Monkeypox: Stigma and false accusations

Monkeypox continues to spread: more than 30,000 cases have now been registered worldwide. But public knowledge about the disease is still incomplete – and this opens the door to false reports.

Lily Simon, from New York, was shocked when she noticed a video of her doing the rounds on the TikTok platform, she reports to the New York Times. The video – recorded secretly – shows Simon sitting on the subway with a monkey emoji. Because the user who secretly filmed Simon mistakenly thought her skin changes were contagious monkeypox. Simon has the genetic disease neurofibromatosis. A feature of the disease: many superficial skin tumors.

Simon from the USA is not an isolated case. A photo from a Madrid subway, which was also supposed to show a person with monkeypox, was shared thousands of times on Twitter. Numerous media picked up the story and spread it. Here, too, the person concerned spoke up some time later and made it clear: he did not have monkeypox, but neurofibromatosis.

Monkeypox difficult for laypeople to recognize

The examples show that there is still a need for clarification on the subject of monkeypox. In any case, medical laypeople should be careful not to publicly denounce those who are supposedly infected. “Other diseases such as chickenpox, herpes zoster, scarlet fever, herpes simplex and syphilis can also cause skin changes that cannot always be clearly distinguished from monkeypox,” said a spokeswoman for the Robert Koch Institute (RKI).

Uwe Schwichtenberg, board member of the Professional Association of German Dermatologists, says that monkeypox is difficult to distinguish visually from other diseases. “Monkeypox is multifaceted and can come in a variety of forms.” There are infected people with a lot of knots all over their body, others only have three to four. In contrast to neurofibromatosis, for example, the knots are firm and not soft and cannot be easily pressed in. The RKI has sample images of monkeypox published on its website.

“We’ve been fighting stigma for years”

Schwichtenberg fears that the stigmatization of people with skin diseases may increase in the wake of the monkeypox epidemic. The epidemic has heightened people’s perception of skin changes and could lead to people with skin diseases being avoided for fear of contracting monkeypox.

“Even with Corona, we saw how people kept their distance from each other, even when the risk of infection was still very low,” says Schwichtenberg. Something similar could now also threaten with monkeypox. People with skin diseases would already have a difficult time anyway. “We’ve been fighting the stigma surrounding skin diseases for years,” he says.

At the beginning of the corona pandemic in the USA, the stigmatization of Asians led to increased racist attacks on the Asian-American community.

Hostilities against gay and bisexual men

Not only people with skin diseases have already been wrongly stigmatized as a result of the spread of monkeypox. Men who have sex with men are also subject to false claims. “We are observing with concern that terms such as ‘gay epidemic’ in connection with the monkeypox virus are becoming socially acceptable again,” says René Mertens from the Lesbian and Gay Association. “This primarily fuels hatred of gay and bisexual men.”

This leads to hostility, especially in social networks, says Mertens: “There is a risk that stigmatizing reporting will increase this hostility and culminate in violence. A person’s sexual orientation is irrelevant for the virus.” Even before the outbreak of monkeypox in Germany, there were at least three LGBTI-hostile crimes per day. “It cannot be ruled out that these numbers will increase again.”

The current situation brings back memories of the outbreak of HIV in the 1980s, says Mertens. At that time, too, the virus was mainly associated with homosexual men, and the media spoke of “gay plague”, among other things. “We know from the history of HIV prevention how painful and dangerous such terms are,” says Mertens. “They act as catalysts for homophobic attitudes and ideologies.”

The RKI also reports that the risk of infection is not limited to people “who are sexually active or to men who have sex with men”. Anyone who has close physical contact with an infectious person can become infected.

Shingles instead of monkeypox?

Conspiracy ideologists have already discovered monkeypox for themselves. The outbreak of the disease was planned and “played through” by the Munich Security Conference last year – which, among other things, from the fact fox of the Bavarian Radio has already been refuted. In a post shared on Telegram, on the other hand, it says that monkeypox is a result of the corona vaccination. There is no evidence of this either.

Nor for the claim made in the social networks that in most cases it is not a monkeypox infection but shingles (herpes zoster) as a result of the corona vaccination. This looks similar and is therefore mistakenly confused with monkeypox. According to the Paul Ehrlich Institute, there are 1.42 reported cases of herpes zoster per 100,000 corona vaccine doses.

“In the beginning, shingles can look very similar to a monkeypox infection,” says Schwichtenberg. However, the course of the two diseases would then differ significantly from each other. In addition, only infections detected with a PCR test are included in the statistics of monkeypox cases of the RKI, so that incorrect numbers due to incorrect diagnoses can be ruled out.