When Kevin Kwong's first lesions appeared, not one or two but several specialists mistook them for scabies or herpes because they didn't look like the ones in the monkeypox photos they had seen circulating.
By the time he got the correct diagnosis in early July, his health had already worsened and he had between 600 and 800 welts on his hands, feet, elbows, throat and near his eyes.
[He was diagnosed with herpes and scabies but had monkeypox. His case portrays US failures in the face of the outbreak]
"My symptoms got worse and none of my drugs worked for what we thought was herpes simplex and scabies," the 33-year-old Kwong said on Instagram.
"I felt like I didn't know what was happening to me, but I didn't realize how little information the doctors had and how unprepared they too were," he assured Kaiser Health News, allies of Noticias Telemundo.
His experience circumventing the health system is not unique.
Kevin Kwong received several misdiagnoses. Courtesy / Kevin Kwong
"Sometimes these lesions already have scabs and in their mature stage they don't even look like the ones we see in magazines and on the news, and that
has proven to be a challenge for most doctors
," explains Dr. Mauricio González Arias, a specialist. in internal medicine and emergencies, who has been attending for more than seven years at the Metropolitan Hospital Center in New York.
González has had several patients with monkeypox:
"Little by little we have become familiar with it,"
he explained to Noticias Telemundo.
The first cases of this outbreak were detected in May 2022. As of August 5, almost 30,000 were reported in 88 countries around the world, and 7,510 of them in the United States, which declared the disease a public health emergency in August.
Being so little known in places where it was not endemic, that is, where it does not commonly appear, new myths arose every day.
But here's what is known so far, according to the Centers for Disease Control and Prevention (CDC):
It was first detected in 1958 in monkeys.
Its origin is unknown, but it is believed that African rodents and primates can harbor the virus and infect people.
The first human case was reported in 1970.
Before 2022, it was recorded in countries in central and western Africa.
The virus that causes monkeypox is part of the same family as smallpox and its symptoms, although similar, are milder.
Monkeypox has been stigmatized as a disease of gay men, but it is not.
July 25, 202202:33
what the doctors say
In addition to speaking with Dr. González Arias, we spoke with Katrine Wallace, an epidemiologist and professor at the University of Illinois School of Public Health, and Margaret Russell, a family doctor in Chicago and a specialist in LGBTQ health, to clarify common doubts about this disease.
They are no strangers to debunking fake news.
They use their accounts on networks like TikTok or Twitter to amplify what science says.
This is what they explain:
It is not a sexually transmitted disease.
That the flu can be spread during sex does not make it a sexually transmitted disease, Wallace says.
And the same thing happens with monkeypox: the infection is caused by close contact with the infected person.
"What we have seen is that the proximity of the sexual act, with active lesions, leads to transmission," says González Arias, "it has not been classified as a sexually transmitted disease, but that does not mean that it will not be in the future".
It is not exclusive to the LGBTQ community:
“There is nothing biological about being a man who has sex with men or a gay person that predisposes you to monkeypox, it could happen to anyone who has been exposed to the virus”, Wallace clarifies.
Children and women and men of any sexual orientation can get it.
Yes, there are vaccines.
“In the United States we have vaccines and antivirals.
The vaccine after exposure is being applied to people who are at high risk, who may have immunocompromise”, says the specialist in Internal Medicine and Emergencies.
Before administering any drug, it must be verified that the person is infected.
Skin lesions do not always look like the photos.
The virus has different stages: a person can be sick and have symptoms like those of the flu or COVID-19, before the skin rash appears.
"These lesions progress, initially they can be seen as pimples, like acne, but as the days go by, vesicles form," says González Arias.
COVID-19 precautions work to prevent contagion:
"It doesn't bother me if people wear a mask to prevent smallpox because it also helps us with COVID-19," adds Wallace, who insists that unlike the coronavirus - which is very contagious even without direct contact –
monkeypox needs skin-to-skin contact to spread.
We explain it below.
1. It is not only transmitted through sex
Monkeypox is spread by "close and personal, often skin-to-skin" contact.
Such contact can occur in the context of an intimate relationship by kissing, hugging, rubbing or massaging someone who is infected, but there is no evidence that it can be spread through "semen, vaginal fluids, urine or feces," according to the CDC.
"Studies are needed to better understand this risk," acknowledges the World Health Organization (WHO).
"Clothes, sheets or sharing a bed with someone who is infected exposes you to a large amount of the virus," says Professor Wallace.
And so are unsanitized towels that were exposed to the rashes, shells, and bodily fluids of an infected person.
