Public health officials have not stopped monkeypox, but they want to rename it

Public health has many competencies. Reading the room is not one of them.

Experts in the field responsible for identifying the origins of infectious diseases and preventing their regional and global spread say that monkeypox and its geographically identified variants require a new name given the murky origins of the world’s latest outbreak.

The World Health Organization (WHO) agrees, saying this week that the search for a less offensive name will begin immediately.

“The WHO is also working with partners and experts around the world to change the name of the monkeypox virus, its genera and the disease it causes,” WHO Director-General Tedros Adanom Gebreyesus told a news conference on Tuesday. “We will announce the new names as soon as possible.”

His comments came days after an international collection of infectious disease researchers issued an open letter calling for a “neutral, non-discriminatory and [sic] a non-stigmatizing naming scheme that abandons the use of the term monkeypox in both “West African” and “Central African” or “Congo Basin”.

“In the context of the current global epidemic, the continuing mention and nomenclature of this virus as African is not only inaccurate, but also discriminatory and stigmatizing,” the researchers wrote.

Their letter makes a special exception to the use by the media of photographs showing patients with African monkeypox to depict the effects of the disease. While acknowledging that the origins of the current global epidemic are still unknown, these researchers said the use of poles with African names obscures the likely fact that “transcontinental, mysterious human transmission” has lasted much longer than expected. .

The name change will fight a possible but unproven “story in the media and among many scientists trying to link the current global epidemic to Africa, West Africa or Nigeria,” they wrote.

Until this last global epidemic, smallpox most commonly infected people in Africa, often after coming into contact with infected animals – including rodents and monkeys. According to the WHO, the first non-African epidemic did not appear until 2003, when infected rodents imported from Ghana to the United States led to outbreak which infected 70 people.

The African origin and predominance of the virus, as well as the fact that primates can spread it to humans, may seem to the casual observer an excuse to stick to the original name of monkeypox and African-specific logs. The rarity of cases outside Africa may also explain why images of patients with African monkeypox dominate the media. If images of non-African patients with monkeypox were more common, we might argue that African victims of the disease have been ignored.

The naming of diseases in the places where they are found has been controversial among public health professionals for years. The above letter from the researchers refers to a WHO document from 2015 which sets out best practices for naming new human infectious diseases. The document explicitly recommends not using places, animals and professions to name new diseases and gives monkeypox as an example of a disease with a bad name.

However, the WHO Best Practice Paper also recommends that you do not try to rename diseases that already have a common name in circulation. It seems advisable not to remove the already well-established monkey pattern.

The above letter from the researchers proposes to create a replacement hMPXV instead of monkeypox and to replace the logs “West Africa” ​​and “Central African” with the charming names A.1, A.2, etc.

This also contradicts the conclusion of a WHO working group on naming COVID variants. This group recommends against alphanumeric naming schemes, as they “lead to complex names that are prone to misreading and misunderstanding”.

The argument that naming options by geographical location is stigmatizing and discriminatory is also irrelevant. Researchers say this is inappropriate because we do not know the origin of this latest outbreak. Yet, as origins are currently a mystery, a preventive name change to avoid associations with Africa also seems premature and, if nothing else, is intended to promote an alternative, also unproven, non-African history of history for this latest epidemic. .

Changing virus names and variants to avoid stigmatizing countries and regions did not work very well during COVID. When a new version of COVID was discovered by South African researchers, Biden’s White House strictly called it not the South African version, but B.1.1.529 or Omicron. He also quickly banned travel from the country.

Although the geographical names of diseases can make it difficult for several staff members at tourist offices, this hardly seems as detrimental to a country’s or region’s reputation as some public health officials present. People are still ready to rest in Barcelona, ​​despite the fact that the Spanish flu killed more people than the Kaiser.

The sudden concern for monkeypox misses its main usefulness: it sounds ridiculous and therefore memorable. Its uniqueness encourages people to pay attention to the virus, which public health officials should want. The fact that there was so much reflection on a global but still relatively insignificant outbreak certainly has something to do with the name. If nothing else, the name encourages people to pay too much attention to the disease – hence all the articles “do not panic about monkeypox.” Do public health officials suddenly worry that people are being overly cautious about a contagious disease?

Finally, the fact that the name monkeypox is controversial in general is in itself a failure in public health. The public health bureaucracy exists to a large extent to monitor diseases and prevent them from causing global outbreaks. This did not happen with monkeypox, a known disease that nevertheless managed to spread around the world.

How he did it is still a mystery. Instead of breaking this case, some public health officials seem content to play games with waking words.

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