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People wait in line at a monkeypox vaccination clinic run in Montreal, Canada. Alamy Stock Photo

'Not the only transmission route': Calling monkeypox an STI may create false sense of security

Speaking to The Explainer podcast, Dr Cillian de Gascun said it should not be overlooked that household contacts and healthcare workers are also at risk.

THERE IS A DANGER that commentary around the current global monkeypox outbreak could cause a false sense of security about the level of risk posed by the virus, a leading Irish virologist has said.

There have now been over 100 reported cases of monkeypox in Ireland since the start of the outbreak in May. Around 30,000 cases have been reported across 80 countries where monkeypox is not endemic and the World Health Organization (WHO) has declared the outbreak a Public Health Emergency of International Concern (PHEIC).

While the majority of cases in this outbreak have been among gay and bisexual men and other men who have sex with men (gbMSM), experts have cautioned against linking transmission solely to sexual activity and have warned that messaging, if not managed correctly, risks stigmatising people. 

Speaking to The Journal‘s The Explainer podcast this week, Dr Cillian de Gascun, Director of the National Virus Reference Laboratory said the terminology around the outbreak can be “challenging”, with some referring to it as a sexually transmitted infection (STI).


The Explainer / SoundCloud

“Traditionally, we wouldn’t have considered it an STI because when we think about sexually transmitted infections we often think about pathogens, like chlamydia or gonorrhoea, that require direct sexual contact – be that penetrative or otherwise – for transmission,” he explained.

“Now, when we look at monkeypox we know that’s not the case. It’s typically skin-to-skin direct contact, but it can also be respiratory droplets or through contaminated fomites or objects in an infected person’s households.”

Dr de Gascun said referring to monkeypox as an STI “automatically causes some people to think they are not at risk because perhaps they’re not sexually active or they haven’t been in contact with somebody sexually in a period of time or they haven’t seen somebody with lesions”.

Referencing the way Covid was transmitted in various specific sectors or groups in society, de Gascun said “viruses just follow human behaviour”.

“They don’t pick and choose different groups within society. So when we talked about Covid, Covid didn’t pick on people that were going to pubs, Covid didn’t pick on people that were going to weddings, it’s just the virus will follow human behaviour,” he said.

De Gascun said the virus “doesn’t really care about your sexuality” and it should not be overlooked that household contacts of infected persons and healthcare workers are also at risk. 

“Certainly sexual contacts are at increased risk as well, but that’s not the only route of transmission,” he said. 

Balancing the need to ensure those at risk get information and protection with the risk of stigmatising a particular group in society is a challenge for public health officials, de Gascun said.

“We would have seen it historically in the 80s and 90s with something like HIV as well, so I think what public health and all of us as medical professionals have to do is communicate as effectively as we can, to educate the population at large, but also have our messages targeted at people where they’re likely to receive them,” he said.

We know that maybe younger people, for example, don’t watch traditional news as much so they might get their information from podcast or they might get their information on social media. So the likes of the HSE and the Health Protection Surveillance Centre have done huge work in trying to get the message across those platforms as well.

He said that while public health messaging needs to speak to the whole population, it is also important to be responsive to the data and explain to people where the cases are and why some of the messaging may be targeted.

“Again if we look at the likes of Covid, obviously we had a significant issue in residential care facilities so they might have had enhanced measures,” he said.

“So I think it’s important that we don’t get too caught up in the populations or the groups that are involved themselves, but if we explain why we’re directing certain messaging at particular groups and provide the context, then I think most people would be happy to take that on board and wouldn’t be I suppose, unduly offended by it. But it is a fine balance.”

The National Immunisation Advisory Committee (NIAC) has recommended that smallpox vaccine can be used to provide protection against monkeypox. The European Medicines Agency has also recently approved the use of this vaccine for the prevention of monkeypox disease.

The HSE has said it is continuing to work on a vaccination programme targeting those who are most at risk of infection, including gay, bisexual and other men who have sex with men. However the health service has said supplies of the vaccine in Ireland are currently low and limited. 

Health authorities have said Ireland, along with other EU countries, is actively exploring options to increase the medium to long-term supply of vaccines.

