Spain leads Europe in Monkeypox, struggles to control spread

As a sex worker and adult film actor, Roc was relieved to be one of the first Spaniards to receive a monkeypox vaccine. He knew of several cases of men who have sex with men, the main demographic for the disease, and he feared he could be next.

“I went home and thought, ‘Oh my God, I’m saved,'” the 29-year-old told The Associated Press.

But it was already too late. Roc, the name he uses for his work, had been infected by a client a few days earlier. He joined Spain’s steadily increasing number of monkeypox infections that have become the highest in Europe since the disease spread beyond Africa, where it has been 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 struggle to control an outbreak that has left two young men dead. They reportedly died of encephalitis, or brain swelling, which can be caused by some viruses. Most cases of monkey pox cause only mild symptoms.

Spain has confirmed 4,942 cases in the three months since the outbreak began, which has been linked to two raves in Europe, where experts say the virus was likely spread through sex.

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

Global number

In total, the global monkeypox outbreak has seen more than 26,000 cases in nearly 90 countries since May. There have been 103 suspected deaths in Africa, mainly in Nigeria and Congo, where a more deadly form of monkey pox is spreading than in the West.

Health experts emphasize that this is not technically a sexually transmitted disease, although it has spread primarily through sex among gay and bisexual men, who account for 98% of cases outside Africa. The virus can be transmitted to anyone who has close physical contact with an infected person, their clothing or bedding.

Part of the complexity of fighting monkeypox is striking a balance between not stigmatizing men who have sex with men, while ensuring that both vaccines and pleas for greater caution reach those currently most at risk.

FILE - A pharmacist loads a monkeypox vaccine syringe Aug. 3, 2022, in West Hollywood, California.  Spain struggles to contain Europe's largest monkeypox outbreak.

FILE – A pharmacist loads a monkeypox vaccine syringe Aug. 3, 2022, in West Hollywood, California. Spain struggles to contain Europe’s largest monkeypox outbreak.

Spain has distributed 5,000 injections of the dual vaccine to health clinics and expects to receive another 7,000 from the European Union in the coming days, the health ministry said. The EU has purchased 160,000 doses and is giving them to member states on an as-needed basis. The block expects to have another 70,000 shots available next week.

To make sure those injections are administered wisely, community groups and sexual health associations target gay men, bisexuals and transgender women.

In Barcelona, ​​BCN Checkpoint, which focuses on AIDS/HIV prevention in gay and trans communities, is now reaching out to at-risk groups to offer them one of the precious vaccines.

Pep Coll, medical director of BCN Checkpoint, said the vaccine rollout is targeting people already at risk of contracting HIV and receiving preventive treatment, men with a large number of sexual partners and those who engage in sex with the use of drugs, as well as people with suppressed immune responses.

But there are many more people who fit into those categories than doses, about 15,000 people in Barcelona alone, Coll said.

The lack of vaccines, which is much more serious in Africa than in Europe and the US, makes social public health policy critical, experts say.

Contact tracing more difficult

As with the coronavirus pandemic, tracing contacts to identify people who may have been infected is critical. But while COVID-19 could easily spread through the air to anyone, the close physical contact that serves as the primary vehicle for monkeypox makes some people hesitant to share information.

“We have a steady stream of new cases and it is possible that we will have more deaths. Why? Because contact tracing is very complicated because it can be a very sensitive issue for someone to identify their sexual partners,” Amós said. García, epidemiologist and president of the Spanish Society of Vaccinology.

Spain says that 80% of cases occur in men who have sex with men and only 1.5% in women. But García insisted that this will change unless the entire public, regardless of gender or sexual orientation, understands that having different sexual partners carries a greater risk.

Given the lack of vaccines and the problems with tracing contacts, there is more pressure to promote prevention.

From the outset, government officials have ceded the leading role in the “get-out-the-word” campaign to community groups.

Sebastian Meyer, president of the STOP SIDA association committed to AIDS/HIV care in Barcelona’s LGBTQ community, said the logic was that his group and others who like it would be trusted messengers with personal knowledge on how to improve health. warning home.

Community associations representing gay and bisexual men have bombarded social media, websites and blogs with information about monkeypox safety. Officials in Catalonia, the region including Barcelona with more than 1,500 cases, are pushing public service announcements on dating apps Tinder and Grindr warning of the disease.

But Meyer believes fatigue from the COVID-19 pandemic may have played a role. Doctors advise people with monkeypox lesions to isolate until they are completely healed, which can take up to three weeks.

“When people read to self-isolate, they close the web page and forget what they read,” Meyer said. “We’re just coming out of COVID, when you couldn’t do this or that, and now we’re going again. … People just hate it and bury their heads in the sand.”

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