Some people argue that the name is racist and disparages an entire continent. Others view it as offensive to gay men. And then there are those who fear it could lead to indiscriminate killing of monkeys, as happened in Brazil.
All that menace from one word: monkeypox.
As the threat from the disease spreads, experts around the world have pledged to change its name to something that doesn’t carry the weight of stigma. No less an authority than the World Health Organization is holding an open forum to elicit suggestions for a new moniker.
“Monkeypox is kind of a strange name to give to a disease that’s now afflicting humans,” said Dr. Anthony Fauci, the U.S. government’s leading expert on infectious diseases.
But tossing out the old name is easier than deciding on a new one.
Already, public health agencies, researchers and nonprofit organizations around the world have taken it upon themselves to abbreviate or shorten the controversial name. But at this point there is little agreement on what to call the disease that has sickened more than 46,700 people around the world.
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![Monkeypox](https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/0/ea/0ea38c8e-99dc-5da6-82a9-217e8ada1c8b/630908bd708a8.image.jpg?resize=200%2C133 200w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/0/ea/0ea38c8e-99dc-5da6-82a9-217e8ada1c8b/630908bd708a8.image.jpg?resize=300%2C200 300w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/0/ea/0ea38c8e-99dc-5da6-82a9-217e8ada1c8b/630908bd708a8.image.jpg?resize=400%2C267 400w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/0/ea/0ea38c8e-99dc-5da6-82a9-217e8ada1c8b/630908bd708a8.image.jpg?resize=540%2C360 540w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/0/ea/0ea38c8e-99dc-5da6-82a9-217e8ada1c8b/630908bd708a8.image.jpg?resize=750%2C500 750w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/0/ea/0ea38c8e-99dc-5da6-82a9-217e8ada1c8b/630908bd708a8.image.jpg?resize=1200%2C800 1200w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/0/ea/0ea38c8e-99dc-5da6-82a9-217e8ada1c8b/630908bd708a8.image.jpg?resize=1600%2C1067 1700w)
A medical laboratory technician picks up from a fridge a reactive to test suspected monkeypox samples at the microbiology laboratory of La Paz Hospital on June 6, 2022, in Madrid, Spain.
The California Department of Public Health is referring to it as MPX — pronounced “M-P-X” or “em-pox” — as it waits for the WHO to pick a new name. Officials in Oregon, Vermont, New Jersey and elsewhere have gone with hMPXV. Some LGBTQ community organizations in Canada use Mpox.
Changing the name of an infectious disease in the middle of a growing outbreak may seem risky. But experts are confident it can be done — and that it would be riskier to do nothing. They fear the current name could discourage patients from seeking treatment, cause people to shun those who are infected, and reinforce racist tropes.
“Is there going to be one solution that’s going to make every single person happy? Nope,” said Dr. Perry N. Halkitis, an infectious-disease epidemiologist and dean of the Rutgers School of Public Health. “But there’s going to be one solution that’s going to be the least offensive of all of the solutions, and it’s going to move us in a slightly better direction with this disease.”
The name dates back to 1958, when the virus was first documented in a group of lab monkeys in a Copenhagen research institute. It’s an orthopoxvirus, a type that’s often named for the animals in which they are initially identified. Its original source in the wild remains unknown, though it’s much more common in rodents than in primates.
Monkeypox was first recorded in humans in 1970, in a 9-month-old boy in the Democratic Republic of the Congo. In past outbreaks animals — especially rodents — have been the primary source of transmission to humans.
The disease is endemic in rural parts of western and central Africa, where several thousand cases and scores of deaths are seen each year in men and women of all ages. Until recently, the virus was rarely known to spread from person to person. But in the current outbreak in Europe and North America, the overwhelming majority of cases have involved transmission among men who have sex with men.
The condition — characterized by a rash and lesions that can look like pimples, bumps or blisters — can spread through prolonged skin-to-skin contact with those lesions, which may be in hard-to-see places or mistaken for other skin issues.
A cousin of smallpox, it got its name more than a half a century before the WHO, the World Organization for Animal Health and the Food and Agriculture Organization of the United Nations set best practices for labeling diseases in 2015. Two of the no-no’s? Names that refer to countries or geographical locations, and names tied to animals.
