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Health Alert: Beyond STIs
Sexually active people can become infected with more than just the commonly known diseases of Chlamydia, Gonorrhea, Syphilis, Hepatitis B, and Hepatitis C. In 2022, two other diseases are having reported outbreaks of cases among the category known as ‘Men who have Sex with Men’, aka MSM. Today we’ll bring awareness to these two new disease outbreaks.
Meningococcal Disease Outbreak in FL
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- CDC page
- What MSM Need to Know PDF
- Serogroups
- What are they? A group of bacteria containing a common antigen
- How many exist?
- At least 13 serogroups for Meningococci have been described: A, B, C, D, E, H, I, K, L, W-135, X, Y, and Z
- Serogroups B and C have caused most cases of meningococcal meningitis in the United States since the end of World War II; before that, group A was more prevalent.
- More than 99% of meningococcal infections are caused by serogroups A, B, C, 29E, or W-135.
- In response to the serogroup C outbreak in Florida, CDC is encouraging gay, bisexual, and other men who have sex with men (with or without HIV) to:
- Get a MenACWY vaccine if they live in Florida
- Talk with their healthcare provider about getting a MenACWY vaccine if they are traveling to Florida
- CDC routinely recommends MenB vaccine for people 10 years or older who are at increased risk for meningococcal disease during an outbreak involving serogroup B. CDC also recommends a booster shot for those at increased risk due to an outbreak who received the vaccine more than 1 year ago.
Monkeypox Disease Global Outbreak
- History/Naming:
- First discovered in 1958, two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research
- Source of the disease remains unknown; African rodents and non-human primates may harbor the virus and infect people
- First human case of monkeypox was recorded in 1970
- Prior to 2022, nearly all monkeypox cases in people outside of Africa were linked to international travel or through imported animals
- The 2022 Outbreak
- World Health Organization info: Most reported cases so far have been identified through sexual health or other health services in primary or secondary health-care facilities and have involved mainly, but not exclusively, men who have sex with men.
- Actual number of cases is likely to be underestimated, in part due to the lack of early clinical recognition of an infection previously known in only a handful of countries, and limited enhanced surveillance mechanisms in many countries for a disease previously ‘unknown’ to most health systems.
- CDC Global Case Map – updated frequently
- As of July 8 ‘22, reported 8,238 cases
- UK: 1,552
- Germany: 1,490
- Spain: 1,256
- US: 790
- As of July 8 ‘22, reported 8,238 cases
- CDC US Case Map – updated frequently
- As of July 8 ‘22
- New York: 153
- California: 136
- Illinois: 91
- Florida: 72
- District of Columbia: 64
- As of July 8 ‘22
- CDC Monkeypox FAQs
- Spread:
- Respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact.
- Pregnant people can spread the virus to their fetus through the placenta.
- Touching items (such as clothing or linens) that previously touched the infectious rash or body fluids.
- Not considered a sexually transmitted infection. Monkeypox can be spread during intimate physical contact between people. This contact can happen when you have sex, including:
- Oral and insertive sex, plus touching the genitals or anus of a person with monkeypox
- Hugging, massage, kissing or talking closely with a person infected with monkeypox
- Touching fabrics, shared surfaces, and objects, such as bedding, towels and sex toys, that were used by a person with monkeypox
- Anyone can get monkeypox if they have close contact with someone who has the virus.
- Sex is not required for infection, but is a delivery mechanism.
- Signs / Symptoms:
- Typically presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications
- Underlying immune deficiencies may lead to worse outcomes.
- Usually a self-limited disease with the symptoms lasting from 2 to 4 weeks
- Incubation period (interval from infection to onset of symptoms) of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days
- Invasion period (lasts between 0–5 days) characterized by:
- Fever, intense headache, swelling of the lymph nodes
- Back pain, muscle aches, and an intense lack of energy
- Skin eruption period usually begins within 1–3 days of the appearance of fever.
- Rash tends to be more concentrated on the face and extremities rather than on the trunk.
- Affects the face (in 95% of cases), and palms of the hands and soles of the feet (in 75% of cases).
- Also affected: oral mucous membranes (in 70% of cases), genitalia (30%), and front of the eye and lines the inside of the eyelids (20%), as well as the cornea.
- Rash evolves sequentially from lesions with a flat base to papules (slightly raised firm lesions), vesicles (lesions filled with clear fluid), pustules (lesions filled with yellowish fluid), and crusts which dry up and fall off.
- Number of lesions varies from a few to several thousand.
- In severe cases, lesions can coalesce until large sections of skin slough off.
- Treatment / Vaccination:
- There are no treatments specifically for monkeypox virus infections.
- Although vaccination against smallpox was protective in the past, today persons younger than 40 to 50 years of age (depending on the country) may be more susceptible to monkeypox due to cessation of smallpox vaccination campaigns globally after eradication of the disease.
- CDC does not recommend widespread vaccination against monkeypox at this time.
- U.S. government has two stockpiled vaccines—JYNNEOS and ACAM2000—that can prevent monkeypox in people who have been exposed to the virus.
- Watch for changes on this as vaccine availability changes. There is a presumption that at-risk populations, such as MSM, are encouraged to get prophylactic vaccination.
Takeaways:
- Knowledge and awareness are the prevention tools of fear. While these diseases can be life changing and could lead to death if not treated, we have the tools to limit infections and community spread.
- If you are unsure about any symptoms you are experiencing, talk with a healthcare professional, preferably one that is familiar with these diseases. This could be staff at a Federally Qualified Health Center [FQHC], your personal physician, or a reputable LGBTQIA health practitioner.
- Meningococcal Disease
- Talk with your healthcare provider about getting a MenACWY vaccine, especially if travel to Florida may be in your plans.
- Provide them with information/links and be your own health care advocate.
- Monkeypox Disease
- More than ever, know your partners and their sexual history / awareness.
- While a preventive vaccine is not being offered universally, be aware of options as they occur.
- Some regional areas with higher cases have been offering vaccination events. Pretty much every time, the response overwhelms the available supply.
- US Dept of Health and Human Services is planning to make 1.6 million doses available by the end of 2022
- Prevention is key in public health to limit the spread of infections.
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