Beyond their physiopathology, diseases are linguistic and cultural realities: recognizing and naming groups of pathogens, symptoms, and processes as a disease is a social process with profound implications.1 The way we refer to a disease has practical effects: it influences access to treatments, identity formation, or the economic support received. For this reason, today we are reflecting on the need to adopt the term “viruela M” (Mpox) to refer, in Spanish, to the disease caused by the monkeypox virus, currently called “viruela del mono” (monkeypox) or “viruela símica” (simian pox).
In May 2022, an outbreak of mpox with community transmission began in countries of the globalized North, associated with clade IIb. This led the World Health Organization (WHO) to declare a Public Health Emergency of International Concern in July 2022.2 Mpox was previously endemic in Central and East African countries, with occasional imported cases in the rest of the world.3 This situation was coupled with the disproportionate impact of the epidemic on gay, bisexual and other men who have sex with men (GBMSM) and on African American and Hispanic populations in countries such as the United States and Spain,4,5 and Hispanic communities globally.6 Overall, this led to the emergence of disinformation and hate speech, including homophobic, racist, and stigmatizing messages, primarily on social media. The impact of disinformation and hate was global.7
In November 2022, the WHO, after consulting with global experts, proposed changing the name of “monkeypox” to “mpox” in English.8 The WHO did not provide instructions regarding the naming of the disease in other languages. As a result, in Spanish the terms “viruela del mono” (monkey pox) in Spain and Latin America, and “viruela símica” (simian pox) in Latin America, remain in use. A search on the Google.com search engine conducted on August 24, 2024, yielded a total of 18.3 million results for the term “viruela del mono” since November 2023, when the period of transition to the new name (mpox) set by WHO ended. The term “viruela símica” yielded a total 2.8 million results. The term “mpox” yielded 10,1 million results. Findings were similar in other browsers, and this diversity of nomenclature was also found in the official websites of several Spanish-speaking countries. This inconsistency generates a heterogeneity in scientific communication and the dissemination of information to the public.
On August 14, 2024, the WHO declared a new Public Health Emergency of International Concern due to the increase in cases of clade Ib virus in several African countries.9,10 Once again, we have observed the spread of disinformation and hate speech on Spanish-language social media, targeting racialized individuals and GBMSM. In Spanish, the terms “mono” (monkey) or “simio” (simian) are sometimes used in a derogatory manner to refer to people of African descent in Spain or indigenous origin in some countries in Latin America.11 These discourses, which antagonize and stigmatize the communities most vulnerable to the disease, are intertwined with racist and homophobic narratives about the origins and transmission of diseases such as HIV and COVID-19.12
For these reasons, the Latin American Alliance of Infectious Diseases and Clinical Microbiology (Alianza Latinoamericana de Enfermedades Infecciosas y Microbiología Clinica, ALEIMC), and experts in social science, propose changing the Spanish name “viruela del mono” to “viruela M.” This term would help to combat the stigmatization of the disease in some Spanish-speaking countries, as well as to unify the terminology internationally. Unification of terminology will not only generate the benefits discussed above, but will also help to consistently index articles based on keywords, facilitating the identification of relevant literature in the future.
This change of name is important and must be accompanied by internationally coordinated political actions that are guided by justice and equality and developed in collaboration with the people and communities most affected by the viruela M. In line with this, it is essential that healthcare systems in Latin American countries prioritize access to vaccines for communities most vulnerable to this virus and guarantee quality healthcare, allowing for early diagnosis and effective, non-stigmatizing, management of viruela M. Likewise, the Scientific Societies of ALEIMC are committed to contribute to the response to this public health emergency, both by carrying out outreach activities to educate the population and through academic activities that update and train medical personnel in our countries in best practices to manage this disease.
