Since coming out to his family and friends as a homosexual almost four years ago, Fred* (pseudonym) says that he developed a thick skin, and not once has he felt hurt over the typical jokes made about his sexuality.

That is until last week when he was told by a family member, "you all better not bring your gay disease to Dominica."

"That really hurt me," the almost 30-year-old told the Sun. "Since I heard of this Monkeypox disease and it being prevalent among the gay community, I knew people would start thinking stuff like this."

Monkeypox is now a global threat

Monkeypox, once a relatively obscure virus endemic to Africa, has bloomed into a global threat, infecting more than 20,000 people in 75 countries and forcing the World Health Organization (WHO) last month to declare it a worldwide health emergency.

According to WHO, about 99% of cases are among men, and at least 95% of those patients are men who have sex with men. Therefore, for many gay and bisexual men in Dominica, the summer has been consumed with similar conversations as monkeypox cases spike.

Though Tom*- another gay man in Dominica- understands the statistics on who the outbreak has been impacting most, he, however, emphasized that any gender could bring in the virus to the island and transmit it to others, therefore, "this is really everybody's problem."

"Forty years ago, AIDS was also called a "gay disease" because the initial outbreaks were primarily among gay men, now look where we are, both men and women can contract the virus," he pointed out.

The 25-year-old is also fearful that the gay community could become a scapegoat in the event of a larger and more widespread monkeypox outbreak.

"It's already hard being who you are and loving who you love in a country that's so closed-minded, so imagine if this virus gets in and everyone starts pointing fingers at us, I only see things getting worse for our safety," he distressingly stated.

His 23-year-old partner Eddie* has also expressed his frustration and lack of confidence in the system's ability to properly prevent an outbreak in Dominica by not taking preventative measures.

WHO asked gay men to limit the number of sexual partners

It's really disheartening that little information is coming from the authorities on monkeypox. This shouldn't be the case, more public information and knowledge on this virus should already be blasting the airwaves before it is too late," he told our reporter.

Last Wednesday, the WHO issued a call to gay and bisexual men to limit their number of sexual partners to protect themselves from monkeypox and help slow the transmission of the rapidly spreading virus.

WHO chief, Tedros Adhanom Ghebreyesus said it is crucial for public health authorities to engage communities of men who have sex with men to reduce transmission of the virus and take care of those infected while protecting human rights by fighting stigma and discrimination.

"For men who have sex with men, this includes for the moment, reducing your number of sexual partners, reconsidering considering sex with new partners, and exchanging contact details with any new partners to enable follow-up if needed," Tedros said.

Though WHO scientists have said that the virus is primarily spreading through skin-to-skin contact during sex, they've cautioned that anyone can catch the virus through close physical contact.

This includes hugging and kissing within a family, for example, as well as shared towels or bedding that are contaminated. There have been cases of women and children catching the virus during the current outbreak, though transmission appears to be low in the broader community at the moment.

Monkeypox can also spread through respiratory droplets when infected individuals have lesions in their mouth, though this requires prolonged face-to-face interaction. The outbreak still might be able to contain if people limit their risk of exposure now, Lewis said. Unusual symptoms

Most people who catch monkeypox are recovering in two to four weeks, according to the U.S. CDC. But the virus causes a rash that can be very painful. In the past, monkeypox began with symptoms similar to the flu and then progressed to a rash that can spread over the body.

But monkeypox symptoms in the current outbreak have been unusual. Some people are developing a rash first, while others have a rash without any flulike symptoms at all. Many people are developing a localized rash on their genitals or anus.

In countries like the US, the Jynneos vaccine which requires two doses 28 days apart is just starting to be administered.

Europe is currently the epicentre of the global outbreak, reporting more than 70% of monkeypox cases, followed by the U.S, then Spain.

The global monkeypox outbreak has seen more than 22,000 cases in nearly 80 countries since May. There have been 75 suspected deaths in Africa, mostly in Nigeria and Congo, where a more lethal form of monkeypox is spreading than in the West.

As of July 29, Caribbean countries such as Puerto Rico (13 confirmed, 12 suspected), Dominican Republic (3 confirmed, one probable), Jamaica (2 confirmed), Bahamas (one confirmed, one suspected), Barbados (one confirmed), Bermuda (one confirmed), and Martinique (one confirmed) have been reported.

Meanwhile, Dominica's Health Minister Dr. Irving McIntyre revealed that all suspected cases of monkeypox have been tested at the hospital and thus far, all have returned negative.

"So we are ahead of the game, we have measures in place to address this," he said.

(*) represents a change of the names to protect the identity of those interviewed.

-By Ronda Luke