Spain leads Europe in monkeypox and is struggling to contain the spread

BARCELONA, Spain (AP) – As a sex worker and adult film actor, Roc was relieved to be among the first Spaniards to receive a monkeypox vaccine. He knew of multiple cases in men who have sex with men, which is the leading demographic for the disease, and feared he might be next.

“I went home and I was like, ‘Whew, 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 work, had contracted it from a client a few days earlier. He joined the steadily rising number of monkeypox infections in Spain, 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 recovering well enough to be discharged.

Spanish health officials and community groups are struggling to contain an outbreak that has already claimed the lives of two young men. They reportedly died from encephalitis, or brain swelling that can be caused by some viruses. Most cases of monkeypox cause only mild symptoms.

Spain has had 4,577 confirmed cases in the three months since the outbreak began, which have 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.

Overall, 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, mostly in Nigeria and Congo, where a deadlier form of monkeypox is spreading than in the west.

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

So part of the complexity of tackling monkeypox is finding a balance between not stigmatizing men who have sex with men, while ensuring that both vaccines and calls for greater caution reach those who are currently most at risk .

Spain has distributed 5,000 shots of the two-shot vaccine to health clinics and expects to receive another 7,000 from the EU in the coming days, its health ministry said.

To ensure these shots are administered wisely, community sexual health groups and associations targeting gay men, bisexual and transgender women are taking the lead.

In Barcelona, ​​BCN Checkpoint, which focuses on AIDS/HIV prevention in gay and transgender communities, is now contacting vulnerable people to offer them one of the valuable vaccines.

Pep Coll, medical director of BCN Checkpoint, said the vaccine rollout will focus on people who are already at risk of contracting HIV and who are undergoing preventive treatment, men with a high number of sexual partners and those who those involved in “chemsex” (sex involving drug use) and those with suppressed immune responses.

But there are many more people who fit into these categories than cans.

“If we just look at the number of people (on prophylactic HIV treatment) plus the number of people living with HIV, we’re talking about 15,000 people (only in Barcelona),” Coll said.

Vaccine shortages, far more severe in Africa than in Europe and the US, make social health policies a key factor, experts say.

As with the coronavirus pandemic, contact tracing is critical to identifying those who may be infected. But while COVID-19 could simply spread through the air to anyone, the close physical contact that serves as a leading vehicle for monkeypox makes some people reluctant 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 identifying their sexual partners can be a very sensitive issue for someone,” said Amós García, epidemiologist and president of the Spanish Association of Vaccinology.

Spain says most cases occur in men who have sex with men and only 5% are women. But García insisted that unless the public at large, regardless of gender or sexual orientation, understood that having different sex partners posed a greater risk, that would even out.

“Same thing happened with AIDS/HIV, when in one moment the group of men who had sex with men was the hardest hit (before it spread to other groups) and that may become the route this takes when we are not able to send a strong message to society,” García said.

With vaccine shortages and contact tracing problems, more pressure is being put on promoting prevention.

From the beginning, government officials gave community groups the lead role in the “Speak Out” campaign.

Sebastian Meyer, president of the STOP SIDA association, which is dedicated to AIDS/HIV care in Barcelona’s LGBTQ community, said the logic is that his group and others like them are trusted ambassadors who know how from person to person one promotes health warning home.

While community groups representing gay and bisexual men have bombarded social media, websites, and blogs with information about monkeypox safety, Meyer says there is still work to be done.

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

“When people read that they need to self-isolate, they close the site 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.”

Meyer said his group is currently considering ways to revamp and restart their message.

“If you haven’t been chosen for a vaccine, the answer isn’t to desperately hope you get one,” he said. “The answer is to be more careful. This is way better than any vaccine.”

SHARE: