News Forum - Thailand records fifth case of monkeypox in Thai woman

[Thaiger]

A Thai woman who recently returned to Thailand from Dubai has tested positive for the monkeypox virus. The positive result was confirmed today by Thailand’s Ministry of Public Health. Airport staff noticed that the 25 year old woman looked unwell and had blisters on her body when she arrived at Suvarnabhumi Airport on August 14, so they took her to the airport’s quarantine facility, said Public Health Minister Anutin Charnvirakul. Samples were taken and sent for testing, which came back positive, said the health minister. The woman is now receiving treatment in hospital. Anutin said the woman had recently had […]

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[NorskTiger]

The article makes an inference to that woman had been having "intercourse" in Dubai, without going into the specifics. 

  It is, most likely,  not the fact of being gay in itself that is a risk for Moneypox, but rather of engaging in sodomy.  

     Women who engage in anal sex are probably just as likely to catch it as homsexuals doing the same. IMHO, I have read little reporting that suggests Monkey Pox will spread to any significance through regular sex. 

[Chatogaster]

51 minutes ago, NorskTiger said:

The article makes an inference to that woman had been having "intercourse" in Dubai, without going into the specifics. 

  It is, most likely,  not the fact of being gay in itself that is a risk for Moneypox, but rather of engaging in sodomy.  

     Women who engage in anal sex are probably just as likely to catch it as homsexuals doing the same. IMHO, I have read little reporting that suggests Monkey Pox will spread to any significance through regular sex. 

 

That might be possible (at these early stages), but I think it's not something that should be said out loud (especially but not only because you have neither expertise nor supporting evidence).  

Statements like yours will make (many) people believe that they can't contract monkeypox even though they're sexually active (but don't have anal intercourse). Your statement then amounts to giving what's most likely to be a false sense of security, and that's irresponsible.

Eventually, the virus will either be stamped out or there'll be a heterogeneous spread of the virus. The main cross-over event from the current sub-population to the entire population might be due to some particular type sexual act, it might be because of bisexual relationships, it might be something else (including combinations). Once that has happened, the type of sexual act will hardly matter anymore.

 

[NorskTiger]

First of all, I DO have expertise. I have treated many people for STD's and have had a male-health clinic at some time. I have furthermore been giving care to many women for well.woman exams and therapy. 

 There is little evidence to substantiate any spread of this outside of anal sex. 

  I am not coming with any absolutes and therefore do NOT give a "false sense of security". If you have any evidence of an outside spread of this disease, then for all sake, come with it. 

 With regards to your latest paragraph, you don't seem to have an understanding over how viruses act and exist. HIV has existed for long time and STILL the main source of spread is sodomy (especially receptive, but also insertive), which exists along both genders. If you do not do IV drugs, receive blood transfusions and do not engage in these sex acts, your chance of catching HIV is much lessened. 

  According to your theory, the "type of sex act" should not matter much now with regards to HIV, which is definitely not true. The prophylactic HIV drugs are marketed specifically towards MSM (Men having Sex with Men) and why do you think that is? On the contrary, I am not familiar with any reported and well-documented cases of lesbians contracting HIV. 

     Monkey Pox does not appear to spread by airborne route and neither is there any evidence for it. 

 

[Chatogaster]

43 minutes ago, NorskTiger said:

First of all, I DO have expertise. I have treated many people for STD's and have had a male-health clinic at some time. I have furthermore been giving care to many women for well.woman exams and therapy. 

 There is little evidence to substantiate any spread of this outside of anal sex. 

  I am not coming with any absolutes and therefore do NOT give a "false sense of security". If you have any evidence of an outside spread of this disease, then for all sake, come with it. 

 With regards to your latest paragraph, you don't seem to have an understanding over how viruses act and exist. HIV has existed for long time and STILL the main source of spread is sodomy (especially receptive, but also insertive), which exists along both genders. If you do not do IV drugs, receive blood transfusions and do not engage in these sex acts, your chance of catching HIV is much lessened. 

