It has been two weeks since the White House declared monkeypox a public health emergency, with cases surging in several states including California, Florida and New York.
At press time, the Southern Nevada Health District (SNHD) had reported 100 documented cases in the region since the state’s first case in mid-June, at least one of which is a student in the Clark County School District.
In a statement, CCSD said it was working with the health district to conduct contact tracing and notifications, and was following official guidelines for sanitizing. People with weakened immune systems, eczema or children 8 and younger are more at risk of serious illness or death from the viral disease, which typically causes flu-like symptoms followed by a rash.
In an August 4 press conference, Dr. Cortland Lohff, chief medical officer with the health district, acknowledged that even though children have accounted for very few monkeypox cases in the U.S. thus far, they could be at risk of exposure, especially if a member of their household becomes infected. “But the risks there are very minimal,” he added.
Still, a vaccine shortage could make it more difficult to stop the spread of a painful and potentially scarring disease. The federal government is allocating vaccines “to meet the needs of at-risk individuals and prioritizing jurisdictions that have been hardest hit by the outbreak,” Lohff said, adding that Nevada must follow this system, request doses from the U.S. Department of Health and Human Services and wait in line, like the other states.
Reacting to growing concerns about vaccine availability, U.S. health officials recently authorized using one-fifth of the usual dosage for adults, citing a study from the National Institutes of Health that found that the smaller dose produced an immune response only a few percentage points below that of the full dose. The strategy has been used in other countries for vaccinating against yellow fever, polio and other diseases.
The Food and Drug Administration also authorized emergency use of the full dose in children younger than 18. Two doses are necessary for long-lasting protection, according to health agencies.
Officials have said using lower doses will multiply currently available doses to about 2 million, still below what’s needed for the 3.2 million Americans identified as being at “highest risk.” Since July, the U.S. has ordered 5 million full doses of monkeypox vaccine; however, reports say those likely will not arrive until 2023.
“The Health District has updated its monkeypox administration protocols to implement the new guidance from the FDA at its vaccine clinics,” the health district tells the Weekly. “It is anticipated that the new protocol will assist with providing monkeypox vaccine to more at-risk individuals.”
Antioco Carrillo, executive director of Aid for AIDS of Nevada, says he’s concerned about vaccine availability, as many of his clients fall within the “at risk” category and are immunocompromised, and therefore more at risk of serious illness.
His primary concern, he says, is the public’s reaction to official reports that men or nonbinary people who have sex with men are considered to be “high risk” due to the fact that they have accounted for the majority of cases in 2022.
According to official guidance, those who have been in contact with someone known to have or suspected of having monkeypox, those who have traveled to countries where the disease is spreading, or those in a “social network that is experiencing monkeypox activity” are all at higher risk of infection. Officials have also identified people who don’t know the health or travel history of their dating or sexual partners, as being at higher risk of infection.
“Men who have sex with men who meet partners through an online website, an app or social event (e.g., bar or party),” could be at higher risk,” the SNHD’s website notes. It also notes that “the risk of monkeypox in the United States is believed to be low. Monkeypox does not spread easily between people.”
“We’re really looking at the kind of direct, intimate contact between individuals,” Lohff told members of the media. “Perhaps in situations where they might be engaging in sex, or maybe at parties or events like that, where they have limited amount of clothing on. So in situations where people are clothed, I think the risk is very, very low.”
Carrillo has been advocating in Las Vegas for people living with HIV since 1994, when there was much discrimination and separate treatment of gay and bisexual men in the wake of the HIV pandemic, he says. He sees many parallels between the HIV and COVID-19 pandemics—and now, with monkeypox.
Having learned from those experiences, he says, the gay community tends to be “assertive” with their health care and public health awareness. Carrillo points out that the disproportionate monkeypox diagnoses in the LGBTQ community early in the current outbreak could possibly be attributed to the LGBTQ community’s proactive attitude toward health care, and greater likelihood to see a doctor if there’s potential for infection.
“One reason we are currently hearing more reports of cases of monkeypox in communities of men who have sex with men may be because of positive health seeking behavior in this population group,” the World Health Organization’s website notes. “Monkeypox rashes can resemble some sexually transmitted diseases, including herpes and syphilis, which may partly explain why these cases are being picked up at sexual health clinics. As we learn more, we may identify more cases in the broader community. Engaging communities of gay, bisexual and other men who have sex with men to raise awareness is essential to protect those most at risk.”
Furthermore, Carrillo says he’s less concerned about the community’s ability to prevent monkeypox. “I’m more concerned about how people are going to see the community,” he says.
The same way disinformation about COVID-19 and scapegoating of Chinese and other Asian people led to increased violence toward Asian Americans, monkeypox could lead to an uptick in violence toward the LGBTQ community, Carrillo warn
“Many in the gay community were the first ones to get the vaccine for COVID. They were the first ones to sign up for clinical trials for COVID. We were the first ones to be involved,” Carrillo says. “Because we know what happens if you let that go and ignore it. … You get to be, as a group, dehumanized. … then the risk for discrimination, for death, for violence … is there.”
The Centers for Disease Control and Prevention (CDC) acknowledges that potential, advising that “Anyone can get monkeypox … Focusing on cases among gay and bisexual men may inadvertently stigmatize this population and create a false sense of safety among those who are not gay and bisexual men.”
According to the CDC, “Monkeypox can spread to anyone through close, personal, often skin-to-skin contact,” including contact with a rash, soiled linens, respiratory and body fluids from an infected person.
Settings in which skin-to-skin contact could occur include congregate living situations like nursing homes and correctional facilities, day cares, beauty salons, massage businesses and certain sports and fitness environments. In other words, monkeypox doesn’t only spread through casual dating and kink parties, as some messaging might have suggested. “If it’s skin-to-skin contact … if it’s about hugging and kissing and having sex, I mean, who doesn’t do that?” Carrillo asks. “Is that exclusive to the gay community?”
An infected person will start to see symptoms within three weeks of exposure to the virus, and can remain contagious from the time symptoms present until skin lesions have completely healed, typically in 2-4 weeks, according to the CDC. Scientists still are researching whether the virus can be spread asymptomatically, and how often it is spread through respiratory secretions or other body fluids.
Click HERE to subscribe for free to the Weekly Fix, the digital edition of Las Vegas Weekly! Stay up to date with the latest on Las Vegas concerts, shows, restaurants, bars and more, sent directly to your inbox!