In article <t2kmi9$3mncl$80@news.freedyn.de>
<governor.swill@gmail.com> wrote:
>
> It's a FAGGOT SPREAD DISEASE! Nothing will change that.
>

The global monkeypox outbreak is now a public health emergency
both in the US and globally, with more than 38,000 cases
currently reported across 93 countries as of August 17. Health
authorities worldwide are still struggling to get it in check:
According to the World Health Organization, cases increased by
more than 19 percent in the past week.

They�re also struggling to figure out how to talk about what it
takes to transmit the infection. During an Infectious Disease
Society of America press briefing last week, the director of a
large LGBTQ health clinic delivered what�s become a standard
talking point among health authorities: �Skin-to-skin contact is
causing transmission of this virus� in the context of sex, he
said.

He wasn�t wrong, per se: The virus does spread most readily when
one person�s skin is exposed to another�s open sores. But many
officials seem hesitant to talk in detail about the role of
penetrative sex between men � that is, body part-in-orifice sex,
like anal and oral sex � in the current outbreak.

It�s part of a larger trend of health officials across the
country being mealy-mouthed when it comes to clear risk
communication. A story in the Washington Post referenced one
state health department official who argued that �urging people
to have less sex unfairly places the onus on individuals to end
the outbreak,� which seems to minimize the options people have
for reducing their infection risk. The official also argued that
urging people to have less sex �distracts from other potential
sources of transmission, such as dancing in packed clubs.�

Similarly, a New York City health department epidemiologist
wrote of his employer�s unwillingness to publicly recommend
sexual behavior changes that �we seem paralyzed by the fear of
stigmatizing this disease.�

Many health officials� reluctance to speak frankly might be
coming from a well-intentioned place. As other journalists have
noted, some of the vague-speak may be an effort to avoid giving
ammunition to people who�d use gay and queer men�s sexual
practices to demonize same-sex sexual contact and justify
discrimination.

But unclear communication won�t stop this outbreak: People can�t
take action to keep themselves safe from infections if they
don�t know how they�re spread, and which behaviors appear most
risky according to the latest data.

Gay and bisexual men � and the health organizations run by them,
for them � have been at the forefront of offering clear
communication about monkeypox risk reduction. It�s time for
public health officials and the medical leadership who serve the
general public to do the same.

Although clinicians and scientists in sexual health are engaged
in a heated debate over whether monkeypox is a sexually
transmitted infection, this is a semantic argument, and one
that�s ultimately less important than helping people keep
themselves safe. Making clear statements about the sexual
behaviors most likely to spread monkeypox can help people across
the spectrum of anatomy and sexual orientation understand how to
protect themselves.

Let�s break it down.

Connecting the spots: Why scientists think sex is spreading
monkeypox
As more data about this outbreak comes in, scientists are
getting a clearer picture about how monkeypox infections start.

Scientists theorize that in people infected with monkeypox who
develop a rash � as the vast majority of them do � the first
spots turn up at the body site where the virus first made its
way in.

This �inoculation site� theory is in part based on the way
monkeypox infections have historically played out: For many
infected people, the first symptom is a rash localized to one
part of the skin or mucous membranes, which are the moist
linings of openings like mouths, noses, vaginas, and anuses.

Several days afterward, these rashes are frequently followed by
fever and aches. After that, a more widespread rash affecting
other skin surfaces often develops. In both the first and third
phases, the lesions of the rash are �chock-full� of virus, said
Donald Alcendor, a virologist at Meharry Medical College.

Most experts believe the inoculation-site theory to be true,
among them Chloe Orkin, an infectious disease doctor at Queen
Mary University of London whose research group conducted a study
describing 528 monkeypox cases in the United Kingdom. �We and
others have speculated that the main site of the first lesion is
likely to represent the point of inoculation,� Orkin wrote in an
email.

A caveat: Some people involved in the current outbreak have had
somewhat different experiences with monkeypox than the
inoculation-site theory would predict. In one study, a third of
cases did not report fever, and in some cases, the rash present
in the third phase of infection has been pretty mild. These
differences in the usual pattern of the disease make it harder
to pinpoint the virus�s entry point, and it�s not clear what�s
causing them.

However, cases in which the virus�s entry point can be
identified paint an emerging picture: People are first getting
infected during sex involving penises, mouths, and butts.

Most current monkeypox transmission is currently happening
during sex
Before 2019, body parts involved in sex were not front and
center in reports of monkeypox outbreaks. Then a publication
describing a Nigerian outbreak noted large numbers of patients
turning up with genital rashes. That study didn�t offer
specifics of the exact location of genital rashes � but more
recent studies have.

These studies get specific: They suggest that contact involving
men�s mouths, penises, and anuses is responsible for the lion�s
share of monkeypox spread right now.

For example, in a recent Spanish study of 181 monkeypox cases,
nearly all of whom were men, 55 percent of patients had genital
lesions, 25 percent had lesions in or near their mouths, and 36
percent of patients had rashes around the anal area. (Many
people in the study had lesions in more than one area, and were
counted in more than one category.)

Orkin�s similar study of cases in the UK found 73 percent had a
rash in the �anogenital area,� which includes both the anus and
the genitals. A US study found that 25 percent of patients had
lesions near their mouths. Across all three of these studies, 14
to 25 percent of patients have had proctitis, an extremely
painful condition in which the tissues of the rectum � the part
of the large intestine beyond the anus � get irritated and
inflamed.

Reports of symptoms involving the anus, the mouth, and other
mucous membranes have been particularly surprising, as they had
rarely been reported with monkeypox infections during past
outbreaks, said John Brooks, chief medical officer of HIV
prevention division and the monkeypox response at the Centers
for Disease Control and Prevention (CDC). �This real
concentration in the anogenital region, which is where sexual
contact occurs, and mucosal lesions � this is unusual,� he said.

Why are scientists so suspicious these rashes represent the
places on the body where patients first became infected,
implying sexual transmission? After all, the currently
circulating monkeypox virus is genetically distinct from
previous strains. Isn�t it possible one of its new features is a
predisposition to causing genital rashes after first exposure
elsewhere on the body?

They�re suspicious because of how commonly those rashes follow
sexual activity involving the place where they appear. In the
Spanish study, for example, 91 percent of people with proctitis
due to the virus said they had been on the receiving end of anal
sex, and 95 percent of people with symptoms in the mouth or
throat said they�d given oral sex.

Again, what this suggests is that contact during anal and oral
sex � potentially including �rimming,� or oral-anal sex � is
responsible for the majority of monkeypox spread right now.

Sex can spread infections fast � and more sex can spread
infections faster
The rapid spread of monkeypox seen during this outbreak is
unusual for this virus. For example, Nigeria � the country with
the highest burden of this monkeypox strain prior to the current
outbreak � reported 915 suspected and confirmed cases in total
between September 2017 and mid-June of this year. As many global
cases are now recorded each day.

But for a sexually transmitted infection within interconnected
sexual networks, where lots of people have sex with the same
people, it�s not particularly surprising. �The more sexual
partners one has, the higher the risk of exposure and
transmission,� wrote Orkin. Cases in her group�s study reported
a median of five sexual partners in the preceding three months.
Again, this suggests that the current spread is not due to any
old skin-to-skin contact, but due to sexual contact happening
between people who have multiple sex partners.