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    Mute Ole dan tucker
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    Nov 1st 2019, 7:20 AM

    Ya right

    504
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    Mute The long walk home☘️
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    Nov 1st 2019, 8:16 AM

    @Ole dan tucker: Whatever about him the Garda and police have allowed this get to where it is. They allowed signs be posted that defame and send threatening messages to staff, was any poster dusted for Fingerprints or DNA, no because nobody wanted to move them. 70 incidents in the last few years and no arrests. Quinn is a gambler that’s problem caught up with him.

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    Mute Dow Dubrov
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    Nov 1st 2019, 8:22 AM

    @Ole dan tucker: He’s getting a bit of heat from his actions and is trying to tone it down temporarily. He hasn’t gone away, you know.

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    Mute SF Knee Knockers
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    Nov 1st 2019, 9:01 AM

    @The long walk home☘️: ye it’s the Gardas fault. Border area has always been peaceful and law abiding. Police need evidence and witnesses, the local community know who these criminals are and are the only ones who can provide the Garda with the information needed to lock them up.

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    Mute Kyle
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    Nov 1st 2019, 7:34 AM

    Ye Sean, we believe ya

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    Mute Mark Johnson
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    Nov 1st 2019, 7:56 AM

    @Kyle: I notice there has been no statement from or interview with his son on this, Sean Jnr

    219
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    Mute Levante Dublin
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    Nov 1st 2019, 8:12 AM

    @Mark Johnson: or his wife or sisters. Or the postman, or the priest

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    Mute James Douglas
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    Nov 1st 2019, 8:23 AM

    @Mark Johnson: I’d say you love Cluedo, Mark?

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    Mute Mark Johnson
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    Nov 1st 2019, 8:30 AM

    @James Douglas: just stating the obvious: Interview the young son, not the father pensioner. @Levante Dublin what has the postman and priest got to do with this?

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    Mute John Mulligan
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    Nov 1st 2019, 9:41 AM

    @Mark Johnson: the one who ran away?

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    Mute The long walk home☘️
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    Nov 1st 2019, 8:30 AM

    If he really was contrite he would stop blaming banks, regulators and everyone else and apologize to his staff for his gambling that almost led to the loss of their jobs, to the taxpayers that had to bail out his underfunded insurance company and thank the management of his former companies that got the finance together to save local jobs, and be grateful he still lives in a mansion and still has a sh*t load of money for a man that was bankrupt.

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    Mute Conoroconnor
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    Nov 1st 2019, 12:40 PM

    @The long walk home☘️: he still has an awful lot for a man who ‘lost everything’ CAB should be on his case.

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    Mute John Killeen
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    Nov 1st 2019, 8:55 AM

    Any chance of an apology to all the people in Ireland who have to pay a levy on insurance to pay off his gambling debts?

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    Mute The Great Unwashed
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    Nov 1st 2019, 7:27 AM

    It’s inconceivable that these threats and attacks could take place in that part of the country without the direct involvement of or consent from paramilitaries.
    The question is who is the ‘paymaster’ the QIH directors keep referring to?

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    Mute The Great Unwashed
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    Nov 1st 2019, 7:30 AM

    An ‘ordinary decent criminal’ can’t even sneeze there without permission from paramilitaries.

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    Mute John Mulligan
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    Nov 1st 2019, 9:43 AM

    @The Great Unwashed: that would be some other lad, like.

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    Mute Chin Feeyin
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    Nov 1st 2019, 8:30 AM

    Sorry, Sean. Don’t believe you.

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    Mute 2thFairy
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    Nov 1st 2019, 9:08 AM

    Perhaps the directors are standing up to racketeering. I’d say Quinn paid a hefty amount to gangsters in his day and nurtured a nice easy income for some nasty people. These directors are brave men and should be protected at all costs.

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    Mute John Mc Donagh
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    Nov 1st 2019, 11:18 AM

    @2thFairy :Maybe the nub of the problem!

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    Mute Bass demon
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    Nov 1st 2019, 10:45 AM

    Interesting that when Quinn Holdings rehired SQ for a year all the intimidation stopped .We saw what happened in Cherry Orchard recently where CAB went after 2 goughers who had a protection racket going on against a construction company I wonder was something similar going on here.