  According to your theory, the "type of sex act" should not matter much now with regards to HIV, which is definitely not true. The prophylactic HIV drugs are marketed specifically towards MSM (Men having Sex with Men) and why do you think that is? On the contrary, I am not familiar with any reported and well-documented cases of lesbians contracting HIV. 

     Monkey Pox does not appear to spread by airborne route and neither is there any evidence for it. 

 

I'll grant you that you may have some expertise, but you still seem oblivious of the effect statements like yours have.

Take something simple as: "there is little evidence to substantiate any spread of this outside of anal sex.". Being very lenient with your absolute term "any", I'm personally willing to go along with that and know what it actually entails.

But, surely you do realize that many people will mentally simplify that to "there's no spread of this outside of anal sex.", which is my point: an important psychological effect that you insist on ignoring.

I haven't done an in-depth study, but a quick google shows that in the USA 20% of new HIV diagnoses concern women (in 2018). No-one would call that negligible and I'm sure you're well aware of the fact that it doesn't (next?) take anal intercourse for it to easily pass.

Statistics-wise, anal reception/injection may very well still be a dominant factor. That doesn't make the rest negligible (unless you have evidence to the contrary, e.g. reducing it to the probability of winning a lottery, which would be beyond belief). People should be kept aware of that and not be lulled into a sense of imagined safety.

 

 

[Faz]

1 hour ago, NorskTiger said:

There is little evidence to substantiate any spread of this outside of anal sex. 

 

Monkeypox has spent most of its evolutionary history living inside Central and Western Africa’s small mammals — squirrels, rats, mice, - surely you're not suggesting .............................!

There are three ways you can be exposed to sufficient amounts of the virus to become infected: direct skin-to-skin contact with the lesions caused by the virus, touching contaminated objects, and close contact with respiratory secretions like saliva from a person with lesions in their mouth or throat. What’s clear from the epidemiological evidence so far is that the current monkeypox epidemic is being driven overwhelmingly by the first of these — in particular, close intimate contact between sexual partners. (Not necessarily anal sex)
https://www.statnews.com/2022/08/10/what-scientists-know-and-dont-know-about-how-monkeypox-spreads/

 

[Vigo]

3 hours ago, NorskTiger said:

The article makes an inference to that woman had been having "intercourse" in Dubai, without going into the specifics. 

  It is, most likely,  not the fact of being gay in itself that is a risk for Moneypox, but rather of engaging in sodomy.  

     Women who engage in anal sex are probably just as likely to catch it as homsexuals doing the same. IMHO, I have read little reporting that suggests Monkey Pox will spread to any significance through regular sex. 

What are you rambling on about? Why would monkeypox be a more likely outcome from sodomy than other  contact?  You have read little reporting of alternative transmission because of your own bias and the fact that offering a scapegoat to blame is much more politically correct than to pint out that the origins are with the African and Asian practice of consuming wild animals,i.e. bush meat.

It is no secret how the virus is spread and is well documented by every reputable international health service. This is US CDC;

 

• Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
  • Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
  • Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
  • Contact with respiratory secretions.

• This direct contact can happen during intimate contact, including:
  • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
  • Hugging, massage, and kissing.
  • Prolonged face-to-face contact.
  • Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.

• A pregnant person can spread the virus to their fetus through the placenta.

 

 

The initial spread of Monkey pox is with gay community because they were the first to participate in the open air raves and because there were two sex based festivals, one in Spain a sex rave, and then a fetish sex festival in Belgium. It is at fetish festival that the female cases began to appear. Initially in western world, it was almost all men, average age 36 who have the infection. However, in Congo it is evenly spread between men and women. Now, the illness is spreading into western female population. The rash and skin lesions in the beginning stage are easier to  see on fair skin people. It is difficult to detect on darker skin tone until full eruption. It can be several weeks that one is infectious without full scale eruption of the boils/blisters. This is another reason why illness is more likely in some people.

 

[NorskTiger]

4 hours ago, Chatogaster said:

I'll grant you that you may have some expertise, but you still seem oblivious of the effect statements like yours have.

Take something simple as: "there is little evidence to substantiate any spread of this outside of anal sex.". Being very lenient with your absolute term "any", I'm personally willing to go along with that and know what it actually entails.