[Government declares monkeypox public health emergency]
On whether it is possible to get infected by trying on clothes in a store, the epidemiologist emphasizes that it is unlikely.
"The level of the virus is probably not high enough to give you - we're not seeing that kind of community transmission today and hopefully people with smallpox aren't in stores trying on clothes."
Positive and negative monkeypox test tubes. DADO RUVIC / REUTERS
2. It is not exclusive to the LGBTQ community
Although the infections have spread among men who have sex with men, Wallace believes that “it has more to do with the close interconnectedness of social and sexual circles that exist in that community.
This disease has been seen especially in men who have sex with men, but that does not mean that it is exclusive to them, and
that has hurt and stigmatized this community
, ”says González Arias, who has treated all kinds of cases including Latinos. .
Most, he says, are mild.
Most cases are mild: young patients who only require isolation and symptomatic treatment"
Mauricio González Arias Internal Medicine
"They are young patients who are not extremely ill, who only require isolation and symptomatic treatment, that is, oral fluids and eating well, resting, ibuprofen or Tylenol for fever or muscle aches or headaches," adds the doctor.
[Couple beaten up in Washington DC and insulted with homophobic hate speech and monkeypox allusions]
'I feel horrible': Monkeypox hits Latino men hard
Aug. 9, 202201:51
3. There are two vaccines available
ACAM2000.
It was approved for use against smallpox and doses are available.
But "it is associated with more side effects and problems related to its toxicity and safety," says the epidemiologist: "It cannot be used in people with compromised immune systems, or pregnant women, or in someone with eczema."
Jynneos.
It was initially approved for adults, but after the positive case of a worker in an Illinois daycare center was detected, its use was authorized in children in exceptional situations.
"Unfortunately we do not order enough doses and the response has been limited because of that,
right now we are only vaccinating people at high risk
," says the doctor.
That risk is determined if someone has been in close contact with a positive case, "it can be the sexual partner, or a person who has had multiple sexual partners in an area with an outbreak."
Dr. Margaret Russell's work focuses on sexual and reproductive health as well as access to healthcare for LGBTQ patients.
She says that, in the face of an emergency, tests and vaccines were "limited and reserved for people at higher risk," as was the case at the start of the COVID-19 pandemic.
That led to "a lot of misconceptions about the disease and who is potentially at risk."
In late July, Russell debunked monkeypox hoaxes in a Twitter thread.
“
It is not restricted to age, gender, sexual orientation or any other personal characteristic
”, she insists.
According to the WHO, several studies have shown that "smallpox vaccination is approximately 85% effective in preventing monkeypox."
4. Lesions don't always look like the photos
"I have seen quite a few cases, the vast majority young men without added pathologies, who present the characteristic symptoms: fatigue, fever, lack of appetite and that days or weeks later the lesions that we already know appear," explains González Arias.
"From that point you shouldn't go out, one to four days later the rash will appear," Wallace continues.
That rash also goes through different stages.
"
The first rashes are small, like a pimple, then they will start to grow
and grow until they create scabs that eventually fall off, when they fall off it is believed that the person is no longer contagious, "he explains.
Kevin Kwong had more than 600 injuriesCourtesy / Kevin Kwong
Symptoms can begin three weeks after exposure to the virus and "the illness usually lasts two to four weeks," according to the CDC.
González acknowledges that it has been a challenge for professionals to become familiar with them and their different stages.
Russell agrees with him.
"Many doctors have never seen it and may not feel confident in diagnosing
it," he explained to Noticias Telemundo.
One of the peculiarities of this outbreak is that the viral symptoms do not always appear or start after the rash.
The parts of the body where pimples arise also varies.
"They often start in the genital area or inside the mouth and rectum, where people may have pain but the lesions are hard to see," says Russell.
5. Some measures against COVID-19 work
COVID-19 is so contagious that you don't need close contact, but monkeypox does.
Although the CDC lists different routes of transmission, not all are equally dangerous, Wallace believes.
"You probably won't get monkeypox from something casual like being in the supermarket or at a cafe,"
he explains.
Vaccines are not enough to stop the spread of monkeypox in the US.
Aug. 2, 202201:28
"We believe that it can also be infected by drops of saliva, but we do not know how effective this transmission route is," says Gutiérrez Arias.
The comparisons between the two viruses are based on the familiarity that people have with COVID-19 and its prevention measures after two years of the pandemic, experts consider.
The use of a mask and social distancing are always useful.
“They are two completely different families of viruses,” Wallace clarifies, so
“yes it is possible to have them at the same time”.
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