Spain leads Europe in monkey disease, struggles to control spread

BARCELONA, Spain (AP) — Sex worker and adult film actor Roc was relieved when he was among the first Spaniards to receive the monkeypox vaccine. She knew there were a few cases among men who had sex with men from the leading demographic of the disease, and she feared she might be next.

“I went home and thought, ‘Wow, I survived,'” the 29-year-old told the Associated Press.

But it’s too late now. Roc, the name he used for business, was infected by a client a few days ago. Spain has joined the ever-increasing number of monkeypox infections, reaching the highest level in Europe since the disease had spread beyond Africa, where it was endemic for years.

He began to show symptoms: pustules, fever, conjunctivitis, and fatigue. Roc was hospitalized for treatment before he was well enough to be released.

Spanish health authorities and community groups are struggling to control an epidemic that has claimed the lives of two young men. They reportedly died of encephalitis, or brain swelling, which can be caused by certain viruses. Most cases of monkeypox cause only mild symptoms.

Spain has 4,577 confirmed cases in the three months since the outbreak began, which is linked to two outbreaks in Europe that experts say the virus is likely to be spread through sex.

The only country with more infections than Spain is the much larger USA, which has reported 7,100 cases.

In total, the global monkeypox epidemic has seen more than 26,000 cases in nearly 90 countries since May. There have been 103 suspected deaths in Africa, mostly in Nigeria and the Congo, where a more deadly species of monkeypox has spread than the West.

Health experts stress that although it spreads mainly through sex among gay and bisexual men, which account for 98% of cases outside of Africa, it is not technically a sexually transmitted disease. The virus can spread to anyone who has close, physical contact with an infected person, their clothes or linen.

So part of the complexity of tackling monkeypox is striking a balance between not stigmatizing men who have sex with men, while also ensuring that both vaccinations and appeals for greater attention reach those who are now in the greatest danger.

The health ministry said Spain has distributed 5,000 shots of the vaccine to health clinics and expects to receive 7,000 more from the EU in the coming days.

Community groups and sexual health associations targeting gay men, bisexuals and trans women are taking the lead to ensure these vaccines are administered wisely.

Focusing on AIDS/HIV prevention in the gay and trans community in Barcelona, ​​BCN Checkpoint is now contacting people at risk to offer them one of the valuable vaccines.

Pep Coll, medical director of BCN Checkpoint, said the vaccine offering is focused on people who are already at risk of contracting HIV and receiving preventive treatment, men with multiple sexual partners and those who participate in “chemsex”. medication) as well as people with suppressed immune responses.

But there are far more people than doses that fit into these categories.

“If we consider just the number of people (receiving prophylactic HIV treatment) plus the number of people with HIV, we’re talking about 15,000 people (in Barcelona alone),” Coll said.

Experts say the lack of vaccines, which is much more severe in Africa than in Europe and the United States, is making social public health policies key.

As with the coronavirus pandemic, contact tracing is critical to identify people who may be infected. But while COVID-19 can spread to anyone through the air, the close bodily contact that serves as the leading vehicle for monkeypox has made some people hesitant to share information.

“We are experiencing a steady stream of new cases and it is possible that we may have more deaths. Why? Why? “As contact tracing is so complex, identifying one’s sexual partner can be a very sensitive issue,” said epidemiologist Amós García, president of the Spanish Association for Vaccinology.

Spain says most of its cases are among men who have sex with men, with only 5% being women. But García insisted that he would go out, regardless of gender or sexual orientation, unless the entire public realized that having a variety of sexual partners poses a greater risk.

“The same thing happened with AIDS/HIV, where suddenly the group of men who have sex with men was the group most affected (before it spread to other groups), and if we don’t get it, that might be the path to take. send a strong message to the community,” García said.

Given the scarcity of vaccines and the problem of contact tracing, there is more pressure to promote prevention.

From the beginning, government officials delegated the leading role in the news campaign to community groups.

Sebastian Meyer, president of the STOP SIDA association dedicated to AIDS/HIV care in Barcelona’s LGBTQ community, said the rationale is for his group and others like him to be reliable message bearers with person-to-person information on how to maintain good health. home warning.

While community associations representing gay and bisexual men are bombarding social media, websites and blogs with information on monkeypox safety, Meyer says there is still much to be done.

Meyer, who has served on monkeypox advisory boards for both the Spanish national government and regional authorities covering Barcelona, ​​believes fatigue from the COVID-19 pandemic has played a role. Doctors advise people with monkeypox lesions to isolate until they are fully healed, which can take up to three weeks.

“When people read that they need to isolate themselves, they close the web page and forget what they’re reading,” Meyer said. “We’re just coming out of COVID, you can’t do this or that, and now we’re starting again… People hate it and they’re burying their heads in the sand.”

Meyer said her group is currently brainstorming ways to refresh and reboot their messages.

“If you haven’t been selected for a vaccine, the answer is not to hopelessly hope that you will get a vaccine,” he said. “The answer is to be more careful. It’s much better than any vaccine.”

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