The cases of monkeypox detected in the United Kingdom and Portugall, as well as the suspects being studied in Spain, have generated a stir. It is not for less, because we come from more than two years of pandemic and even the most innocent of outbreaks leaves our hearts in a fist. But as usual in these cases, this fuss is giving rise to a lot of misinformation. For example, it is being mistakenly commented that monkeypox is a sexually transmitted disease (STD).
This idea comes from the fact that, apparently, a good part of the cases detected are homosexual or bisexual men. In short, men who admit having recently had sexual relations with other men. This leads one to think that monkeypox is an STD and that it also only affects men, but both are incorrect ideas.
On the other hand, the Minister of Health of the Government of Spain, Carolina Darias, wanted to correct this error in an interview on La Sexta, arguing that it is not an STD, but a virus. But that is not the best argument to deny that it is sexually transmitted, basically because the vast majority of diseases of this type are transmitted by viruses. Good examples of this are HIV or the human papilloma virus. But then, what is the correct explanation? Why can we ensure that monkeypox is not an STD? To find out, it is best to start at the beginning.
What is an STD?
In reality, and despite the fact that it is still used by many people, the term “sexually transmitted disease (STD)” is an obsolete qualification. Today they are more correctly known as sexually transmitted infections (STIs). This is because a person may be infected but not develop any illness. It occurs very commonly with the human papillomavirus (HPV).
It is more correct to use the term “sexually transmitted infection”
As for its definition, as its name suggests, they are those infections that are transmitted mainly by contact with mucous membranes and fluids during sexual intercourse . It is important to focus on that “mostly”, as there may also be other routes of contagion. For example, by the exchange of syringes contaminated with blood or from mothers to children during pregnancy, childbirth or breastfeeding. But that is not the main route of transmission.
They are not transmitted through respiratory secretions or other fluids, such as saliva, hence other routes of contagion are ruled out. That is why monkeypox cannot be considered an STD.
The biases of this monkeypox outbreak
Monkeypox is much more common in Africa, especially in the Democratic Republic of the Congo and some countries in the western part of the continent. However, there have been some very limited outbreaks in other parts of the world from time to time.
It is known as monkeypox because it was first described in 1958, after being detected in laboratory monkeys. It can also be found in apes in the wild. However, its main animal reservoir is usually rodents.
The virus can also be transmitted through respiratory secretions and this is something that does not happen with sexually transmitted infections
In terms of human-to-human infection, it occurs mainly by contact with the fluids of the patients, as well as with the secretions of their skin lesions. These fluids also include respiratory secretions, although for this type of contagion to occur there must be very close and prolonged direct contact.
In short, there are many ways of contagion, so sexual is just one more. However, if we look at this outbreak, coincidentally it seems that the vast majority of infections have occurred among men who have had sex with other men. This generates a bias that can lead us to think that it is an STD. If we only look at that, and not at the thousands of infections that take place every year on the African continent, we might think that the transmission is sexual.
But if we look at the outbreaks of COVID-19 that took place in nursing homes during the beginning of the pandemic, we might think that it is a disease that only affects older people. Or if we focus on the outbreaks that happened in prisons, we might think that it is a virus that can only infect inmates. The coronavirus itself can be transmitted during sexual intercourse, in which people breathe heavily, close together and usually in closed places. But it is not an STD.
So no, monkeypox is not a sexually transmitted disease. Nor is it an exclusive disease of men, and much less of homosexual people. The trees are not letting us see the forest. The options are much broader and it is up to the relevant health authorities to track what is happening . The good news is that it is not as highly contagious as COVID-19, so there is hope of stopping it. But no, no matter how many memes are made on the internet about the luck of Twitter users as it is a sexually transmitted disease, not even they would be safe if it spreads.