But, surely you do realize that many people will mentally simplify that to "there's no spread of this outside of anal sex.", which is my point: an important psychological effect that you insist on ignoring.

I haven't done an in-depth study, but a quick google shows that in the USA 20% of new HIV diagnoses concern women (in 2018). No-one would call that negligible and I'm sure you're well aware of the fact that it doesn't (next?) take anal intercourse for it to easily pass.

Statistics-wise, anal reception/injection may very well still be a dominant factor. That doesn't make the rest negligible (unless you have evidence to the contrary, e.g. reducing it to the probability of winning a lottery, which would be beyond belief). People should be kept aware of that and not be lulled into a sense of imagined safety.

 

    That people will "simplify" does not mean one should not discuss the truth and to what xtent this holds true is also not clear.

    20% of new cases being women (I am not sure what statistics you are referring to, but in any case it does not matter), you say, but again, the mode of transmission is not mentioned. Are you saying that women do not participate in receptive anal intercourse? 

   Also, of these women, there is probably a quite proportionate part that is IV drug users. 

 

    I never said neglible, the only thing I said was that there is little EVIDENCE of mode of transmission outside of sodomy. 

[NorskTiger]

3 hours ago, Faz said:

Monkeypox has spent most of its evolutionary history living inside Central and Western Africa’s small mammals — squirrels, rats, mice, - surely you're not suggesting .............................!

There are three ways you can be exposed to sufficient amounts of the virus to become infected: direct skin-to-skin contact with the lesions caused by the virus, touching contaminated objects, and close contact with respiratory secretions like saliva from a person with lesions in their mouth or throat. What’s clear from the epidemiological evidence so far is that the current monkeypox epidemic is being driven overwhelmingly by the first of these — in particular, close intimate contact between sexual partners. (Not necessarily anal sex)
https://www.statnews.com/2022/08/10/what-scientists-know-and-dont-know-about-how-monkeypox-spreads/

     I have no idea what you are suggesting I am suggesting (!!). The fact that the reservoir was animal source in evolutionary term depends upon the total time of that evolution and when first human case was registered versus total time of reported cases. In any case, this is a question of CURRENT transmission among humans and how it appeared there is unclear. 

  Yes, you are partially correct about skin-to-skin, but the more accurate description would be MUCOSAL contact. The rectal mucosa has significant histological differences from the vaginal one (for example). One can see that with use of condoms, for example. Condom breakage is more likely to happen in rectal intercourse versus vaginal one. Likewise, contact with blood is more likely to happen in a rectal milieu. 

     There is no evidence pointing away from a PREDOMINANT mode of transmission with regards to the new monkeypox cases being sodomy. If you can point to something, I would be happy to see it. 

[NorskTiger]

3 hours ago, Vigo said:

What are you rambling on about? Why would monkeypox be a more likely outcome from sodomy than other  contact?  You have read little reporting of alternative transmission because of your own bias and the fact that offering a scapegoat to blame is much more politically correct than to pint out that the origins are with the African and Asian practice of consuming wild animals,i.e. bush meat.

It is no secret how the virus is spread and is well documented by every reputable international health service. This is US CDC;

• Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
  • Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
  • Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
  • Contact with respiratory secretions.

• This direct contact can happen during intimate contact, including:
  • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
  • Hugging, massage, and kissing.
  • Prolonged face-to-face contact.
  • Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.

• A pregnant person can spread the virus to their fetus through the placenta.

The initial spread of Monkey pox is with gay community because they were the first to participate in the open air raves and because there were two sex based festivals, one in Spain a sex rave, and then a fetish sex festival in Belgium. It is at fetish festival that the female cases began to appear. Initially in western world, it was almost all men, average age 36 who have the infection. However, in Congo it is evenly spread between men and women. Now, the illness is spreading into western female population. The rash and skin lesions in the beginning stage are easier to  see on fair skin people. It is difficult to detect on darker skin tone until full eruption. It can be several weeks that one is infectious without full scale eruption of the boils/blisters. This is another reason why illness is more likely in some people.

     I am a physican and rely upon facts, science and reality. For you to come with these wild insinuations that I have some kind of agenda here while ignoring science and data is merley showing how miuch you simly do not understand, or don't want to understand. 

