Dr Zack Turner on Australians’ biggest concern about monkeypox

Welcome to the weekly Ask Doctor Zac column on news.com.au. This week, Dr Zack Turner talks about the stigma associated with the monkeypox outbreak for all Australians and how to deal with the outbreak.

QUESTION:

Hey Dr. Zach, I’m going to Europe for a cruise and I can’t wait! Except for one thing that worries me. There has been so much talk over the last couple of weeks about monkeypox rages in Europe in gay communities, that makes me nervous.

Our government doesn’t seem to care as much as others – the US government has just authorized the use of vaccines, while Australia has not.

Is there a reason why the Australian government is not more active? Haven’t we learned from the HIV/AIDS epidemic? Their inaction is due to the fact that the gay community should not worry about monkeypox here in australia? I heard that we already have 45 cases in Australia – is it only a matter of time before we have the same number as in Europe? — Benjamin, Adelaide

REPLY:

Let’s start with the fact that although monkeypox is a virus, it is not like HIV/AIDS. It is also unlike the human papillomavirus (HPV), a serious cause of cervical cancer, which is often transmitted from infected asymptomatic men to women. Like any virus, it spreads in its own way, has its own symptoms and treatments. I believe that at-risk groups should receive more education and accelerated treatment (in which case there is an available vaccine) to avoid unnecessary consequences, especially for the immunocompromised people in our communities.

Fortunately, monkeypox requires skin-to-skin contact, making it much less infectious and transmissible than Covid-19. We know that it can be transmitted between infected animals (originally monkeys, hence the name and prevalence in the countries where these animals live) and infected people. However, compared to many other viruses in modern society:

• hard to convey

• often does not require treatment, as it goes away on its own

• and we have modern vaccines that are effective both prophylactically (pre-exposure) and post-exposure.

We know that many diseases, including this virus, are spreading more easily in part because of climate change, which is allowing viruses normally found only in very hot and humid environments (such as Central Africa) to now survive in Europe, the US and Australia. . Although we still do not know the natural reservoirs of monkeypox in countries where it has existed for many years, it can be assumed that the ease of movement these days will make containment and control of the virus a higher priority.

Monkeypox has been around for over 70 years in various countries, and due to a recent global outbreak, it has not been associated with a single death in countries that are not endemic (meaning where it has been for decades) – so that’s a certainty .

While it can be quite unpleasant when people get infected and develop boils and rashes, remember that the same thing happens with chickenpox if you’ve had it before. Coxsackievirus, also called “hand disease, foot-and-mouth disease”, affects kindergartens and children around the world and looks terrible, is highly contagious and, like monkeypox, has a quick recovery with very few long-term problems.

It is useless at best, and extremely harmful at worst, to depict, label or stigmatize the virus for any people, groups, countries, cultures or genders. The fact that this virus, which has been around for so long, can be portrayed as a “gay virus” is a very dangerous narrative. I will explain why in a moment. Virus misinformation has had a profound effect on people for centuries, and we should learn from these past mistakes.

Anyone can get monkeypox, but during the latest outbreak, the virus is spreading primarily among men who have sex with men – at this stage. monkeypox is not considered a sexually transmitted disease, although it has recently been upgraded to an “infectious disease of national concern”, an important step by the public health authorities as it will allow for the rapid distribution of available resources and vaccines.

Like I said in me previous column on monkeypox, prolonged skin-to-skin contact is the main cause of current transfer. Monkeypox transmission rates, even through prolonged close contact, are very low, with only about 3 percent of contacts becoming infected.

If you are one of those 3% of infected people, you will typically have a fever, headache, muscle aches, and possibly swollen lymph nodes 5 to 21 days after infection.

Shortly thereafter, skin rashes often appear on the arms, legs, and face. These are most likely photos you have seen online. As with most viruses, this can lead to fever and upper respiratory symptoms such as cough or runny nose.

I do believe that the Australian government should step up public health information about the virus and educate Australians on how to limit transmission. They must also eradicate any growing stigma that this is a gay virus and, as I will discuss below, why rapid-acting vaccines are so important.

Even though a large number of cases have occurred among men who have sex with men, this could very well be an outbreak in other networks where there is contact between people, such as a football team, a nail salon, a massage studio. , a brothel, a church choir or even a kindergarten. With prolonged skin contact in the net, there is a risk of an outbreak of monkeypox.

The problem with forming this stigma is that people will believe they won’t get monkeypox because they are not homosexual. Therefore, if they do have the virus, they will unknowingly infect their community and its vulnerable individuals. Or, if their symptoms are very bad, they will refuse treatment and suffer alone because they are afraid that their friends will label them as gay.

Now for your question about the Australian government’s hesitation on vaccines. Let’s start with the fact that there are effective treatments and vaccines, so at this stage there is no need to worry about waiting a year for them to be made. As with all medications and vaccines that work, there are potential side effects.

Unlike Covid-19, HPV, and other viruses, which are transmitted quickly and with serious complications, people with monkeypox, like those with chickenpox, have recovered quickly and completely in the past. The benefit/risk balance of vaccinations should always be discussed with a healthcare professional, not with your Twitter or Facebook feed. At this stage, vaccination will only be necessary for individual cases and groups exposed during the incubation period and their close contacts.

I do believe that the Australian government should inventory its monkeypox vaccines and actively distribute them accordingly to clustered areas across the country. But I don’t think it should publicly and directly target gays and say, “This virus only affects you, only you need to get vaccinated.”

Any Australian who becomes infected must be vaccinated, regardless of sexual orientation or gender.

How to protect yourself from monkeypox

Over the past few weeks, I have been in touch with several overseas colleagues about their countries’ access to vaccines and the response to this outbreak. I am very happy to report that I was surprised by the level of access to foreigners who have been in contact with vaccines and medical centers abroad.

At the time of this writing, I was aware of Australian citizens who were able to arrange vaccinations while already abroad, with a waiting time of only 3-4 days. I have some prudent advice if you are like some of my patients and friends who are going to “spend the summer in Europe” contact with others). with other revelers).

I would definitely recommend that you make an appointment with your GP in Australia and make sure all your vaccines are up to date. And if the monkeypox vaccine isn’t available to you yet, check online and book ahead of time abroad. And do it on your first day in a country where you can get a booking.

There are a number of measures and habits that need to be adopted to limit the incidence of the disease in the community. I have experience in Central Africa and the Congo, and although the disease was more common in these regions, we were much more aware of the need for strict personal hygiene. We also received vaccinations before we ventured into these areas.

Wash your hands! Like any other virus and disease, handwashing with soap goes a long way in limiting transmission. Alcohol handwash works just as well. While it’s probably safe to assume that monkeypox cases in Australia weren’t linked to monkeys or other animal vectors, we need to be especially careful at this time until we know exactly how it spreads.

Please remember that if you are not feeling well, now is the time to stay home, and if you must go outside, wear a mask as this will reduce the spread of droplets that can infect others. If you end up with monkeypox, isolate yourself from others and seek the advice of healthcare professionals.

Benjamin, enjoy your holiday! Take care of yourself, get vaccinated if you can, and watch for symptoms.

Got a question:

askdrzac@conciergedoctors.com.au

Dr. Zach Turner holds a Bachelor of Medicine and Surgery degree from the University of Sydney. He is both a medical practitioner and co-owner of a telemedicine service. Concierge doctors. He was also a registered nurse and a qualified and experienced biomedical scientist, as well as a doctoral student in biomedical engineering.

Originally published as Dr Zack Turner on Australians’ biggest concern about monkeypox