Terms such as “swine flu” and “Middle East Respiratory Syndrome” have had “unintended negative impacts by stigmatizing certain communities or economic sectors,” Dr. Keiji Fukuda, a former assistant director-general for health security at the WHO, said in 2015.
“We’ve seen certain disease names provoke a backlash against members of particular religious or ethnic communities, create unjustified barriers to travel, commerce and trade, and trigger needless slaughtering of food animals,” he said. “This can have serious consequences for peoples’ lives and livelihoods.”
Concerns like these were voiced in June about the fact that the two major groups of the monkeypox virus were known as the Congo Basin clade and the West African clade. An international group of scientists called for those labels to be dropped on the grounds that linking the disease to Africa “is not only inaccurate but is also discriminatory and stigmatizing.”
Christian Happi, who helped put the campaign in motion, took issue with media outlets’ use of historical photos of African patients to illustrate an outbreak in the United Kingdom and North America, calling it “nothing else but racism to the core.”
The WHO agreed with the scientists. This month, it announced that the Congo Basin clade will now be known as Clade one or I, and the West African clade will be known as Clade two or II.
“This was a big victory,” said Happi, the founder and director of the African Center of Excellence for Genomics of Infectious Diseases in Redeemer’s University, Ede, Nigeria. “We in Africa will no longer accept to be undermined. We will stand up to anything that is against the image of this continent or that tries to undermine the image of this continent.”
Ask people what they dislike about the name “monkeypox” and you’ll likely get a different answer from each of them.
For Halkitis, it’s that it reflects “a history of nomenclature related to diseases that assigns blame.” He cited the early days of the AIDS epidemic, when the disease was mislabeled as “gay-related immune deficiency” or “GRID.”
“Using the word ‘monkey’ to refer to a virus not only directly links it to an animal that is associated with the African continent, but also associates potentially the behavior of gay men as ‘monkey-like,'” Halkitis said. “In the hands of the wrong people” that can stigmatize those who might be affected by the disease, he added.
Halkitis isn’t concerned that changing the virus’ name mid-outbreak will sow confusion, but he did acknowledge that coming up with something new won’t be easy.
In a recent seminar at Rutgers, he referred to the disease as “MPX,” an alternative he called “absolutely not ideal” after learning that MPX was the name for a type of submachine gun. He called “Mpox” a possible option, but not a great one because “the monkey attribution doesn’t really go away.”
“I think there’s some really smart people out there who work in marketing who can think of a good name,” he said.
Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation, said the current name creates a false and disparaging association between monkeys and people who catch the disease, which could create barriers for those seeking care.
Besser was acting director of the Centers for Disease Control and Prevention during the H1N1 flu pandemic in 2009. That disease was commonly referred to as “swine flu,” a practice that “created false associations of people who got the flu with having had contact with pigs.” (The pork industry took a major hit as well, he said.)
“There always are challenges in changing a name of a disease in the midst of an outbreak, but that should not be a barrier to changing the name if the name in and of itself is causing harm,” Besser said. Indeed, he said, the scientific community should look at “a wholesale rebranding of a lot of diseases.”
Los Angeles Times staff writer Marissa Evans contributed to this report.