    You are talking about the old "bush meat" theory, but where is the evidence to that? With regards to HIV origins, there is no scientific rigor pointing to this as an explanation for the transmission of Simian (or chimpansee) HIV Virus to humans, although there have been suggestions of various kinds.  (This is only rferring to HIV; but shows how we still, after all these years do not know much about the disease origins). 

    Back to Money Pox: The current outbreak appears to be relatively new as I have seen few significant reports in the past  You listed three possible routes of transmission, which are surface contact with objects (have not read reports of it) airborne (possible, but not proven) and contact, which we will stick to here. 

  In the direct category, I think hugging, kissing, massage and prolonged face-to-face contact is very rear if not non-existant. This is also how HIV spread was thought of for along time and later not cosidered very significant. 

   What remains then is the pure sex and I think touching of genitals is also very unlikely, unless one has injured finger and is touching open wounds. 

    Then we are left with oral, vagina and anal. Of thesethe anal stands out significantly on basis of epidemiology (the gay community and possibly prostitutes engaging in receptive anal intercourse); established knowledge about the tissues involved and a typical increased transmission rate to STD's through this route. 

    Note that it is exactly due to the sensititvity and vitriole displayed in your post that it is vital to discuss these modes of transmission. Even if it was a significant risk (not reported so far) of transmission through the vaginal-oral route of let's say 20% of the cases, would it not be prudent to point out that sodomy carries a much higher risk burden? This is Thailand, so one can talk about these things at  more open pace than many other places and still have understanding. When a bar girl (asks me flat-out if she can avoid HIV by not doing anal, condom use or not, I am not telling her there is a zero risk. However, I DO tell her the risk to herself is significantly lowered and it does not come as a surprise to most of them as they have already heard that from many sources. When you add to this that (anectdotally, but still widely acknowledged) Thai girls are smaller both vaginally and in the rear than most; condom tear and trauma is probably even more likely to happen than normally, making receptive anal intercourse a high-risk activity. 

        The point with all this is to identify most precisely the risk to one self or others for an exposure. Many factors may play in, but that shoudl not stop one from acting based upon the few factors one is pretty certain about. 

          The more sensitive a topic is, the more it probably should be dissected. 

[Janneman]

I kinda miss the general outrage by the 'concerned citizens' about yet another case of someone fleeing a country while being infected. Or is that because this time it is a Thai fleeing? And not a Nigerian or German?

[Faz]

7 hours ago, NorskTiger said:

Yes, you are partially correct about skin-to-skin, but the more accurate description would be MUCOSAL contact.

Monkeypox was first traced to rodents and prairie dogs from Ghana.
Therefore, according to your theory, in order to spread to humans, there must have been some form of mucosal contact between human and animals.

Contrary to your theory, other studies and reports from qualified virologists point to infection from lesions on the skin. On the balance of probabilities, this theory is far more likely the cause of the virus crossing over from animal to humans.

Studies also prove the virus can be transmitted by contact with surfaces contaminated by an infection person, such as toilet seats, bedsheets, door handles etc. 
https://www.fiercehealthcare.com/providers/potentially-infectious-monkeypox-viral-loads-detected-upon-high-touch-hospital-room

https://www.independent.co.uk/news/health/monkeypox-humans-dogs-lancet-study-b2145138.html

[Vigo]

12 hours ago, NorskTiger said:

First of all, I DO have expertise. I have treated many people for STD's and have had a male-health clinic at some time. I have furthermore been giving care to many women for well.woman exams and therapy. 

 There is little evidence to substantiate any spread of this outside of anal sex. 

  I am not coming with any absolutes and therefore do NOT give a "false sense of security". If you have any evidence of an outside spread of this disease, then for all sake, come with it. 

 With regards to your latest paragraph, you don't seem to have an understanding over how viruses act and exist. HIV has existed for long time and STILL the main source of spread is sodomy (especially receptive, but also insertive), which exists along both genders. If you do not do IV drugs, receive blood transfusions and do not engage in these sex acts, your chance of catching HIV is much lessened. 

