Sex between men, not skin contact, is fueling monkeypox, new research suggests

  1. I am a newish mod and the only one on tonight and I see this having the potential to get hostile/brigaded, not to mention I don't love that it is a news page, but it is well-sourced.

  2. For historical reasons I enjoy comparing the current response of the CDC to their actions after an outbreak of monkeypox in 2003 among pet prairie dogs:

  3. I work in the ED in Miami Beach and see multiple cases daily. All the positive cases I've seen personally all have the risk factors of MSM. It's not about going against the LGBTQ+ community for us, it's about education. A lot of the patients are still having unsafe practices even after developing symptoms. We love our LGBTQ+ community in Miami Beach and want to take care of them. It is important to get the right information to help us prevent the spread of this disease.

  4. Are non-msm people with suspicious rashes even able to get tested though? My impression from the monkey pox positive subs was that, maybe until very recently, it basically took an act of divine intervention for a test to be readily available, even for many msm dudes.

  5. Same situation in Berlin. There have been monkey pox sex parties for people "to get over with it" as we've run out of vaccines. The authorities are powerless/do not care.

  6. Question for you, do the pox resemble hand foot and mouth disease? We had an adult patient present with that recently, lesions on hands. He did state his child had been ill, hand foot and mouth was going around at the daycare. But we don’t do any testing for that, just clinical judgment and from what I’ve read they have similar symptoms.

  7. It's spreading around this community but that doesn't mean the root cause lies therein. A female who has anal sex with male partners is just as likely to contract it, we just aren't seeing it in those communities YET.

  8. Can we get a direct link to said studies - the internal link on the article doesn't seem to be working for me. I'm quite interested.

  9. The presence of virus in semen does not mean that semen is causal in transmission. For example, measles virus is found in urine and yet urine is not a mode of transmission for measles.

  10. Your urine analogy is quite flawed. Which mucocutaneous surface in another person with fresh microabrasions (as in sexual intercourse) commonly gets exposed to measles urine?

  11. This article is well cited, but none of the citations offer much support to the headline that this is primarily a sexually transmitted disease. The isolation of MP DNA from semen is interesting, but unclear if this is replication competent/infectious virus or just viral particles. There’s an opportunity to learn more about this virus through this outbreak, but making premature conclusions isn’t helpful to anyone

  12. There was a Lancet article a few months ago that concluded that semen likely was infectious based on collected samples. I’m not sure whether they made that assessment based on PCR of the entire intact genome or whether they were able to observe intact virions via electron microscopy of samples… I just remember the conclusion….

  13. I mean, it could help a lot of people right? Not premature conclusions per se but looking at the risk factors and telling those with risk factors to avoid further exposure

  14. If we can tell people to maintain social distance, masks etc, why can't we send a simple message : avoid unprotected sex for the foreseeable future, especially if you have multiple partners.

  15. While I agree, I don't think wearing additional PPE and being explicitly different in how we act around an already marginalized community is going to win anyone over or further that community's confidence in medicine.

  16. I think it’s very reasonable to be cautious about jumping full-heartedly to this conclusion given the absolutely horrible way that HIV was handled and the gross stigmatization of gay men that went along with it.

  17. Well-sourced article that's admittedly challenging my understanding of this disease's transmission. This should inform us in how we shape our public messaging.

  18. I was saying this about a week or two ago, and got destroyed for suggesting it was sex causing transmission (or at least the close and intimate body contact of gay men during sex) and most people were not at any risk.

  19. I think we need to be careful about assuming causation out of correlation. It is not surprising, out of how this outbreak began and where it was spread, that the population affected is what it is; however, children have also been affected and, unless we assume the worse, that demonstrates to me that there is still skin-skin transmission.

  20. I mean, four or five centuries of experience with poxviruses tells us there's skin-skin transmission. There has to be. It may just be a much smaller proportion of total cases in the current outbreak.

  21. At this point, if I see children with monkeypox lesions on their genitals, I am going to assume the worst. It would be delusional to think otherwise.

  22. This is pretty consistent with what I’ve been seeing (anecdotally). Most of the confirmed cases I’ve seen have been in MSM with risk factors or people who have sex with MSM. That being said though, testing is already abysmal to being with and it’s already incredibly difficult for non MSM to get tested so I’m afraid that this may make it even MORE difficult to access testing for people without risk factors.

  23. It seems like it was a fairly small study (under 200 participants) with a large percentage of gay men (above 90% of the participants). I'm not sure if that percentage was so high because that is representative of the people who are getting monkey pox or not. I haven't seen any stats on what percentage of monkey pox positive patients are men who have sex with me. Is that percentage high enough to justify a study with above 90% gay men participants and reaching this conclusion?

  24. “I haven’t seen any stats on what percentage of monkey pox positive patients are men who have sex with me.”

  25. Why is asking people that are at highest risk to practice monogamy or safe sex out of an abundance of caution seen as unrealistic? Shouldn't potentially protecting others be seen as a laudable goal? I understand people do not want a repeat of the 80s anti gay crusades but asking those that are promiscuous to be safer is apparently off the table. If we truly have a concern for the wellbeing of the gay community who are the highest risk, especially those not in strictly monogamous relationships, we need to stress the importance of acting in a manner which reduces contact with the most amount of possible vectors. Sicking our head in the sand and pretending that if we remain politically correct the problem will just go away is the opposite of helpful for the gay community or the population as a whole.

  26. It's reasonable to ask high-risk populations to abstain or practice safer sex, it's very unlikely that recommendation alone will stop an outbreak. Where that line of logic gets dangerous is when people say "We should just tell gay men to stop having unsafe sex, and then the problem is solved. If the outbreak continues, it's their own fault, and therefore not my problem."

  27. then why don't we see as many women being affected by monkeypox? women tend to be very physically affectionate, too. the skin-to-skin factor seems limited in this spread

  28. Talk to a sexually active gay man and find out where most semen ends up after ejaculating. Hands, abdomens , faces, mouths, etc are frequent spots (same with heterosexuals or MSWs?). I am not trying to be crude but rather suggest that the skin of the genitals and perineum (as well as rectal mucosa of course) may be uniquely more susceptible than other skin most interestingly oral mucosa. I don't have data to back it up (nor likely does anyone) but my read is that oral sex is more common that anal sex in MSM occuring both during an encounter with anal sex as well as those without it. But we should remember that HIV was/is detected In tears and saliva and they're not modes of transmission.

  29. I mean, I know plenty of het folks that have essentially unprotected encounters because the woman is just on bc. When I asked a friend "well how do you know her sti status" regarding a rando he was hooking up with, he was just like "well she says she's clean/I didn't see anything." Because that's totally a sure thing lol.

  30. Thank you for posting in a sub where I don't have to wade through hate. From my reading, the majority of those currently infected are on HIV or Prep medication. Can this be mutating the virus or impeding their immune response?

  31. So if this is true, the healthcare community should keep it under-wraps to do what? We are educated medical professionals and if you don’t acknowledge a high risk group, that will be a disservice to those at risk.

  32. I think part of it frustration. After the COVID fiasco, the media started peddling Monkeypox as the new 'pandemic' without giving clear data on how it is contracted. People learn it's pretty much only gay men spreading it and lash out.

  33. Idiots gonna be idiots. Still think we shouldn't censor, spread misinformation cause it might trigger a caveman.

  34. Buddy please go to the other sub for this. I understand your frustrations but this is a subreddit for every healthcare worker. And the mod was very respectful about this. Please don’t bring that toxicity to this sub from residency or noctor.

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