Public health officials haven’t stopped Monkeypox but want to rename it

The public health community has many skills. Reading the room is not one of them.

Professionals in the field responsible for identifying the origins of infectious diseases and preventing their regional and global spread say that monkeypox and its geographically tagged variants require a new name given the obscure origins of the last global outbreak of the virus.

The World Health Organization (WHO) agrees, stating this week that it will start looking for a less offensive name right away.

“WHO is also working with partners and experts from around the world to change the name of the monkeypox virus, its clades and the disease it causes,” WHO Director-General Tedros Adhanom Ghebreyesus said at a conference. print Tuesday. “We will announce the new names as soon as possible.”

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

“In the context of the current global epidemic, the ongoing referencing and nomenclature of this African virus is not only inaccurate, it is also discriminatory and stigmatizing,” these researchers wrote.

Their letter makes particular exception to the media’s use of photos showing African monkeypox patients to describe the effects of the disease. And while they concede that the origin of the current global epidemic is still unknown, these researchers said the use of African-named clades obscures the likely fact that “cryptic human transmission across continents” has been going on much longer. expected .

Changing the name would fight the possible, but unproven, “narrative in the media and among many scientists who are trying to link the current global epidemic to Africa or West Africa or Nigeria,” they write.

Up until this latest global outbreak, monkeypox had 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 outbreak only occurred in 2003, when infected rodents imported from Ghana to the United States led to an outbreak that infected 70 people.

The virus’s African origins and predominance, and the fact that primates can spread it to humans, might seem to the casual observer a justification for sticking to the original name of monkeypox and African-specific clades. The rarity of cases outside of Africa may also explain why images of African monkeypox patients dominate in the media. If images of non-African monkeypox patients were more common, it is possible that it was debated whether African victims of the disease were ignored.

Naming diseases based on where they were discovered has been controversial among public health professionals for years. The letter from the aforementioned researchers references a 2015 WHO document that lays out best practices for naming new human infectious diseases. The document specifically recommends not using places, animals, and occupations to name new diseases, and provides monkeypox as an example of a disease with unknown names.

However, the WHO best practices document also advises against trying to rename diseases that already have a common name in circulation. This would seem to discourage the demolition of the already established monkeypox.

The researchers’ letter above suggests creating the placeholder hMPXV in place of monkeypox and replacing the clades “West Africa” ​​and “Central Africa” ​​with the fascinating names A.1, A.2, etc.

This also goes against the conclusion of a working group assembled by WHO on the naming of COVID variants. That group recommended against alphanumeric naming schemes, as “they result in complex names that are prone to misreporting and misunderstanding.”

The argument that naming variants based on geographic locations is stigmatizing and discriminatory also misses the mark. Researchers say it’s inappropriate because we don’t know the origins of this latest outbreak. However, as origins are currently a mystery, even changing the name in advance to avoid associations with Africa seems premature and, if anything, designed to promote an alternative, even unproven, non-African origin story for this latest outbreak.

Changing the name of viruses and variants to avoid stigmatization of countries and regions did not work very well during COVID. When a new variant of COVID was discovered by South African researchers, the Biden White House scrupulously defined it not as the South African variant, but as B.1.1.529 or Omicron. He also quickly banned travel from the country.

While the geographic names of the diseases may make the job of some tourism bureau officials more difficult, it doesn’t seem as damaging to a country or region’s reputation as some public health officials claim. People are still willing to go on vacation to Barcelona despite the fact that the Spanish flu has killed more people than the Kaiser.

The sudden concern about monkeypox omits its primary utility: it has a funny and therefore memorable sound. Its uniqueness encourages people to pay attention to the virus, which public health officials should want. The fact that there has been so much coverage of a global, but still relatively minor, epidemic 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 “don’t panic about monkeypox” articles. Are public health officials suddenly concerned about people showing great caution when faced with a communicable disease?

Finally, the fact that the name monkeypox is the subject of controversy is itself downstream of a public health failure. Public bureaucracy largely exists to monitor diseases and prevent them from causing global outbreaks. This did not happen with monkeypox, a known disease that has nevertheless managed to spread around the world.

How he managed to do this is still a mystery. Rather than solving that case, some public health officials seem to content themselves with playing cute puns instead.

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