  According to your theory, the "type of sex act" should not matter much now with regards to HIV, which is definitely not true. The prophylactic HIV drugs are marketed specifically towards MSM (Men having Sex with Men) and why do you think that is? On the contrary, I am not familiar with any reported and well-documented cases of lesbians contracting HIV. 

     Monkey Pox does not appear to spread by airborne route and neither is there any evidence for it. 

The medical community has not used the term STD in publications for a decade. The correct term is sexually transmitted illness STI. Obligatory continuing education coursesfor health professionals have used the term STI for the past decade. In the absence of a verification of your self claimed  expertise, I can only go by established practice and what is published as accepted fact. If you are a physician, your statements indicate that you are not knowledgeable  on this disease as your statements are not supported either in the literature or by published evidence.

"There is little evidence to substantiate any spread of this outside of anal sex. "

Unsupported claim. The fact is that the infection between its discovery in 1970 and the last international outbreak in 2003 had nothing to do with sexual contact, unless you are claiming that there were organized sex parties where rodents engaged in anal sex with humans.

Monkeypox is rarely exported from the African continent. In 2003, there was a zoonotic outbreak in the USA causing 47 confirmed or suspected cases.     (Ref: i) Clinical characteristics of human monkeypox, and risk factors for severe disease. Clin Infect Dis. 2005; 41: 1742-1751; ii) Monkeypox in the United States, https://www.cdc.gov/poxvirus/monkeypox/outbreak/us-outbreaks.html Date: 2021;   iii) The detection of monkeypox in humans in the western hemisphere. N Engl J Med. 2004; 350: 342-350

 

The 2003 outbreak was linked to the importation of Gambian giant rats, squirrels, and dormice, which had transmitted the virus to prairie dogs that were then sold as pets. Only 14 patients were hospitalised and there were no confirmed cases of person-to-person transmission. Imported monkeypox infections in humans following travel have been reported in the UK, Israel, Singapore, and in 2021, in the USA. There was no suggestion of anla intercourse or MSM activity in these infections.  (Ref: Two cases of monkeypox imported to the United Kingdom, September 2018.Euro Surveill. 2018; 231800509; Diagnosis of imported monkeypox, Israel, 2018 Emerg Infect Dis. 2019; 25: 980-983; A case of imported monkeypox in Singapore. Lancet Infect Dis. 2019; 191166)

 

Africa has had endemic Monkeypox for the past 50 years. It has existed not because of a vast network of sodomites engaging in frenzied infection events, but through the common practices of the population. Back in 2020, WHO published a warning about the increasing  number of cases   https://www.who.int/emergencies/disease-outbreak-news/item/monkeypox-democratic-republic-of-the-congo    I am going to go with the established scientific fact that WHO referred to evidence suggests that native African rodents may be potential sources. Contact with live and dead animals through hunting and bush meat are presumed drivers of human infection  rather than your suggested "sodomy".  Considering the  large number of children under the age of 5 who died of the disease, I don't think it is plausible that they had engaged in anal intercourse as a regular practice.

 

 

 

 

 

 

 

 

There is absolutely no documentation published that shows anal intercourse as the cause of the illness, or the primary route of transmission. All of the published documentation of the most recent outbreaks in the western world suggest that the infections are driven by skin on skin contact events. This is common sense. Raves and dance parties feature large crowds of mostly undressed young people engaged in lengthy physical contact. One does not need to have anal intercourse to become infected.   A recent Nature article summed up the facts quite nicely, https://www.nature.com/articles/d41586-022-02178-w

 

As global monkeypox cases continue to soar, researchers are learning more about how the disease is spreading. Early predictions that the virus transmits primarily through repeated skin-to-skin contact between people have largely borne out, according to a tranche of new studies.

 

 It looks like you have confused the route of infection and its impact upon the severity of the infection and the assumed characteristic of the current group of patients in Europe. The fact remains that the vast majority of patients in Africa have been infected  in a manner other than "sodomy" as you term it.  The trending western  infections reflect the increased number of large dance parties involving international travellers.  The takeaway and it is a prediction I will make now, if the Monkeypox infections continue, is that we will see infections spread at  Thailand full moon dance party events where people are nearly naked, under the influence of various substances and given to over touching activity. The infections will be imported by western tourists.

