I can think of three ways to interpret this. I assume that it means that a large portion of the cases they’re seeing are in gay men. This could mean:
For some bizarre reason, gay men really are more prone to transmitting the disease than anyone else. This seems very implausible.
By random chance, there was a superspreader event at a gay bar or similar in Nigeria, and subsequent spread through regular social contact is producing a lot of new cases in gay men because gay men are more likely to hang out with other gay men.
It’s purely ascertainment bias, and the virus isn’t actually more prevalent in the gay community. This is pretty bad if true, because it means there are a huge number of undetected cases in straights. OTOH, it would also mean that the disease likely isn’t that severe, because someone who ends up hospitalized with a bunch of weird sores is probably getting diagnosed.
Yeah not great, but it seems like it’s yet to be fully confirmed from scientists that those are a lot of changes over four years and that the changes are having a material impact on the situation. But it does start to make that quite a bit more likely, as this information in context of the situation points in that direction.
re: the title of this thread. I’ve seen that phrase so many times now that I think it might be some sort of Berenstain Bears type thing. Mercutio’s line in Romeo and Juliet is “A plague o’ both your houses!” Not pox. Plague.
Hm. Maybe something like one or more people involved with exporting exotic pets caught a bad batch of rats, went to a pride festival and didn’t do a great job with washing their hands after work.
Could be. One thing that doesn’t quite add up is that the person who was suspected of being the index case in the UK was hospitalized before this festival started and started showing symptoms in Nigeria. So either he was the index case, and he infected someone else who went to the festival (seems like a stretch?) or there were at least two cases exported from Nigeria: that guy plus someone who went to the pride festival.
I googled the Pride festival and this was one of the top results:
Or someone from Nigeria went to the Pride festival, infected one or more people early on, and by middle of the festival (It was May 5-15), they were contagious and infected others, who by the end were contagious… Then they all got on planes and flew home.
Also possible that it’s circulating among that rodents in the Canary Islands, much like it spread in prairie dogs in the US. Maybe someone in the Canary Islands has an exotic Nigerian rat and it bites a mouse or something.
A scenario where the outbreak in Nigeria is worse than anyone suspected, perhaps with a lot of asymptomatic cases - I suspect that in the next decade we will learn that there is way more asymptomatic spread of all diseases than we ever imagined, could lead to exporting a few cases here and there and this time a chain of transmission was established through a Pride festival, which was the perfect set of circumstances. Long enough to establish a few generations of spread, lots of physical contact, tons of people available to infect (80K) from all over the world, and they fly back just before realizing they’ve got pox on their body.
Yeah that’s possible, too. Although then, we’d expect to find a lot of cases in the Canary Islands, wouldn’t we? 2.2M people live there, and as far as I know we haven’t heard of any cases from there. The cases in Spain were in Madrid, I believe.
Given we are likely to see an increased proliferation of these kind of diseases as we cook the planet, this might be an appropriate time to start adapting by normalizing good masks indoors as ordinary course and ending unfettered international travel (bonus points for the massive carbon reduction from the latter).
Can confirm ID docs seem to think they’re paid by the word in their notes.
Radiologists are the worst though. I’m convinced they just make up words for their reports… like parenchyma, hilar, and opacity. At least words like encephalomalacia and cholelithiasis sound Greek/Latin enough to have a real meaning.