For years, dating app Grindr has been doling out sexual health advice to its more than 11 million users. Now the app, which serves the gay, bisexual and transgender community, is using its platform to raise awareness of monkeypox, a virus that has long been endemic to parts of Africa but has recently spread to countries like the United States and the United Kingdom.

Monkeypox is characterized by clusters of blister-like rashes, which health officials say have led to the disease being misdiagnosed as common sexually transmitted infections. The virus also appears to be spread in much the same way as STIs: through close, intimate contact. But repeated misdiagnoses could allow monkeypox to spread undetected – and prevent infected people from getting the right treatment.

Typically, monkeypox is thought to be spread via large respiratory droplets, contact with wounds, or sharing things like bedding or clothing with someone who is spreading the virus. So far, many of the new cases have been linked to men who have sex with men, suggesting the virus could be spread through sexual networks, experts say. Thus, Grindr has been working to get accurate information about the outbreak to its users. Last weekend, the app sent a pop-up alert in 13 different languages ​​to users in the UK and Europe, where the majority of cases have been detected so far. The alerts contained links to verified and up-to-date information on monkeypox from public health authorities like the European Center for Disease Prevention and Control.

“We see ourselves as the connective tissue between groups on the ground, like the European CDC and the UK Health Security Agency, and our users,” said Jack Harrison-Quintana, director of Grindr’s advocacy arm, Grindr for Equality. “Public health has long been embedded in the gay community.”

This public health story dates back to the early years of the HIV/AIDS crisis, which disproportionately affected the LGBTQ community and continues to do so to this day.

The currently circulating strain of monkeypox is generally mild and symptoms may resolve on their own, although effective antivirals are also available to treat the disease. Anyone can get monkeypox, but most cases associated with this current outbreak are in men who have sex with men, according to the US Centers for Disease Control and Prevention. And although many cases have been identified at sexual health clinics, health officials have warned there is not yet evidence of transmission occurring specifically through seminal or vaginal fluids. “Monkeypox is not a sexually transmitted infection in the typical sense, but it can be transmitted through sexual and intimate contact,” said Laura Bachmann, chief of the CDC’s STD Prevention Division.

Previous outbreaks of monkeypox have occurred outside of Africa, but normally these cases are associated with travel to the continent or are linked to spillovers from infected animals. But cases of monkeypox in this most recent outbreak are occurring without evidence of either catalyst. This raises concerns that sexual contact could very well be what is spreading the virus this time around, experts have said in multiple interviews. Previously, sexual transmission of monkeypox was thought to occur rarely, if at all, according to a report from European health officials. Generally, diseases can be spread through multiple routes, and in recent years studies have shown that several infectious diseases can actually be spread sexually. Mosquito-borne infections Zika and dengue can be sexually transmitted, for example, as can Ebola. Even Shigella, a common source of food poisoning, is increasingly recognized as a sexually transmitted insect.

Understanding the main ways a pathogen spreads is key to knowing how best to stop it.

While monkeypox now uses sexual networks to spread, it’s unclear exactly how that became its mode of transmission, said Amesh Adalja, senior researcher at the Johns Hopkins Center for Health Security in Baltimore.

“Is it the actual close, skin-to-skin contact, respiratory secretions that spread during sex? Or is it actually a sexually transmitted infection transmitted through bodily fluids that are exchanged during sex? said Adalja.

– Looks more like an STI –

The CDC says clinicians should be on the lookout for rashes that occur in men who have recently had close, intimate contact with other men. The agency also lists travel to epidemic areas and contact with confirmed or suspected cases as reasons for heightened concern. Since monkeypox is not normally found in the United States, it could be especially easy for clinicians to misdiagnose the rash indicative of an STI. But monkeypox requires different treatment than common STIs, so correct diagnosis is essential.

Health officials in the US and UK warn that cases have already been mistaken for STIs. During a media call on Monday, CDC doctors said an early infection was initially misidentified as “severe herpes” rather than monkeypox. The CDC said most of the cases identified so far have presented to sexual health clinics with sores located in the genital area, which could be mistaken for syphilis or herpes. Lesions on the genitals are less commonly associated with the disease, another feature of the recent outbreak making cases more difficult to diagnose. The most common site for the rash is usually the face, followed by the palms of the hands and the soles of the feet. Some of the recent cases also did not develop a fever or any of the other usual flu-like symptoms associated with monkeypox, according to the CDC.

In Montreal, the first reported cases were treated in clinics specializing in sexually transmitted diseases. Health officials first thought they were dealing with cases of chancroid, a bacterial disease that causes painful genital ulcers, until they heard of a case of monkeypox in the United States. United and are changing the focus of their investigation, The Canadian Press reported Thursday.

– Fighting stigma –

While so far most cases have appeared in men who have sex with men, health officials have warned that this is not an isolated disease in a single community.

“There’s a lot of stigma and discrimination that surrounds many diseases,” Andy Seale, of the World Health Organization’s Department of Global Programs on HIV, Hepatitis and STDs, said during a briefing. question-and-answer session on Monday. “While we see cases among men who have sex with men, it’s not a gay disease.”

The European Center for Disease Prevention and Control also said it prioritizes community engagement and that efforts should be made to ensure there is no stigma around monkeypox based on sexual orientation. “Risk communication messages could also indicate that infection with the monkeypox virus is not indicative of a person’s sexual orientation or that sexual orientation influences their susceptibility to disease,” the agency said. in a report. In the United States, the CDC coordinates with partners in the LGBTQ community. community to raise awareness about monkeypox, which involves working with sexual health organization Building Healthy Online Communities to explore providing information about the outbreak to dating apps — much like Grindr’s recent efforts in UK and Europe. “Certain groups may have a greater chance of exposure right now,” said Christina Hutson, head of the CDC’s Poxvirus Branch. “But the current risk of exposure to monkeypox is by no means exclusive to the gay and bisexual community.”