[Faraday]

1 hour ago, Vigo said:

The correct term is sexually transmitted illness STI.

The correct term is : "Infection"

 

https://www.who.int/health-topics/sexually-transmitted-infections#tab=tab_1

[Faraday]

1 hour ago, Vigo said:

The medical community has not used the term STD in publications for a decade.

Incorrect again:

 

https://journals.lww.com/stdjournal/pages/default.aspx

https://www.cdc.gov/stdconference/default.htm#:~:text=The 2022 STD Prevention Conference will be held virtually September,science%2C program%2C and policy.

[Cabra]

One thing seems apparent... the global fear and loathing of monkey pox has only just begun... 

[Vigo]

3 hours ago, Faraday said:

Incorrect again:

https://journals.lww.com/stdjournal/pages/default.aspx

https://www.cdc.gov/stdconference/default.htm#:~:text=The 2022 STD Prevention Conference will be held virtually September,science%2C program%2C and policy.

The correction that I should have used infection and not illness is my own sloppy translation. I take responsibility for that hurried effort and stand corrected. However, there is an underlying point and it is buried in much of the literature,  the spread of the monkeypox infections occurs in part because a large number of infected do not have easy to see symptoms at first (The rash may only becomes evident on some people a week after the person is infectious.) .  An infection does not necessarily have symptoms, and to have a disease, there must be symptoms. For example with chlamydia, one of Thailands' most common STIs, there may be no immediate symptom. This is why the change from STD to STI when making reference to public health. (YOu may reference teaching text of common western medical schools to see for yourself.)  And whether or not  one wishes to use STD or STI, Monkeypox is not classified as a sexually transmitted disease (Nor sexually transmitted infection.) 

BTW, please read your link. You will see there is a reference within the webpage.  More specifically, the CDC does use the term STI and  that is for the explanation I give above.    "Four debates on behavioral interventions for STIs, Real-time STI data, Test of cure (TOC) for pharyngeal gonorrhea, and STI interventions increase in health inequity"  Many of the  sexually transmitted infections we see now do not have symptoms for some time, thus making it easier for spread. Remember, an infection without symptom is not a disease. There can still be STDs, but the correct term to use when referring to the full spectrum is  STI. 

However, i do not wish to go off on a tangent  about STI or STD, call it whatever you want, but the issue for me was the claim that monkeypox followed the format of sexual transmission and was due to "sodomy". It was an irresponsible statement, and I doubt very much a practicing specialist physician licensed in Europe would use such a term since the current approach is still official;  Monkeypox is transmitted to people from various wild animals, such as rodents and primates, but can also be transmitted between people following direct or indirect contact.  European Medicines  Agency 22/07/2022

[Vigo]

4 hours ago, Cabra said:

One thing seems apparent... the global fear and loathing of monkey pox has only just begun... 

No fear. No loathing. A vaccine is available now. Western outbreak countries have enough vaccine stock on hand to target high risk population. Millions of additional doses can be produced . 

 

EMA’s human medicines committee (CHMP) has recommended extending the indication of the smallpox vaccine Imvanex to include protecting adults from monkeypox disease. The medicine has been approved in the EU since 2013 for the prevention of smallpox. It contains an attenuated (weakened) form of the vaccinia virus called ‘modified vaccinia virus Ankara’, which is related to the smallpox virus. It was also considered a potential vaccine for monkeypox because of the similarity between the monkeypox virus and the smallpox virus. The marketing authorisation holder is Bavarian Nordic A/S.

 

[Faraday]

A misleading statementsl has been made & this is to clarify:

 

 

Asymptomatic

Asymptomatic means there are no symptoms. You are considered asymptomatic if you:

• Have recovered from an illness or condition and no longer have symptoms
• Have an illness or condition (such as early stage high blood pressure or glaucoma) but do not have symptoms of it

 

https://medlineplus.gov/ency/article/002217.htm

 

[Janneman]

Well, apparantly the Thai lady from the article did have symptoms. She was taken aside on the airport because she was covered in blisters. Makes you wonder how she got on the plane. 

