Don’t hold back from warning people
Jeff Duchin, MD, health officer for Public Health Seattle–King County, said the CDC is doing a good job toeing the line between alerting MSM groups about the real risks of monkeypox and avoiding stigmatization.
Duchin said in the wake of the COVID-19 pandemic, public health officials have been extremely careful to admit what they don’t know about a virus or to attempt to predict how it will act.
“COVID-19 has shown the importance of acknowledging areas of uncertainty when describing what is known, and in making predictions about, newly emerging pathogens,” Duchin said.
“Monkeypox, on the other hand, is not newly discovered, and there is considerable existing knowledge with it, but it’s probably good to keep an open mind regarding the extent to which the current outbreak may indicate differences in how the virus behaves compared to the past.”
Though monkeypox was first described in humans in the Democratic Republic of the Congo in 1970, infection outside of West and Central Africa has been extremely rare until last month. And cases in endemic countries in Africa are usually linked to eating contaminated bushmeat, or in households. The sexual transmission component of the current outbreak is novel.
Duchin said in Seattle one confirmed case has been closely monitored, with close contacts under surveillance. So far, monkeypox in the area has been limited to a single resident. In King County, the information website on monkeypox is called “Monkeypox in men who have sex with men,” which Duchin said was a deliberate choice.
“We don’t let people hold us back from warning people, and providing them with the best information to protect their health,” Duchin said. “Right from the get go, we have been clear about the risk to MSM.”
Be clear, don’t ‘pussyfoot’
Being clear about that risk is one of the most important messages about monkeypox, according to New Jersey–based risk communication expert Peter Sandman, PhD.
“In the current outbreak, most patients so far are catching it from MSM. But it will almost inevitably spread from MSM, to others who have close contact (especially sexual contact) with MSM, to still others who have close contact (especially sexual contact) with those others,” Sandman said in an email.
“I would urge risk communicators to say all this—and I’d specifically urge them not to let fear of stigmatization deter them from doing so. Fear of stigmatization is an unacceptable reason to withhold or even to soft-pedal this information.