Faced with an increase in cases of monkeypox, NGO proposes protocol

Mexico is experiencing the largest increase in new cases of monkeypox: 284 in seven days.
During August there was an average increase of 119 weekly cases, but in the last week the increase was more than double.
Thus, from July 31, when the first 91 cases were reported, to September 5, just over a month later, they have reached 788.

Given this, civil society reinforces the work of information and advocacy among the most affected populations: gay men, bisexuals, men who have sex with men and people with HIV.  
The organization VIHve Libre is preparing an action plan for meeting places in Mexico City to join the application of a protocol that includes training its employees to implement or reinforce sanitization processes. 
Given the lack of response from the authorities, the Citizen Council for HIV and STIs of Mexico City, to which various associations belong, has pointed out the urgency of decentralizing diagnostic tests so that the results do not take days to be known, start the management of vaccines for our country and promote prevention actions, health promotion and care.

However, it is the organizations themselves that have had to launch information and awareness initiatives.
“We had to translate several materials from the United States that correspond to the prevention of smallpox, because in Mexico we do not have a health secretariat that did that work, and it was not interested in doing it either. We made these materials and had meetings with some doctors to explain transmission, forms of prevention and treatment,” says Alain Pinzón, director of VIH Libre. 
Monkeypox: protocol of action
Mathias Correa, a collaborator of VIHve Libre, goes to one of the 30 centers that the organization has mapped in order to distribute information about monkeypox.
Although he already frequented these places, with the outbreak of monkeypox these visits are more recurrent and in order to provide information; this is reflected in the log he carries with him along with the graphic materials he prints and distributes. 
Mathias wants to talk to the owner of the place to inform him about the new plan to generate a work table and adopt a protocol to take trainings that help reinforce the measures of prevention of contagion, hygiene and sanitization in the most crowded places by men who have sex with men.   
The owner of this club – an adapted house without identification on the façade – prefers that details of the place are not revealed for safety, but assures that it has been formally constituted for five years and has 12 thousand members who can attend any day of the week, except Tuesdays, to enjoy the party and most likely – that depends on each one and does not necessarily happen, clarifies—having some sexual encounter.

Individual and collective awareness
After ensuring their participation in the activities proposed by the organization, the owner of the place and Mathias emphasize that the authorities have not taken any particular measures to pay attention to the populations most affected by the disease. 
Unlike what was recommended by the World Health Organization (WHO) at the end of July, which even suggested a reduction in the number of sexual partners, they assure that the encounters – particularly in the places destined for it – will not stop happening.
That is why they consider it important to raise awareness especially at the individual level, to insist on personal care, on the prevention of contagion from the first appearance of lesions on the skin, but always from a perspective that does not reproduce or promote stigmas. 
They recall that this is how HIV care began, as a condition ignored and relegated because it was believed to be characteristic of a particular population, and that it only began to be taken seriously once it began to affect other population groups. 
Mexico adds 284 new cases of monkeypox; CDMX and Jalisco with more infections.
After the days he has completed, Mathias Correa assures that this is one of the cleanest centers and with greater receptivity towards the work of organizations.
“They don’t always receive me; some have to have their arms twisted to gain access.”
Not everyone has the same capacity, control and number of attendees in their facilities. The one Mathias visits is one of the largest and most popular among gay, bisexual men and men who have sex with men. It is located in the center of the capital and between one and two people come every ten minutes.
Despite the increase in cases of monkeypox, up to ahora there is no specific measure for access to this place; however, the owner states that if a user arrives with any visible alteration of their state of health or any very obvious symptom, their entry is avoided. 
In addition, since before, hygiene and the good condition of the facilities are a priority aspect for the place.
Although the information and dissemination of the materials designed by VIHve Libre is indispensable, and they have even managed to link and channel some cases for their diagnosis and attention from these days, Mathias assures that it is necessary to reinforce the measures in populations and places in which the government does not fix, hence the intention to create a protocol and a commitment to training between civil society and the owners of those establishments. 
“The meeting places are places where men who have sex with other men go, and the truth is that that is where the greatest point of prevention has been located, so we decided to educate, inform the band that goes to the meeting places so that if at any time they are having any symptoms or some discomfort about smallpox, they better go home.
Alaín Pinzón affirms that they have had a fairly favorable response; although a couple of centers have rejected them.
“Something we also continue to do is test for HIV, hepatitis C and syphilis, because the people who tend to have health problems when they get smallpox are those who are not detected,” adds Pinzón.
Several organizations – VIHve Libre, AHF, Casa de la Sal and Inspira, among others – have pointed out the urgency of the decentralization of diagnosis and specific care in the states. 
So far, says the activist, this has only been done in Mexico City with the collection of samples for diagnosis in the Condesa clinics and in the TIII health centers, although in two of them, in Chabacano and Gustavo A Madero, they had to file complaints of discrimination after the refusal of attention.
In the Condesa Clinic, of the Cuauhtémoc mayor’s office, diagnostic tests are available daily from 8:00 a.m. to 4:00 p.m. However, upon arrival at the site there is no visible information about the details and symptoms of monkeypox or about the taking of samples, unlike the other conditions they treat. 
It is until a test is specifically asked, that the gynecology area explains the schedules and invites to do it immediately in case of suspicion, although they reiterate that the sample can only be taken with visible lesions. 
From the GayLatino network, made up of gay leaders from 21 countries who met in Mexico City, last week a call was made to all governments in Latin America and the Caribbean in the face of the monkeypox health emergency.
What does VIHve Libre recommend?
“Did you get a little welt? Do not panic, these are some of the symptoms of monkeypox so that you are on the lookout,” reads one of the posters that the organization distributes in meeting places. 
The type of lesions are whitish spots that may contain fluid (pustules) with a dark navel-like center and that subsequently change to crusts. It can appear only on genitals, but in that case it may be confused with syphilis or herpes. There can be multiple lesions in different phases.
On the other hand, the parts of the body most affected by the lesions are the anogenital (70-80%); trunk, arms and legs (60%), face (20%) and palms and soles (10%). Additional symptoms may be, in that order of frequency: fever, tiredness, muscle pain or headache. 
Recommendations against monkeypox.
Finally, the organization recommends that in case of presenting any symptoms, do not apply medications and seek medical attention. 
According to the most recent weekly report for epidemiological surveillance of monkeypox from the government of Mexico, since 1 January 2022 cases have been reported in 102 countries, territories and areas in the six WHO regions. 
Worldwide, as of September 5, there were 52,015 confirmed cases and 18 deaths. 
Of the 788 counted in Mexico, the predominance in men is 98%, and those aged 30 to 39 are the most affected. 
Mexico City (442), Jalisco (127) and The State of Mexico (51) lead the cases, followed by Yucatan (49) and Quintana Roo (19), although the highest notification rates correspond to the capital and Yucatan.
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Original source in Spanish