Next week the World Health Organization may declare that the recent monkeypox outbreak is a public health emergency of international concern — the highest level of global alert. At the moment, only polio and Covid-19 are in this category.

It’s a nasty disease, though seldom fatal. The symptoms include fevers, headaches, muscle pain, swollen lymph nodes, and an ugly blistering rash. Up until May this year, it seldom occurred outside of sub-Saharan Africa.  

So far this year, more than 1,600 confirmed cases and almost 1,500 suspected cases of monkeypox have been reported to WHO, across 39 countries – including seven countries where monkeypox has been detected for years, and 32 newly-affected nations.

The WHO wants to rename the disease, as some scientists argue that “monkeypox” is discriminatory and stigmatizing, to something catchy, probably hMPXV. Its rapid spread shows that it is no longer an African disease, as implied by the word monkeypox. Most of the cases, in fact, have been in Europe. And Spain, where I am writing from, is home to one of the biggest clusters.

Our experience in Spain shows that monkeypox, or hMPXV, is less a problem of medical science than media ethics.

Journalists have been tying themselves into knots in order not to mention the main protagonists in this drama. From the cases detected in Spain, it was clear that nearly all infections were among men who have sex with men, i.e. of homosexual orientation. Even the WHO acknowledges this in its official advice:

Most reported cases so far have been identified through sexual health or other health services in primary or secondary health-care facilities and have involved mainly, but not exclusively, men who have sex with men.

A report from the UK Health Security Agency found that as of June 8, there had been 336 confirmed cases – 99 percent of these were male. The authorities interviewed 152 of these cases and 151 were men who have sex with men. The one exception refused to give any information.

Unlike Covid, monkeypox does not spread through casual contact. In Spain, the chain of contagion included gay chemsex parties, replete with drugs, risky practices and unprotected sex. But it would be difficult to know this through reports in the media. Journalists have tiptoed around this issue to avoid associating the latest epidemic with the recklessness of certain homosexuals.

For example, a recent headline announced: “Madrid authorities have closed a sauna where sexual relations took place”. It turned out this was the main gay sauna in Madrid and the main contact venue for monkeypox cases in Madrid.  

Spain’s leading daily, El País, referred to a second outbreak: “A huge party in Gran Canaria linked to second major outbreak of monkeypox in Spain”. The report spoke of a “huge party in Gran Canaria, attended by nearly 80,000 people”. You had to wait until the sixth paragraph to find out that the “party” was the Gay Pride Parade of Maspalomas, attended by thousands of people from all over Spain and other European countries.

An early report specified that monkeypox “can affect children, adults, men and women, whatever their sexual preference. But the outbreak that has broken out in Madrid has mainly affected the gay community…”. This gives the impression that the danger of infection is the same at a chemsex rave and a First Communion party… Then it became clearer that the outbreak was limited to homosexuals and that the risk for the general population was low.

Another leading newspaper, La Vanguardia, declared that: “The global spread of the virus in recent weeks can be explained, firstly, by episodes of multiple infections in a group with a high geographical mobility (…) The fact that most of the infections are concentrated in a specific group suggests that the disease’s capacity for transmission to other groups is limited”.

But which was the “specific group”?

The media’s coyness extends to other diseases as well. At the end of March, the European Centre for Disease Control released a report warning of an increase in cases of shigellosis, especially “among men who have sex with men”. It spoke of cases in nine countries –including Spain. The headline in El País read: “Shigellosis, the rising infection in sexual environments that worries Europe”. Sexual environments?

In the case of HIV transmission, in Spain 66 percent of new diagnoses are amongst homosexuals, and only 23 percent amongst heterosexuals. It is sometimes said that this is due to unprotected sex. But why do so many members of the gay community take these risks?

What the media needs in Spain – and elsewhere – is to report the news truthfully and not gloss over the crude reality. If monkeypox has truly become a public health emergency, it became one because of reckless and unhealthy gay behaviour.

US President Joe Biden said last month that monkeypox “is something that everybody should be concerned about”. In a sense that’s true — but some people should be more concerned than others.

Ignacio Aréchaga is a Spanish journalist and blogger.