Notes on monkeypox

If you remember the right wing freakout over Ebola virus -- of which IIRC there were fewer than 5 cases in the U.S., none of which was fatal -- you may wonder why the deafening silence about monkeypox. Ha ha! You don't have to wonder. So far, he monkeypox outbreak in the U.S. and Europe seems to be largely if not entirely limited to men who have sex with men. 

This will likely change, of course. Here are the basics about monkeypox. Unfortunately it's behind the NYT paywall but it's the best summary I could find. Anyway I'll review the situation for you. Monkeypox is indigenous to sub-Saharan Africa, but among the infectious diseases that plague that continent it's not really a major problem. It is not very transmissible, requiring close personal contact, usually sexual. It's also rarely fatal, but severe complications are possible though uncommon; anyway it's self-limiting and severe symptoms usually last only a week or so.

Anyway, like all emerging infectious diseases we'd like to eradicate it in the U.S. and this is certainly possible in principle. Actually it's theoretically possible with all diseases that are transmitted exclusively by intimate contact. What you need to do is identify cases as early as possible and isolate the people from contact that can potentially transmit the virus. Break all the chains of transmission and it will disappear. QED.

The problem is that in the U.S. we have allowed the infrastructure to do this to wither away, particularly in rural areas. What we need are clinics specializing in sexually transmitted infections with staff who know about them, and are familiar and comfortable with at risk populations and that people in those populations are comfortable with as well. You also need to do educational outreach to people at risk so they know what to look for and to go to get tested and diagnosed. Also, obviously, we should promote safer sex. 

The infrastructure exists in many cities, but not in rural areas and obviously, not in the places afflicted with moral panic about sexual and gender minorities. Driving people underground is a very effective way to create problems for everybody else, in this as in other matters.