Photos: The monkeypox response
![Monkeypox Vaccine New York](https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/7a/87aac6c7-f23f-52f0-ab58-2a908e69ce37/62ed419fe6d43.image.jpg?resize=200%2C133 200w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/7a/87aac6c7-f23f-52f0-ab58-2a908e69ce37/62ed419fe6d43.image.jpg?resize=300%2C200 300w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/7a/87aac6c7-f23f-52f0-ab58-2a908e69ce37/62ed419fe6d43.image.jpg?resize=400%2C267 400w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/7a/87aac6c7-f23f-52f0-ab58-2a908e69ce37/62ed419fe6d43.image.jpg?resize=540%2C360 540w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/7a/87aac6c7-f23f-52f0-ab58-2a908e69ce37/62ed419fe6d43.image.jpg?resize=750%2C500 750w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/7a/87aac6c7-f23f-52f0-ab58-2a908e69ce37/62ed419fe6d43.image.jpg?resize=1024%2C683 1200w)
Healthcare workers with New York City Department of Health and Mental Hygiene help people register for the monkeypox vaccine at one of the City’s vaccination sites, Tuesday, July 26, 2022, in New York. The World Health Organization recently declared that the expanding monkeypox outbreak is a global emergency. (AP Photo/Mary Altaffer)
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People line up at a monkeypox vaccination site Thursday, July 28, 2022, in Encino, Calif. (AP Photo/Marcio Jose Sanchez)
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Tom Temprano poses in the Castro neighborhood of San Francisco, Thursday, July 28, 2022. Temprano was scheduled to get his second dose of the Monkeypox vaccine next week but was just notified that it is canceled because of short supply. He is frustrated that authorities have taken so long to respond, and noted they did so after LGBTQ politicians in his community raised their voices.(AP Photo/Eric Risberg)
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FILE – Daniel Rofin, 41, receives a vaccine against Monkeypox from a health professional in medical center in Barcelona, Spain, July 26, 2022. The U.S. will declare a public health emergency to bolster the federal response to the outbreak of monkeypox that already has infected more than 6,600 Americans. That’s according to two people familiar with the matter said. (AP Photo/Francisco Seco, File)
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FILE – A sign urges the release of the monkeypox vaccine during a protest in San Francisco, July 18, 2022. The mayor of San Francisco announced a legal state of emergency Thursday, July 28, 2022, over the growing number of monkeypox cases. Public health officials warn that moves by rich countries to buy large quantities of monkeypox vaccine, while declining to share doses with Africa, could leave millions of people unprotected against a more dangerous version of the disease and risk continued spillovers of the virus into humans. (AP Photo/Haven Daley, File)
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FILE – People line up at a monkeypox vaccination site on Thursday, July 28, 2022, in Encino, Calif. California’s public health officer said they are pressing for more vaccine and closely monitoring the spread of the monkeypox virus. (AP Photo/Marcio Jose Sanchez, File)
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Micro-biologist Annette Atkinson adjusts her power air purifying respirator during a demonstration how the monkeypox is tested for at the Utah Public Health Laboratory Friday, July 29, 2022, in Taylorsville, Utah. (AP Photo/Rick Bowmer)
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FILE – People line up at a monkeypox vaccination site, Thursday, July 28, 2022, in Encino, Calif. California’s governor declared a state of emergency over monkeypox, becoming the second state in three days to take the step. (AP Photo/Marcio Jose Sanchez, File)
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FILE – A man holds a sign urging increased access to the monkeypox vaccine during a protest in San Francisco, July 18, 2022. California’s governor on Monday, Aug. 1, 2022, declared a state of emergency to speed efforts to combat the monkeypox outbreak, becoming the second state in three days to take the step. (AP Photo/Haven Daley, File)
![Monkeypox California](https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/b/9f/b9f694b6-5b37-562d-8146-920657734552/62ed41b9d47af.image.jpg?resize=200%2C136 200w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/b/9f/b9f694b6-5b37-562d-8146-920657734552/62ed41b9d47af.image.jpg?resize=300%2C204 300w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/b/9f/b9f694b6-5b37-562d-8146-920657734552/62ed41b9d47af.image.jpg?resize=400%2C273 400w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/b/9f/b9f694b6-5b37-562d-8146-920657734552/62ed41b9d47af.image.jpg?resize=540%2C368 540w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/b/9f/b9f694b6-5b37-562d-8146-920657734552/62ed41b9d47af.image.jpg?resize=750%2C511 750w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/b/9f/b9f694b6-5b37-562d-8146-920657734552/62ed41b9d47af.image.jpg?resize=1024%2C698 1200w)
