August 17, 2022

BARCELONA, Spain (AP) – As an adult sex worker and film actor, Rock took comfort when he was among the first Spaniards to get a monkeypox vaccine. He was aware of several cases among men who have sex with men, the main demographic group for the disease, and feared he might be next.

“I came home and thought, ‘Oh my God, you’re done,'” the 29-year-old told The Associated Press.

But it was too late. Roc, the name he uses at work, was infected by a client a few days ago. He joined the steadily increasing number of monkeypox infections in Spain, which has become the highest in Europe since the disease spread outside Africa, where it was endemic for years.

He started showing symptoms: blisters, fever, conjunctivitis, fatigue. Rock was taken to the hospital for treatment before his health improved enough to be discharged.

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

Spain recorded 4,577 confirmed cases in the three months since the outbreak began, which has been linked to two massive incidents 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.

In all, the global outbreak of monkeypox 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 more deadly form of monkeypox is spreading than in the West.

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

So part of the complexity of fighting monkeypox is balancing MSM with ensuring that vaccinations and calls for greater caution reach those who are currently at greater risk.

The Spanish Ministry of Health said that Spain has distributed 5,000 injections of the dual vaccine to health clinics and expects to receive an additional 7,000 doses from the European Union in the coming days.

To ensure this picks get wisely, community groups and sexual health associations targeting LGBT people are taking the lead.

In Barcelona, ​​the BCN Checkpoint, which focuses on AIDS/HIV prevention in the LGBT community, is now calling people at risk to provide them with one of the prized vaccines.

Babe Cole, medical director of BCN Checkpoint, said the vaccine rollout is focused on people already at risk of contracting HIV who are on prophylaxis, men who have a large number of sexual partners and those who engage in “chemsex” (sex with the use of medications). ), as well as people with suppressed immune responses.

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

“If we take into account the number of people (who receive HIV prophylaxis) as well as the number of people living with HIV, we are talking about about 15,000 people (in Barcelona only),” Cole said.

Vaccine shortages, which are more severe in Africa than in Europe and the United Statesmakes social public health policies essential, experts say.

As with the coronavirus pandemic, contact tracing to identify people who could be infected is critical. But, while COVID-19 can spread to anyone simply through the air, the close physical contact that serves as a leading tool for monkeypox makes some people reluctant to share information.

“We have a constant flow of new cases, and we are likely to have more deaths. Why? Because contact tracing is very complex because it can be a very sensitive issue for someone to identify their partners,” said Amos García, an epidemiologist and president of the Spanish Society for Vaccines. sexuality.”

Spain says most of its cases are among men who have sex with men and only 5% are women. But Garcia insisted that will continue unless the entire public, regardless of gender or sexual orientation, realizes that having different sexual partners leads to greater risks.

“The same thing happened with AIDS/HIV, when the group of MSM was the most affected (before it spread to other groups), and that could become the path that this takes if we are not able to “Send a powerful message to the community,” Garcia said.

Given the paucity of vaccines and the difficulty of tracing contacts, more pressure is being put on encouraging prevention.

From the start, government officials ceded the leading role in the information campaign to community groups.

Sebastian Meyer, president of the STOP SIDA association dedicated to AIDS/HIV care in the LGBTQ community in Barcelona, ​​said the logic was that his group and others like them would be trusted messengers with personal knowledge of how to lead health. home warning.

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

Mayer, who is a member of the monkeypox advisory boards for both the Spanish national government and regional authorities covering Barcelona, ​​believes fatigue from the COVID-19 pandemic played a role. Doctors advise people with monkeypox lesions to isolate until they recover completely, which can take up to three weeks.

“When people read that they should isolate themselves, they close the web page and forget what they read,” Meyer said. “We just got out of COVID, when you can’t do this or that, and now, here we are again…People hate it and put their heads in the sand.”

Meyer said his group is currently brainstorming ways to renew and relaunch their message.

“If you are not selected for a vaccine, the answer is not in the desperate hope that you will get a vaccine,” he said. The answer is to be more careful. This is much better than any vaccine.”

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