[Mohandas]

8 hours ago, Cabra said:

One thing seems apparent... the global fear and loathing of monkey pox has only just begun... 

Most are so easily persuaded and manipulated. 

Expected.

[Mohandas]

4 hours ago, Vigo said:

No fear. No loathing. A vaccine is available now. Western outbreak countries have enough vaccine stock on hand to target high risk population. Millions of additional doses can be produced . 

EMA’s human medicines committee (CHMP) has recommended extending the indication of the smallpox vaccine Imvanex to include protecting adults from monkeypox disease. The medicine has been approved in the EU since 2013 for the prevention of smallpox. It contains an attenuated (weakened) form of the vaccinia virus called ‘modified vaccinia virus Ankara’, which is related to the smallpox virus. It was also considered a potential vaccine for monkeypox because of the similarity between the monkeypox virus and the smallpox virus. The marketing authorisation holder is Bavarian Nordic A/S.

Only becomes an issue when the West is infected.

[Janneman]

2 hours ago, Mohandas said:

Only becomes an issue when the West is infected.

In the west only high risk groups are being vaccinated. Mostly gay men who also have HIV related issues. It hardly spreads beyond that group.

Now Thailand might be different since 40% of the confirmed cases are female. And Thailand also has a rather large adult entertainment business. Combine those two facts and you can see trouble coming 

[NorskTiger]

First of all, the pettiness about STI vs. STD is merely that.. Pettiness to distract and attempt to make something out of nothing. 

   There is no meaningful gain ito clinical managment with one or the other.  OTOH, there is even a difference in the meaning. INFECTIONS are often asymptomatic and one's own immune system can deal with it without ever manifesting a disease. A good example of this is Covid, but it exists among most infections. 

 It is irresponsible to not acknowledge sodomy as a major risk factor for monkey pox and many other STD's when one (so far) has many things to suggest this is the major infective route. The 40% number for women who get it in Thailand is also meaningless without more detailed history.  Skin to skin contact is really a poor route of transmission for MOST infections UNLESS there is breakage of tissue with blood/serum exposure.. The risk of anal trauma with this conduct is so much higher than in normal sex. When risk-stratifying here it would be malpractice not to take this into accord. 

     Of course, this is something every physician knows whether you practice dermatology, psychiatrist, sports medicine or woman's/men's health.  

 

     Belo are exerpts from a recent  British Medical Journal essay about how this topic is ignored. 

Docs Not Talking About Anal Sex May Put Women at Risk....

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Clinicians' reluctance to discuss possible harms of anal sex may be letting down a generation of young women who are unaware of the risks, two researchers from the UK write in an opinion article published today in The BMJ.

Failure to discuss the subject "exposes women to missed diagnoses, futile treatments, and further harm arising from a lack of medical advice," write Tabitha Gana, MD, and Lesley Hunt, MD, with Sheffield Teaching Hospitals NHS Foundation Trust and Northern General Hospital, Sheffield, United Kingdom.

In their opinion, healthcare professionals, particularly those in general practice, gastroenterology, and colorectal surgery, "have a duty to acknowledge changes in society around anal sex in young women, and to meet these changes with open neutral and non-judgmental conversations to ensure that all women have the information they need to make informed choices about sex."

Asking about anal sex is standard practice in genitourinary medicine clinics, but it's less common in general practice and colorectal clinics, they point out

Anal intercourse is becoming more common among young heterosexual couples. In the UK, participation in heterosexual anal intercourse among people aged 16-24 years rose from about 13% to 29% over the last few decades, according to national survey data.

The same thing is happening in the United States, where research suggests 30%-44% of men and women report having anal sex.

Poster remarks: These datas seem very consistent with own clinical impression when providing care to escorts and other women that provode sex for momey. If a 40% number (females with monkey pox in Thailand) is mentioned, the intersting thing would be to do depth-questioning over how many of these women were indeed providing sex for momey and did it out of higher financial incentives. It is quite clear that repective anal sex carries higher fees and very common knowledge. 

