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Monkeypox hits SA: Concerns over disease being used to stigmatise gay and bisexual men

Homosexuals in Africa are actively persecuted, but a landmark ruling by a Botswana court has recognised a transgender woman as officially female. Picture: Reuters/Andrea Comas

Homosexuals in Africa are actively persecuted, but a landmark ruling by a Botswana court has recognised a transgender woman as officially female. Picture: Reuters/Andrea Comas

Published Jun 23, 2022

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Cape Town - With cases of monekypox mostly involving individuals who self-identify as men having sex with men, there is concern that the disease is being used to stigmatise gay, bisexual and other men who have sex with men (MSM).

This comes as the National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service, has confirmed that South Africa’s first case of monkeypox has been identified.

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The case was identified through laboratory testing at the NICD on Wednesday, June 22, and involves a 30-year-old man living in Gauteng who has no recent travel history.

The NICD said contact tracing has begun in a bid to identify any additional linked cases of monkeypox in South Africa.

Monkeypox is a rare viral infection in humans. Since May 2022, monkeypox has been reported in more than 3 000 individuals from several European countries, the USA, Canada, Australia, Morocco and the United Arab Emirates.

This is the first multi-country outbreak of monkeypox and is already the largest outbreak of monkeypox recorded.

The cases to date mostly involve individuals who self-identify as men having sex with men. Risk factors include reporting multiple sexual partners.

At the beginning of June, before monkeypox reached South Africa, lobby group OUT LGBT Well-being shared concerns that the disease was being used to stigmatise gay, bisexual and other men who have sex with men.

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Media reports that several cases of monkeypox had been identified among MSM in Europe, in some instances through sexual health clinics, led to sensationalistic claims on social media that the disease is being spread by MSM, which has been used to target members of this community.

Monkeypox, however, can affect anyone.

The World Health Organization (WHO) issued a statement at the time and said: “It is important to note that the risk of monkeypox is not limited to men who have sex with men. Anyone who has close contact with someone who is infectious is at risk.”

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Director of OUT LGBT Well-being, Dawie Nel, said: “We have seen this before, where gay and bisexual men were shamed, stigmatised and shunned in the early days of the HIV/Aids epidemic in the US.

“This cannot be allowed to happen again. The outbreak of a disease should never be accompanied by judgement and condemnation but rather with compassion and the sharing of medical facts.”

The WHO believes that one of the reasons that cases of monkeypox have been reported via sexual health clinics for MSM may be “because of positive health-seeking behaviour in this demographic”.

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Caused by the monkeypox virus, monkeypox is a disease most commonly found in Central and West Africa and can be caught from infected animals.

The latest outbreak, however, is taking place in several countries that do not usually have cases.

According to the WHO, symptoms of monkeypox typically include fever, intense headache, muscle aches, back pain, low energy, swollen lymph nodes and a skin rash or sores.

It can be spread through rashes, lesions, bodily fluids or items that come into contact with an infected person.

Monkeypox rashes can resemble sexually transmitted diseases such as herpes and syphilis. Symptoms typically last between two to four weeks and go away on their own without treatment. In some individuals, they can lead to medical complications and rarely death.

"OUT urges members of MSM and LGBTQIA+ communities and broader society to inform themselves about monkeypox and its symptoms and to be vigilant but not to panic.

“It further calls for rational and informed discourse on media platforms without the blaming or shaming of any community,” Nel said.

The NICD said that recent large social events are thought to have served as super-spreader events.

Person-to-person transmission involves close contact (for example kissing, cuddling, sexual contact) with an infected person, or materials that have been contaminated by an infected person (for example, sharing linen, clothes and other household items).

The virus is not highly transmissible and close physical contact is required for transmission. It does not spread similarly to flu or the Sars-CoV-2 virus.

Monkeypox presents with an acute illness characterised by fever and general flu-like symptoms, followed by the eruption of a blister-like rash on the skin. Most cases do not require hospital treatment.

Prevention of infection hinges on the isolation of cases until fully recovered. The risk to the general population is considered low, given the low transmissibility of the virus.

The WHO recommends increasing vigilance for cases with contact tracing and monitoring of laboratory-confirmed cases. Isolation of confirmed cases allows for the prevention of transmission and interruption of the cycle of transmission.

Circulation of the monkeypox virus in humans may be eliminated through this classic containment approach. Mass vaccination against the monkeypox virus is not currently recommended.

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