates for the LGBTQA+ community</a> are using the term MPX, the term I will use here.</p> <p>MPX is, of course, not the first infectious disease to affect men who have sex with men. So there are things we must learn and things we must not repeat from the public health response to HIV.</p> <h2>Lessons from HIV</h2> <p>When HIV emerged among communities of gay and bisexual men in the 1980s, fear and uncertainty about the cause and nature of the virus led to <a href="https://theconversation.com/lessons-from-the-history-of-hiv-aids-in-australia-how-activism-changed-the-image-of-an-illness-4052">vilification of gay and bisexual men</a>.</p> <p>HIV was initially named “<a href="https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.2021.306348">gay-related immune deficiency</a>” or GRID and there was speculation it was caused by men’s excessive sex or drug use (specifically use of <a href="https://theconversation.com/weekly-dose-amyl-started-as-a-poison-antidote-now-a-common-party-drug-64610">amyl nitrate</a>).</p> <p>As well as sparking calls for a crackdown on the rights and freedoms of LGBTQA+ communities, the view gay and bisexual men were to blame for HIV obstructed effective public health responses.</p> <p>Famously, in the United States, then President Ronald Reagan <a href="https://www.nbcnews.com/feature/nbc-out/lgbtq-history-month-early-days-america-s-aids-crisis-n919701">made no public mention of HIV or AIDS</a> until more than 12,000 American citizens had died, and HIV had spread widely into many communities.</p> <p>Although today, globally, <a href="https://www.unaids.org/en/resources/fact-sheet">HIV affects more women</a> than men, it is still difficult to disentangle <a href="https://www.unaids.org/en/resources/presscentre/featurestories/2012/august/20120828punitivelaws">HIV-related stigma from homophobia</a> or stigma against other affected populations, including injecting drug users or sex workers.</p> <p><a href="https://theconversation.com/charlie-sheen-and-ten-million-dollars-worth-of-hiv-stigma-50909">Stigma creates barriers</a> to HIV prevention as people are reluctant to talk about HIV or <a href="https://doi.org/10.1186/s12889-018-6156-4">seek testing</a> for fear of being associated with stigmatised groups. It also perpetuates a fundamental lack of empathy for people living with HIV.</p> <p>For these reasons, it’s important we don’t approach MPX in these terms.</p> <h2>A new approach?</h2> <p>There are <a href="https://www.latimes.com/california/story/2022-07-21/monkeypox-government-response-we-can-do-better">some reports</a> of MPX being used to justify homophobic sentiment or actions. However, a crucial difference between this disease and HIV is <a href="https://www.scientificamerican.com/article/blaming-gay-men-for-monkeypox-will-harm-everyone/">the world has learned</a> from HIV.</p> <p>There is now better understanding of the insidious ways <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30127-3/fulltext">stigma and discrimination undermine public health</a>. HIV also taught us to be cautious about the potential for public health messaging to contribute to stigma, especially when an illness is associated with <a href="https://www.nihr.ac.uk/blog/the-perfect-storm-how-covid-19-public-health-messages-may-not-serve-ethnic-minority-communities/30257">marginalised cultural or racial groups</a>.</p> <p>Health policy makers have been <a href="https://www.theguardian.com/world/2022/may/23/un-denounces-homophobic-and-racist-reporting-on-monkeypox-spread">fast to condemn</a> stigmatising media reporting of MPX. Meanwhile the community-based HIV sector has mobilised existing infrastructure and experience to support <a href="https://www.acon.org.au/">advocacy and MPX education</a> for men who have sex with men.</p> <p>Importantly, we now have better knowledge about the effectiveness of <a href="https://pubmed.ncbi.nlm.nih.gov/31210141/">sex-positive approaches</a> to preventing HIV and other sexually transmissible infections (STIs). <a href="https://doi.org/10.1080/26410397.2019.1593787">Such approaches</a> affirm the pleasures and benefits of sex, aim to build open dialogue about safe sex and ensure people can seek testing without fear of judgement or backlash.