As monkeypox spreads, a campaign to warn the public gains urgency in the US

Monkeypox can infect anyone, regardless of gender, age or sexual orientation. PHOTO: AFP

NEW YORK (NYTIMES) - As hundreds of thousands of people gather in New York City and elsewhere to celebrate Pride this month, city and federal officials, health advocates and party organisers are rushing to disseminate an increasingly urgent health warning about the risk of monkeypox.

"Be aware, but don't panic," said Mr Jason Cianciotto, the vice-president of communications and policy at the Gay Men's Health Crisis, summing up the message the group is trying to convey.

The virus, long endemic in parts of Africa, is now transmitting globally, and, while it can infect anyone, at the moment it is spreading primarily through networks of men who have sex with men, officials say.

Since May 13, when the first case in the outbreak was reported in Europe, more than 2,000 people in 35 countries outside Africa have been diagnosed with the virus.

As of Wednesday, there were 16 cases identified in New York City, among 84 around the country. The most recent New York cases are not linked to travel, suggesting person-to-person transmission is taking place in New York City, the city health department said.

While the raw numbers are still low, public health researchers are concerned because of the level of global transmission and because cases are cropping up without clear links to one another, suggesting broader spread.

The World Health Organisation will be meeting next week to determine if monkeypox now qualifies as a global health emergency.

Monkeypox, so named because it was first discovered by European researchers in captive monkeys in 1958, can infect anyone, regardless of gender, age or sexual orientation.

While it mostly spreads through direct contact with lesions, it can also be spread via shared objects such as towels, as well as by droplets emitted when speaking, coughing or sneezing.

Scientists believe it may also be transmitted through tiny aerosol particles, though that would probably require a long period of close contact. The virus, in general, is much less contagious than Covid-19.

Monkeypox has caused at least 72 deaths this year within African nations where the virus is endemic, said WHO director-general Tedros Adhanom Ghebreyesus on Tuesday. But no other deaths have been linked definitively to the global outbreak outside Africa.

The first 10 cases in New York were all detected in men between ages 27 and 50, and most have identified as men who have sex with men, following the global pattern, according to the city Health Department.

Most of the New York cases have resulted in mild symptoms, officials said, but even mild cases can involve an itchy and painful rash, lasting for two to four weeks.

Public awareness about the outbreak, which would lead to more demand for tests, is still at an early stage, and the virus sometimes causes only a few lesions in the genital area, which can make it difficult to differentiate from other sexually transmitted diseases.

The virus, in general, is much less contagious than Covid-19. PHOTO: NYTIMES

Two vaccines, as well as antivirals, are available, though for now vaccines are primarily being offered in the United States to close contacts of identified or suspected cases.

Pride celebrations are the perfect time to increase awareness among people in the LGBTQ community who are most at risk, health officials said in interviews, but also create a challenge for those seeking to get out a message about protecting the community without creating alarm or stigma. More broadly, organisers and health officials do not want to put a damper on Pride celebrations and their positive messages about sexual identity.

Working with advocates and partners in the LGBTQ community, federal and local health officials have in recent weeks begun to craft social media posts, write fact sheets and post images of what the pox look like to help people know what to look for.

Pride gatherings also are coming at a crucial time, when there is still a chance that aggressive public health actions could keep monkeypox under control, but increased contact during the celebrations might create additional disease spread, particularly if people are not educated about the virus.

"We need everybody to step up their game, because if we're going to contain it, we need a real ramping-up of efforts across the board," said Dr Gregg Gonsalves, a longtime Aids activist and public health researcher at the Yale School of Public Health.

"We're walking the line between containment and persistent spread, and containment would be better."

Health officials' focus for now is to provide information about how the disease transmits - primarily through skin-to-skin contact - and to urge people to seek care if they have a rash or feel unwell. While the messages are targeted particularly to the gay and bisexual community, public health officials also stress that anyone can get infected.

All aspects of the monkeypox response - from education to identification of cases to isolating those infected - should be ramped up, said Dr Carlos Del Rio, chair of the Department of Global Health at the Rollins School of Public Health at Emory University and the incoming president of the Infectious Disease Society of America.

"In order to contain this, we have to move quickly," he said. "I wish we were doing more."

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