September 28, 2022


The monkeypox virus disease is spreading around the world. So far, there are more than 6,300 known cases in the US, almost exclusively among gay and bisexual men. New York, California, Illinois and some cities have declared a state of emergency, following the declaration of a global emergency by the World Health Organization itself.

The headlines are grim enough that you might worry that monkeypox is like SARS or Covid: another virus that could disrupt or even threaten your life. The good news is that monkeypox is much less contagious and much less likely to be fatal than Covid. There are also vaccines and treatments originally developed for smallpox that work on monkeypox.

But while monkeypox probably won’t kill you, it can be excruciating enough that you’ll want to avoid it anyway: It can they cause pain which some patients compare to shards of glass scraping against the skin. And although the virus mostly afflicts gay and bisexual men now, that could change if it continues to spread unchecked. Nothing about the virus limits its spread to men who have sex with men (not everyone identifies as gay or bi).

Today’s newsletter explains what we know about monkeypox and what people can do to stay safe.

Monkeypox causes symptoms that can range from unpleasant to painful, although it is rarely fatal. At least six deaths, out of 25,000 cases, have been reported in places where the virus was not known to exist before the current outbreak. The risk of death is higher for young children and people who are immunocompromised or pregnant.

The telltale symptom is sores, which may look like pimples or blisters. They can be painful, especially in sensitive areas such as the genitals and anus.

“I was afraid to use the toilet,” a recent monkeypox patient, Gabriel Morales, told the Times. He described the wounds as “broken glass” on his body.

Other symptoms include fever, headache, muscle aches, swollen lymph nodes, chills and exhaustion. The illness usually lasts two to four weeks.

Monkey pox is primarily transmitted through close physical contact, usually skin-to-skin contact. Most infections in the current outbreak have occurred through close contact during sex. The virus can also spread through contaminated surfaces, including clothing and bedding. Brief contact, such as shaking hands, is usually not enough to spread monkeypox. Unlike Covid, it doesn’t seem to spread much through the air.

Almost half of the known US cases have occurred in the first three states to declare states of emergency: New York, California and Illinois.

So far, about 98 percent of cases worldwide are among men who have sex with men. Many of them had multiple partners, sometimes strangers. Some early superspreader events it was a gay party in Europewhich appeared to introduce the virus into the social networks of men who have sex with men.

Public health officials have struggled to identify some of these factors, fearing they might stigmatize gay and bisexual men. But part of a proper public health response is targeting the people most at risk and the most dangerous activities, and that requires an honest assessment of what’s going on.

Most people are not at serious risk of contracting monkeypox, with the virus concentrated in gay and bisexual men for now. “Your risk depends on who you are,” my colleague Apoorva Mandavilli, who has covered the current outbreak since the first case was identified in the US, told me.

To reduce the risk, gay and bisexual men can try to make sure their male sexual partners don’t have monkeypox by watching for sores. They can use a condom, which can at least reduce the chances of sores in sensitive areas. They can reduce temporarily their number of sexual partners or to avoid riskier activities such as anonymous sex and sex parties. Practicing good hygiene, such as frequent hand washing, can also help.

There are also vaccines and tests for monkeypox, although they are not currently widely available due to supply shortages and strict government rules on access.

If someone is infected, the CDC recommends isolation at home and staying away from others if possible. But that can be very difficult with an illness that can last four weeks – another reason to prioritize prevention and slow the spread.

Public health officials are trying to make vaccines, treatments and tests more available. President Biden yesterday appointed a national monkeypox response coordinator to oversee these efforts.

But progress was slow. As monkeypox spread in May and June, 300,000 doses of vaccines belonging to the US were found in Denmark.

Officials are also trying to raise public awareness about monkeypox, since it is a new virus to most Americans.

Their main goal now is to avoid a wider outbreak that makes monkeypox an endemic virus that spreads regularly in the US, like the flu. If monkeypox continues to spread unchecked, it could eventually spread to a wider population than gay and bisexual men, said Dr. Celine Gounder, a senior fellow at the Kaiser Family Foundation.

“It’s still manageable,” he added. “But it will require more aggressive screening, testing and vaccination.”

Monkey pox is not typically fatal, but it can still cause painful disease and permanent scarring. The risk is not high for most people now, but that could change if the virus continues to spread. And people at serious risk can take steps to stay safe and prevent the outbreak from getting worse.

It’s pickle summer. Not the actual pickles – although they’re as popular as ever – but the ubiquitous flavor, writes Christina Morales.

The spicy pickle adds a sweet and sour flavor that complements snacks like popcorn and pizza. Frito-Lay now makes pickle-flavored Lays, Doritos and Ruffles chips. Trader Joe’s said its dill pickle seasoning mix sold out soon after it hit shelves in May.

Social media has helped boost the flavor’s popularity. Meg and Maddie Antonelli, a mother-daughter TikTok duo, make pickle pizzas at home, put pickle dip on burgers, and combine pasta with dill pickle seasoning. “I wish this was always a trend,” said Meg Antonelli, “because I love pickles.”



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