</p> <h2>The impact of sexual moralising</h2> <p>We have learned lessons from HIV. However, MPX has exposed the ways sexual moralising is ever-present in public health, undermining sex-positive health promotion.</p> <p>Observers of early media responses to MPX note efforts to avoid stigmatising gay and bisexual men have <a href="https://www.theguardian.com/commentisfree/2022/jun/23/monkeypox-outbreak-public-information-virus-homophobia">led to obtuse and confusing reporting</a> about the ways in which the disease, <a href="https://theconversation.com/how-does-monkeypox-spread-an-epidemiologist-explains-why-it-isnt-an-sti-and-what-counts-as-close-contact-188130">although not classified as an STI</a>, can be spread through close physical contact and why gay and bisexual men may be at risk of exposure.</p> <p> </p> <p>Reporting has been deliberately vague because there is very limited cultural space for speaking about group sex, casual sex or sex with multiple partners without these practices, and people involved, <a href="https://www.nytimes.com/2022/08/04/opinion/monkeypox-communication.html">being shamed</a>.</p> <p>Despite increasing acceptance of sexual diversity, people’s <a href="https://www.ippf.org/sites/default/files/2016-10/Putting%20Sexuality%20back%20into%20Comprehensive%20Sexuality%20Education_0.pdf">right to engage in pleasurable sex</a> outside a married, monogamous relationship is rarely affirmed. Young women, for example, are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296320/">shamed</a> for having “too many” sexual partners, while calls for comprehensive, <a href="https://theconversation.com/sex-ed-needs-to-talk-about-pleasure-and-fun-safe-sex-depends-on-it-and-condom-use-rises-176572">pleasure-based sex education</a> are controversial.</p> <p>While the world has come a long way toward acceptance of same-sex marriage, homophobia often drives condemnation of gay and bisexual men’s sexual cultures.</p> <p>This is most visible in relation to public health. For example, when pre-exposure prophylaxis (PrEP) first became available to prevent HIV, public funding for it <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566537">was critiqued</a> by some on the grounds this amounted to subsidising gay and bisexual men’s <a href="https://blogs.bmj.com/medical-ethics/2016/10/08/sex-and-other-sins-public-morality-public-health-and-funding-prep/">promiscuity</a>.</p> <p>When considered through the lens of public health, casual sex is <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-9566.2012.01475.x">often equated with irresponsibility</a>. People’s right to seek sex and intimacy can also be devalued or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6951379/">seen as irrelevant</a>.</p> <p>We know, however, <a href="https://www.who.int/news/item/11-02-2022-redefining-sexual-health-for-benefits-throughout-life">acknowledging the significance</a> of sexual identities and sexual connection in people’s lives is the best way to engage communities in sexual health promotion.</p> <h2>A sex-positive approach</h2> <p>As current vaccine supplies for MPX are limited in many jurisdictions, including Australia, <a href="https://theconversation.com/australia-secures-450-000-new-monkeypox-vaccines-what-are-they-and-who-can-have-them-187691">priority access is being given</a> to high-risk groups, including men who have sex with men who have multiple sexual partners.</p> <p>Given men are being asked to disclose their sexual practices to obtain a vaccine, assurance of non-stigmatising health care will be essential for this program to be successful.</p> <p>A sex-positive approach to MPX prevention will also support more open conversations so people can gain a better handle on risk and prevention, no matter who they are.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/188295/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/jennifer-power-4215">Jennifer Power</a>, Associate Professor and Principal Research Fellow at the Australian Research Centre in Sex, Health and Society, <em><a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-need-to-talk-about-monkeypox-without-shame-and-blame-188295">original article</a>.</p> <p><em>Image: Getty</em></p>