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    Mute Tom McHugh
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    Nov 1st 2019, 9:02 AM

    Ahh the Badlands again. The narrative has been written in such a way that these areas feel they have been completely neglected and must look after their own. The criminals can act with impunity flying under the flag of convenience of “republicanism” etc. This is just a magnifying glass on the vagaries of life from which those living in cities have been protected. Instead we are worried about same sex marriage…

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    Mute Keith Mac Suibhne
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    Nov 1st 2019, 10:07 AM

    Pull the other one!

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    Mute Tony O Neill
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    Nov 1st 2019, 9:27 AM

    Two faces ?

    28
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    Mute Irish big fellow
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    Nov 1st 2019, 11:16 AM

    Godfather – Mafia – Omertà
    Sounds familiar! These instigators go around pretending to be pillars of society. Misguided people look up to them.
    Big mansions no mortgages – send in CAB to flush out the person(s) behind the attacks on the Directors.

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    Mute Rebecca De Stanleigh
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    Nov 1st 2019, 11:31 AM

    Sure cause you’re a stand up guy! As transparent as my window so he is.

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    Mute Paul Dooley
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    Nov 1st 2019, 12:05 PM

    If it’s this bad now I wonder how many small businesses got strong armed and intimidated by certain big businesses over the years

    It would be great if these people rang joe Duffy and put an end to this fraud pretending to be an angel

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    Mute Noel O Sullivan
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    Nov 1st 2019, 9:35 AM

    A boycott of businesses and services in these areas should begin.

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    Mute Denis Logan
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    Nov 1st 2019, 8:05 PM

    @Noel O Sullivan: why?

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    Mute Olive Whyte
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    Nov 1st 2019, 9:10 AM

    He was abducted the 17th September, not 23rd.

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    Mute Elizabeth Sheehan O'Reilly
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    Nov 1st 2019, 12:13 PM

    @Olive Whyte: irrelevant. He was abducted

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    Mute Olive Whyte
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    Nov 1st 2019, 5:45 PM

    @Elizabeth Sheehan O’Reilly: it’s not irrelevant. If you write a news article you have to have your facts correct. Basic rules of journalism, that I’m not sure those who write for the Journal understand.

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    Mute Robert Hand
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    Nov 1st 2019, 8:36 PM

    Golden Rule: Follow the Money
    Criminals won’t work without reward. Risk is so big, the Reward must be BIG. Who has pockets deep enough. Who has grievance big enough. Clearly, only ONE answer

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    Mute Jp Murray
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    Nov 1st 2019, 5:55 PM

    Sean Fitzpatrick and David drum are the root cause of this. They are the ones that manipulated the Anglo share price by there unlawful activity.Sean Quinn along with many others were buying shares in a bank that had false accounts.
    The Irish state should also hang there head in shame for having him put in prison for something that was not his fault.

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    Mute The Great Unwashed
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    Nov 1st 2019, 6:20 PM

    @Jp Murray:
    Quinn bankrupted himself with Contracts for Difference, not Anglo shares. I’m certainly no great supporter of Sean Fitz or Drumm, but they were horrified when they learned what he had done.

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    Mute Denis Logan
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    Nov 1st 2019, 8:00 PM

    @Jp Murray: you’re speaking rubbish.. Seán Quinn gambled with people’s insurance premiums and lost. Now we’re all paying for his gambling. He belongs behind bars. You sound like a sneaking regarded for these murderous thugs. You should be ashamed of yourself

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    Mute Denis Logan
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    Nov 1st 2019, 8:04 PM

    @Jp Murray: he should still be in prison for gambling with the insurance premiums. You sound like a sneaking regarder of these murderous thugs.

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    Mute martin hayes
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    Nov 1st 2019, 1:56 PM

    This is too little to late front the head honcho. People are so involved in this now they will not have the desire to pull back .

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    Mute Eleanor Dowd
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    Nov 1st 2019, 10:23 AM

    Not before time ,too little too late for Mr Lummey and his family.

    1
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