A A group of scientists from Africa and elsewhere is urging the scientific community and leading health experts worldwide to drop the stigmatizing language used to distinguish monkeypox viruses, and are even advocating renaming the virus itself.
In a position paper published online on Friday, the group assumes this proposed cancellation the existing names for monkeypox virus clades – West Africa and Congo Basin – and replacing them with numbers, stating that the current names are discriminatory.
“In the context of the current global outbreak, the continued reference to and nomenclature of this virus as African is not only inaccurate but also discriminatory and stigmatizing,” the more than two dozen scientists wrote.
Christian Happi, director of the African Center of Excellence for Genomics of Infectious Diseases at Redeemer’s University in Ede, Nigeria, was one of the main drivers of the proposal.
“If SARS-CoV-2 wasn’t called the Wuhan virus, for example…then the question arises, why do we have a virus or group named after a specific geographic location in Africa and then spread to people extends in those areas,” Happi told STAT. “If we have to go by geographic location, then we should name all viruses by geographic location.”
Happi also expressed anger at the way the outbreak was being portrayed in mainstream media, noting that photos of African children with monkeypox lesions were used to illustrate articles about an outbreak that was spreading among men, who have sex with men in countries of the world north.
“We find that very discriminatory, we find that very stigmatizing and at times … I find it very racist,” he said. “The mainstream media, instead of showing pictures of people with lesions who are white males, continue to show pictures of children in Africa and of Africans. And there is no connection.”
An official at the World Health Organization, which would be involved in any rewrite of clade names, said Saturday the agency was open to the idea.
“There is broad support for this,” said Maria Van Kerkhove, head of the unit for emerging diseases and zoonoses at WHO’s Health Emergencies Programme.
The WHO and the scientific community can effectively rename the clades by agreeing on replacement terms and starting to use them – in official statements, scientific papers and in interviews with journalists. For example, a cumbersome naming process for SARS-CoV-2 variants has been replaced with a system that assigns variants the name of a letter of the Greek alphabet, such as alpha and omicron.
Happi said the group behind the call consulted extensively on the idea and encountered no objections. “There is a consensus from the global community,” he said. “I think it’s high time for us to take this step.”
However, renaming the virus itself is not the responsibility of the WHO. That power rests with an organization called the International Committee on Taxonomy of Viruses, which also gave SARS-CoV-2 its name. The WHO, on the other hand, came up with the name of the disease that causes the virus, Covid-19.
Van Kerkhove said an ICTV subcommittee focusing on the smallpox family “is discussing renaming smallpox viruses in the coming months.”
Using geographic names (think Rift Valley fever) or people’s names (think Epstein-Barr virus) for viruses has been frowned upon for some time. As early as 1976, scientists studying a mysterious and deadly outbreak at a place called Yambuku in the Democratic Republic of the Congo (then Zaire) decided against naming the causative virus after colonization because it would be stigmatizing.
Today, even their compromise — Ebola, after a nearby river — could be seen as violating best-practice disease-naming guidelines published by the WHO in 2015 in collaboration with the United Nations’ Food and Agriculture Organization and the World Organization for Animal Health .
Monkeypox infections have historically been limited to west and central Africa, where the virus is endemic in some animals. Until recently, cases outside of these countries were rare and involved travelers or their close contacts.
But in mid-May, health authorities in the UK announced they had discovered a number of cases in people with no history of travel to the endemic countries. Since they sent this alert, more than 1,500 cases have been detected in more than 40 countries where monkeypox viruses are not normally found. The current unprecedented spread in these areas – and subsequent media coverage – prompted scientists to call for a change in the description of the viruses.
“This was spearheaded by the colleagues from Africa, so both South Africa and Nigeria, who felt that we needed a new set of names that could be used neutrally and objectively to refer to these different genotypic variants of the virus,” said Richard Neher, associate professor at the University of Basel in Switzerland. Neher, who specializes in viral evolution, was a signatory to the proposal.
They proposed that viruses belonging to what is now known as the Congo Basin clade – typically found in several Central African countries – are known as clade 1. The current West African clade would be divided into two designations, with the major eruption in several countries that is currently underway and belonging to what would be known as Clade 3. Also, they propose that an “h” be placed on the front of the short form of the virus – MPXV – to indicate that viruses in clade 3 are transmitted from human to human. In the endemic countries of Africa, it is more common for monkeypox to be transmitted from animal to human, with limited human-to-human transmission, mainly among household contacts.
“The hope is that just this neutral 1, 2, 3 [system] We would have a more detailed breakdown not tied to where this has been sampled in the past,” said Neher, who also expressed confidence that the new names will catch on.
This story has been updated with additional comments.