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“Scary and painful”: Monkeypox survivors recall their experiences

<p dir="ltr">Before suffering full-body chills, a fever and other intense flu-like symptoms, the first sign that Matt Ford had come down with monkeypox were several spots on his body.</p> <p dir="ltr">The US man noticed the lesions after receiving a call from a friend who he’d had skin-to-skin contact with in June.</p> <p dir="ltr">“Right after the call, I checked myself and noticed some lesions I hadn’t seen before,” the 30-year-old told <em><a href="https://7news.com.au/lifestyle/human-interest/excruciating-lesions-and-a-40c-fever-i-had-monkeypox-and-this-is-what-its-like-c-7670514" target="_blank" rel="noopener">7News.com.au</a></em>.</p> <p dir="ltr">The next few days saw him experience flu-like symptoms, including a fever, chills, sweats and fatigue.</p> <p dir="ltr">After those symptoms lessened, the number of lesions increased, with Ford counting 25 in total across his body, including his face, feet and scalp.</p> <p dir="ltr">The lesions quickly became itchy and painful, interfering with his sleep and resulting in him needing narcotics to fall asleep.</p> <p dir="ltr">“I don’t think many people fully understand just how painful it can be, especially if lesions appear in the perianal or genital areas,” he said.</p> <p><span id="docs-internal-guid-f2b9fab0-7fff-8481-c059-b9b775472214"></span></p> <p dir="ltr">“(The pain) was at least an eight or nine out of 10.”</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">I have monkeypox currently and this shit is absolutely no joke.</p> <p>If you’re in New York and can get the vaccine, go do it.</p> <p>— Matt Ford (@JMatthiasFord) <a href="https://twitter.com/JMatthiasFord/status/1540049980253016064?ref_src=twsrc%5Etfw">June 23, 2022</a></p></blockquote> <p dir="ltr">Under local rules, Ford was required to isolate until “all lesions have resolved, the scabs have fallen off, and a fresh layer of intact skin has formed”, ensuring he was no longer contagious.</p> <p dir="ltr">In total, he stayed home for three weeks and was “grateful” for his support network.</p> <p dir="ltr">“It was pretty brutal towards the end of it, and I felt pretty stir crazy,” he recalled.</p> <p dir="ltr">“But I’m grateful to have had a strong support network checking in on me and sending care packages.”</p> <p dir="ltr">For UK man Harun Tulunay, catching monkeypox came with a slightly different experience.</p> <p dir="ltr">The 35-year-old primarily experienced flu-like symptoms, such as a fever of 40 C, swollen glands, a white and red rash, pain and chills.</p> <p dir="ltr">Ten days in, Tulunay had been hospitalised and finally received a diagnosis when he noticed a lesion on his nose.</p> <p dir="ltr">Though painful lesions in his throat made him unable to swallow, Tulunay said most didn’t cause him grief.</p> <p dir="ltr">“I had (lesions) on my back, in my hair, on my feet, on my hands, my legs,” he told <em>7News.com.au</em>.</p> <p dir="ltr">“My whole throat was all covered in painful lesions.</p> <p dir="ltr">“It was the most scary and painful June of my 35 years of life.”</p> <p dir="ltr">After about 35 days, Tulunay’s symptoms had all cleared up.</p> <p dir="ltr">“You really don’t expect it can happen to you until it happens to you,” he said.</p> <p dir="ltr">Ford and Tulunay’s experiences come as Australia’s Chief Medical Officer, Paul Kelly, declared monkeypox a communicable disease of national significance, with most cases occurring among people aged between 21 and 40 years old.</p> <p dir="ltr">“Although monkeypox is not usually considered a sexually transmissible infection, physical contact with an infected person during sexual intercourse carries a significant risk of transmission,” Kelly said.</p> <p dir="ltr">“Intimate physical contact such as hugging, kissing and sexual activities represent a risk of infection, with infectious skin sores being the likely mode of transmission.”</p> <p dir="ltr">The World Health Organisation has also declared monkeypox a public health emergency, with more than 20,000 cases recorded across 71 countries since January.</p> <p><em>Image: Supplied</em></p>

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Subway Monkeypox case "really concerning"

<p dir="ltr">A photo of a man who very clearly had Monkeypox and is standing in close proximity to others has gone viral. </p> <p dir="ltr">The image was shared to <a href="https://mobile.twitter.com/arturohenriques/status/1553322937402507264" target="_blank" rel="noopener">Twitter</a> by a Spanish doctor Arturo Henriques who “cautiously” approached the man and questioned why he was not isolating if he had Monkeypox.</p> <p dir="ltr">He said the man was only told to wear a mask by his doctor and nothing else to which Dr Henriques tried to explain that lesions on the body were most contagious. </p> <p dir="ltr">Dr Henriques then asked a nearby passenger if she was worried about catching Monkeypox which she laughed off saying she wasn’t gay and straight people don’t need to be concerned. </p> <p dir="ltr">This prompted a response from Paul Griffin, Director of Infectious Diseases at Mater Health Services, Associate Professor of Medicine at the University of Queensland.</p> <p dir="ltr">Professor Griffin said it was “really concerning” to see people not taking the disease seriously and need to isolate if they have it. </p> <p dir="ltr">"It's really disappointing, isn't it? I mean, it's actually really concerning," he told <a href="https://au.news.yahoo.com/disturbing-monkeypox-photo-train-warning-virus-myth-005219552.html" target="_blank" rel="noopener">Yahoo News Australia</a>.</p> <p dir="ltr">"But if people don't take that seriously and don't isolate themselves, well, that can certainly facilitate the spread and make something that we should be able to control much more challenging.</p> <p dir="ltr">"While it's really important, we identify who is at greatest risk and we try and modify that risk by approaching those groups and giving them the right advice, we need to be really careful that we don't be discriminatory or stigmatising.”</p> <p dir="ltr">Monkeypox spreads through close skin-to-skin physical contact with someone who has symptoms, such as when you are having sex, or by direct contact with contaminated objects, such as bedding, towels or clothes.</p> <p dir="ltr">​​Many of the cases are in men who have sex with men and have been acquired overseas.</p> <p dir="ltr">Some of the symptoms include: rashes, lesions or sores, particularly in areas that are hard to see such as the genitals, anus or anal area or on the face, arms and legs, ulcers, lesions or sores in the mouth, fever, headache, muscle aches, backache, swollen lymph nodes, chills and/or exhaustion.</p> <p dir="ltr"><em>Image: Twitter</em></p>

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