Individual motivation for anal sex varies. Young women cite pleasure, curiosity, pleasing the male partners, and coercion as factors. Up to 25% of women with experience of anal sex report they have been pressured into it at least once, Gana and Hunt say.

 

However, because of its association with alcohol, drug use, and multiple sex partners, anal intercourse is considered a risky sexual behavior.

It's also associated with specific health concerns, Gana and Hunt point out. These include fecal incontinence and anal sphincter injury, which have been reported in women who engage in anal intercourse. When it comes to incontinence, women are at higher risk than men because of their different anatomy and the effects of hormones, pregnancy, and childbirth on the pelvic floor.

"Women have less robust anal sphincters and lower anal canal pressures than men, and damage caused by anal penetration is therefore more consequential," Gana and Hunt point out.

  

The pain and bleeding women report after anal sex is indicative of trauma, and risks may be increased if anal sex is coerced," they add

Knowledge of the underlying risk factors and taking a good history are key to effective management of anorectal disorders, they say.  

 

Gana and Hunt worry that clinicians may shy away from talking about anal sex, influenced by society's taboos.

Posters remarks: Which is EXACTLY how the response was to me in this thread. 

Currently, NHS patient information on anal sex considers only sexually transmitted infections, making no mention of anal trauma, incontinence, or the psychological aftermath of being coerced into anal sex.  

"It may not be just avoidance or stigma that prevents health professionals [from] talking to young women about the risks of anal sex. There is genuine concern that the message may be seen as judgmental or even misconstrued as homophobic," Gana and Hunt write.

"However, by avoiding these discussions, we may be failing a generation of young women, who are unaware of the risks," they add.

"With better information, women who want anal sex would be able to protect themselves more effectively from possible harm, and those who agree to anal sex reluctantly to meet society's expectations or please partners, may feel better empowered to say no," Gana and Hunt say.

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  When I provide routine care to women who fall into higher risk of getting sick from STD's, the above tends to be among their number 1 concerns. Anecdotally, for the vast majority of women this is something they express hesitation to want to engage in and most already are aware it carries higher risk burden.  I do not provide care to people with HIV and do not prescripe pre-exposure prophylactic medications to those who ask me for it. ((Truvada for example). The reason for the former is that I do not have much experience with the medications and feel they are better served with physicians who carry a higher volume of such patients. It it happens one of mine contract HIV, I DO however refer them to doctors who do. At the same time, I have been operating a male-health clinic that deals with hormonal optimalization, ICP-therapy and wellness enhancement in context of male health. 

      Finally, most women in Pattaya, BKK or Phuket sex industry I encounter as a caretaker already ahve extensive knowledge about this. Many of them come with their phones and ask questions about articles they have read on internet. If I were to blather them with generalizations I would not only lose them as patients, but my credibiliy among their peers would plummet. It probably goes without saying that integrity and an absolute professional discretion is more important than almost anything here. I never recruit new patients, but strictly let the women I take care of inform others when I feel I can accomodate more patients. Many of them are my fitness clients as well, so I tend to know my patients very well. I would never do them the disservice of withholding facts based on clinical and scientific experience out of concern they may feel "stigmatized". 

   I hope this would provide a picture into my world here and likewise provide some ideas about how I have come to the opinions I have, which some here felt so strongly against me stating. 

 

 

 

 

[NorskTiger]

On 8/16/2022 at 1:00 PM, Janneman said:

Well, apparantly the Thai lady from the article did have symptoms. She was taken aside on the airport because she was covered in blisters. Makes you wonder how she got on the plane. 

     Blisters from a recent infection can appear rapidly once the immune defense or overcome. THe skin has a very high turnover of cell cycling. Now, combine this with a prolonged plane travel, which in tiself is suboptimal for maintenance of a good immune system and she may have manifested many of her symptoms throughout the flight. '

     For a comparison, just imagine how rapidly a shingles OUTBREAK may manifest, although many can have pain or irritation in a band on body for several days before. I have seen cases where people have had severe pain in Right-upper Quadrant of abdomen to  warrant an ultrasound looking for gall stones and the herpetic rash emerge 1 day later.