Above: An electron microscope image of a poxviridae virus closely related to monkeypox. Image by Dr. Graham Beards, used under Creative Commons license, CC BY-SA 4.0

As you’ve probably heard, monkeypox is rapidly spreading and a week and a half ago Buncombe County reported its first case.

What you’ve probably also heard is monkeypox portrayed as sexually transmitted disease, primarily by gay and bi men. Everything from CDC pronouncements to mainstream media coverage has put its focus (and blame) on queer and trans people. Often this is done in a way that drags up the rampant homophobia of the ’80s and ’90s AIDS genocides.

This is absolutely, dangerously, wrong. Like with their obsession with travelers from China in the early days of covid (when travelers from Europe and American tourists were already spreading it), federal health officials are more concerned with finding a scapegoat than stopping a disease. In the process they’re completely failing — again — to contain the spread of a damaging, even deadly, illness.

Since lies spread fast it’s important to counter them with the truth. So here is the Blade‘s rundown on the truth behind monkeypox.

Monkeypox is not an STI

That’s the headline of the piece, we just emphasized it in the introduction and now we’re mentioning it again. The disinformation about monkeypox has been that extensive.

Monkeypox is spread by close contact with an infected person. Living in the same space, contact with a surface touched by an infected person (especially towels, sheets or blankets), a prolonged maskless conversation or even a handshake are all far more common ways to get infected.

Monkeypox is endemic in areas of central and west Africa, mostly spread through contact with animal populations in the area (particularly squirrels) that carry it. Because of geographic proximity, outbreaks have also occurred in some other African countries through person-to-person transmission. Monkeypox has occasionally spread to other countries including the U.S., Israel and the United Kingdom through the same method and through the exotic pet trade, though previous outbreaks haven’t reached the same extent this one has.

Notably the health guidelines from African organizations, who’ve monitored and contained the spread of this illness for decades, are being widely ignored. South Africa’s National Institute for Communicable Diseases — one of the more effective health agencies in the world — has a solid FAQ on monkeypox published back in May. Nowhere do they call it a sexually transmitted disease, instead noting succinctly that “person-to-person transmission involves close contact with an infected person or materials that have been contaminated by an infected person.” That’s it.

The NICD also provides this solid, workable description of what monkeypox does and how to detect it:

The incubation period (time from infection to symptoms) for monkeypox is on average 7−14 days but can range from 5−21 days. Initial symptoms include fever, headache, muscle aches, backache, chills and exhaustion. Within 1-3 days of onset of disease, blister-like lesions (very much the same as chickenpox) will develop on the face, the extremities including soles of the feet and palms of the hands. The lesions may however occur on other parts of the body. The number of lesions will vary and not all lesions will be at the same stage of development. The lesions progresses through several stages before scabbing over and resolving. Most human cases resolve within 2-3 weeks of onset without side-effects. The case fatality rate in more recent outbreaks have been on average 1%

…An infected person is contagious from the onset of the rash/lesions through the scab stage. Once all scabs have fallen off, a person is no longer contagious.

Not every material carries the same risk. Touching a doorknob almost certainly won’t get you infected with monkeypox. Using a towel very well might. While not as ridiculously contagious as covid, it’s still a very real danger.

Ironically one transmission method, close maskless conversation, can be halted by following good covid protocols. This is something you should already be doing because Asheville’s in the middle of a massive outbreak. Everyone should be wearing a mask right now.

Monkeypox is a relative of the smallpox virus, but it’s being portrayed like HIV. One of the early superspreader events in this current outbreak was a gay rave in Europe, but it was far from the only one and the virus has since spread well beyond that. Early covid superspreaders included tech and science conferences, but somehow there wasn’t a sudden push to pin the pandemic on scientists and tech workers.

Basically, with any contagious disease, intimate contact often spreads it, but that’s because it’s contagious, not because it’s an STI. If you have sex with someone with the flu or covid you’re probably going to get it.

Portraying monkeypox as an STI is directing violence and bigotry against queer communities in a time when we’re already under attack. It also makes stopping the actual spread of monkeypox nearly impossible. Cishet people are catching monkeypox, but when they go to have it tested they’re often being turned away because they don’t fit a false profile of who gets and spreads the disease. It’s easier to prop up the “monkeypox is only spreading among gay communities” lie if no one else is being tested.

This is happening everywhere from Madrid to North Carolina. With school returning later this month, and summer conferences and festivals still in full swing, expect this to keep spreading. As it stands, that will be blamed on queer people rather than the officials who, once again, failed to do a damn thing to stop yet another disaster.

A vaccine is available

Monkeypox is not an unknown (or novel, to use the epidemiology term) disease, like covid was. The first cases were detected in 1958. There is a proven, tested, highly effective vaccine already available.

It’s a two shot series, administered a month apart. The side effects, including a sore arm and some exhaustion, are usually mild. Unlike a covid vaccine, the monkeypox shot can be administered after someone’s been infected and still help halt the spread of the disease.

If you’re in Asheville, you can get it fairly easily. The Buncombe County Health Department offers it at their walk-in immunization clinic at 40 Coxe Avenue during weekday business hours. WNCCHS also offers it by appointment, which you can schedule by calling 828-285-0622

Initially the local vaccination criteria started out limiting access to men who have sex with men as well as trans and nonbinary people who’ve had sex (anonymous or with multiple partners) in the past two weeks. But, credit where it’s due, that’s now changed to any of those exposed to mnokeypox, those with a particularly high risk of illness (like the immunocompromised) and “individuals who had multiple sex partners or anonymous sex within the past 14 days” regardless of their gender or sexuality.

While still not ideal, that’s a real improvement and better than the intrusive homophobia we’re seeing from health agencies in some cities like New York.

I got the vaccine at the health department last week. I didn’t face any intrusive questions about my partners, sexual activity or identity. I filled out the standard forms and got the shot. The entire experience took just over an hour. Side effects were mild and I felt completely fine by the next day.

If you can get the vaccine, you should do so as soon as possible

If governments were at all set on actually stopping monkeypox they would be ramping up vaccine production and rolling it out to the general population as quickly as possible. Monkeypox doesn’t discriminate, and right now it’s spreading quickly among populations that can’t get vaccinated and too many doctors and clinics won’t even test.

Fight anti-queer lies now

Disinformation sets in quickly during disease outbreaks, especially given the often-abysmal conduct of federal and other health agencies. Once those ideas get firmly rooted it can be hard to dislodge them, and they do real, horrific damage, both sanctioning violent bigotry and rapidly spreading a damaging disease.

To those of us who grew up in the ’80s and ’90s, when the AIDS genocides were in full swing, the past weeks have been particularly horrifying. Old, openly anti-queer tropes and lies are now being trotted out again, as if nothing was learned from that era of horror.

So if you’re reading this, especially if you consider yourself anything like an ally or accomplice to those of us directly under fire, the time to speak up is now. If you hear monkeypox falsely described as an STI, call that bullshit immediately. If you hear people say only gay men can get it or spread it, call that bullshit too. As usual, truth and collective action are the best ways to halt the spread of a disease.

Viruses don’t discriminate. It helps only the plague when humans do.

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Blade editor David Forbes has been a journalist in Asheville for over 15 years. She writes about history, life and, of course, fighting city hall. They live in downtown, where they drink too much tea and scheme for anarchy.

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