Scott Marszalek receives a Monkeypox vaccination at a Pop-Up Monkeypox vaccination site at the West Hollywood Library Community Meeting Room on Wednesday, Aug. 3, 2022, in West Hollywood, Calif. The City of West Hollywood is working with public health officials at the Los Angeles County Department of Public Health in responding to the monkeypox outbreak. (AP Photo/Richard Vogel)
![Monkeypox California](https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/6/09/60995344-1078-5acb-bf82-068a1a22713f/62ed41bc9937a.image.jpg?resize=200%2C139 200w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/6/09/60995344-1078-5acb-bf82-068a1a22713f/62ed41bc9937a.image.jpg?resize=300%2C208 300w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/6/09/60995344-1078-5acb-bf82-068a1a22713f/62ed41bc9937a.image.jpg?resize=400%2C277 400w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/6/09/60995344-1078-5acb-bf82-068a1a22713f/62ed41bc9937a.image.jpg?resize=540%2C374 540w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/6/09/60995344-1078-5acb-bf82-068a1a22713f/62ed41bc9937a.image.jpg?resize=750%2C520 750w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/6/09/60995344-1078-5acb-bf82-068a1a22713f/62ed41bc9937a.image.jpg?resize=1024%2C710 1200w)
People arrive to check in at a Monkeypox Vaccination Pop-Up Site on Wednesday, Aug. 3, 2022, in West Hollywood, Calif. (AP Photo/Richard Vogel)
![Monkeypox California](https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/4f/84f94bda-269f-5f92-a7d5-1e8176d44e19/62ed41c02545a.image.jpg?resize=200%2C140 200w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/4f/84f94bda-269f-5f92-a7d5-1e8176d44e19/62ed41c02545a.image.jpg?resize=300%2C209 300w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/4f/84f94bda-269f-5f92-a7d5-1e8176d44e19/62ed41c02545a.image.jpg?resize=400%2C279 400w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/4f/84f94bda-269f-5f92-a7d5-1e8176d44e19/62ed41c02545a.image.jpg?resize=540%2C377 540w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/4f/84f94bda-269f-5f92-a7d5-1e8176d44e19/62ed41c02545a.image.jpg?resize=750%2C524 750w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/8/4f/84f94bda-269f-5f92-a7d5-1e8176d44e19/62ed41c02545a.image.jpg?resize=1024%2C715 1200w)
A patient receives a Monkeypox vaccination at a Pop-Up vaccination site at the West Hollywood Library community meeting room on Wednesday, Aug. 3, 2022, in West Hollywood, Calif. (AP Photo/Richard Vogel)
![Monkeypox California](https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/9/fd/9fd39013-c8bc-57f0-89f3-3d9d642c0acf/62ed41c286ac8.image.jpg?resize=200%2C133 200w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/9/fd/9fd39013-c8bc-57f0-89f3-3d9d642c0acf/62ed41c286ac8.image.jpg?resize=300%2C200 300w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/9/fd/9fd39013-c8bc-57f0-89f3-3d9d642c0acf/62ed41c286ac8.image.jpg?resize=400%2C267 400w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/9/fd/9fd39013-c8bc-57f0-89f3-3d9d642c0acf/62ed41c286ac8.image.jpg?resize=540%2C360 540w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/9/fd/9fd39013-c8bc-57f0-89f3-3d9d642c0acf/62ed41c286ac8.image.jpg?resize=750%2C500 750w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/9/fd/9fd39013-c8bc-57f0-89f3-3d9d642c0acf/62ed41c286ac8.image.jpg?resize=1024%2C683 1200w)
USC pharmacy intern Gizelle Mendoza, loads a syringe with Monkeypox vaccine at a Pop-Up Monkeypox vaccination site on Wednesday, Aug. 3, 2022, in West Hollywood, Calif. (AP Photo/Richard Vogel)
![Monkeypox California](https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/e/a4/ea4607e7-e9b8-524a-8ffd-f17945667484/62ed41c546ebe.image.jpg?resize=200%2C133 200w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/e/a4/ea4607e7-e9b8-524a-8ffd-f17945667484/62ed41c546ebe.image.jpg?resize=300%2C200 300w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/e/a4/ea4607e7-e9b8-524a-8ffd-f17945667484/62ed41c546ebe.image.jpg?resize=400%2C267 400w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/e/a4/ea4607e7-e9b8-524a-8ffd-f17945667484/62ed41c546ebe.image.jpg?resize=540%2C360 540w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/e/a4/ea4607e7-e9b8-524a-8ffd-f17945667484/62ed41c546ebe.image.jpg?resize=750%2C500 750w, https://bloximages.chicago2.vip.townnews.com/tucson.com/content/tncms/assets/v3/editorial/e/a4/ea4607e7-e9b8-524a-8ffd-f17945667484/62ed41c546ebe.image.jpg?resize=1024%2C683 1200w)
Dr. Andrea Kim, Director of Vaccine Preventable Disease Control talks to the media at a Pop-Up Monkeypox vaccination site on Wednesday, Aug. 3, 2022, in West Hollywood, Calif. (AP Photo/Richard Vogel)
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