Monkeypox a new worry for gay and bi men

[Tactile Daddy]

Reduce your risk. Multitudes of sources have confirmed its primarily sexually transmitted 

[+ Lucky]

Naturally I wish there were more vaccines available, and yes, I do fault the Biden administration for not being on top of this. But what about testing? There is a test to determine if one has monkeypox? Where do you get it? It seems to be a big secret in this area.

Also, I am confused by what has been written here about those of us who had the smallpox vaccine. Does it or does it not give some immunity to monkeypox? With all respect for @SirBillybob, could someone answer me in plain English?

[Luv2play]

I thought I had addressed this in previous posts. Not much data. Only a study done in 1988. May offer some protection. Better get the vaccine as a booster. Even if effective, the new vaccine doesn't offer 100 percent protection. Might reduce severity of disease if contracted despite  vaccinations in past. 

Hey I'm just a layman. Not a medical expert. I just read a lot. Take no info off TV. Sir BillyBob seems to be more expert. But can be tough to get through the medical- scientific jargon he uses.

[+ nycman]

18 minutes ago, Lucky said:

With all respect for @SirBillybob, could someone answer me in plain English?

I will do my best to translate @SirBillybob into street English. 

A) We don’t really fucking know.
B) Remote smallpox vaccination seems to be somewhat protective, especially against severe disease, but not so much against mild (and still transmittable) cases.
C) A single shot of the new vaccine is somewhere around 85% protective 4 weeks after the shot, and again even more so against severe disease. 
D) Two shots of the new vaccine (and I’m willing to bet one old smallpox and one shot new vaccine) seems to get you into the 90-95% protective range and prolongs your immunity past the 2 year mark.
E) A severe case in a double vaxed patient would be very unusual and most likely point to a problem with their immune system. 

In summary, if I got the old smallpox vaccine, I would still get the new vaccine ASAP, and I would still get the second shot of the new vaccine 4 weeks later (if I could). Most importantly, keep your dick in your pants, don’t rub up against other people, keep your mouth off of other people, keep their mouths off of you, and don’t shove a cock up your ass until we get the "all clear". 

I now return you to @SirBillybob’s much more erudite discussion. 

Edited August 5, 2022 by nycman

[Tactile Daddy]

21 minutes ago, Lucky said:

Naturally I wish there were more vaccines available, and yes, I do fault the Biden administration for not being on top of this. But what about testing? There is a test to determine if one has monkeypox? Where do you get it? It seems to be a big secret in this area.

Also, I am confused by what has been written here about those of us who had the smallpox vaccine. Does it or does it not give some immunity to monkeypox? With all respect for @SirBillybob, could someone answer me in plain English?

https://www.instagram.com/reel/Cg4wUW-JQlQ/?igshid=YmMyMTA2M2Y=

 

This might help 

[Luv2play]

24 minutes ago, nycman said:

I will do my best to translate @SirBillybob into street English. 

A) We don’t really fucking know.
B) Remote smallpox vaccination seems to be somewhat protective, especially against severe disease, but not so much against mild (and still transmittable) cases.
C) A single shot of the new vaccine is somewhere around 85% protective 4 weeks after the shot, and again even more so against severe disease. 
D) Two shots of the new vaccine (and I’m willing to bet one old smallpox and one shot new vaccine) seems to get you into the 90-95% protective range and prolongs your immunity past the 2 year mark.
E) A severe case in a double vaxed patient would be very unusual and most likely point to a problem with their immune system. 

In summary, if I got the old smallpox vaccine, I would still get the new vaccine ASAP, and I would still get the second shot of the new vaccine 4 weeks later (if I could). Most importantly, keep your dick in your pants, don’t rub up against other people, keep your mouth off of other people, keep their mouths off of you, and don’t shove a cock up your ass until we get the "all clear". 

I now return you to @SirBillybob’s much more erudite discussion. 

C and D responses would appear to me to be pure speculation as the vaccine has only only be available for less then two months and there has not been sufficient time to test their efficacy through mass testing. That will take at least up to a year like the Covid vaccines.

[SirBillybob]

45 minutes ago, nycman said:

I will do my best to translate @SirBillybob into street English. 

A) We don’t really fucking know.
B) Remote smallpox vaccination seems to be somewhat protective, especially against severe disease, but not so much against mild (and still transmittable) cases.
C) A single shot of the new vaccine is somewhere around 85% protective 4 weeks after the shot, and again even more so against severe disease. 
D) Two shots of the new vaccine (and I’m willing to bet one old smallpox and one shot new vaccine) seems to get you into the 90-95% protective range and prolongs your immunity past the 2 year mark.
E) A severe case in a double vaxed patient would be very unusual and most likely point to a problem with their immune system. 

In summary, if I got the old smallpox vaccine, I would still get the new vaccine ASAP, and I would still get the second shot of the new vaccine 4 weeks later (if I could). Most importantly, keep your dick in your pants, don’t rub up against other people, keep your mouth off of other people, keep their mouths off of you, and don’t shove a cock up your ass until we get the "all clear". 

I now return you to @SirBillybob’s much more erudite discussion. 

I don’t know where you are getting B, C, D, and E. I would be inclined to put those assumptions under A. 

I have not used language that has not been seen in media articles or public health briefings. Some of them may be information sources separate from news reports aimed at the broader public.

Edited August 5, 2022 by SirBillybob

[caramelsub]

 

9 minutes ago, Luv2play said:

C and D responses would appear to me to be pure speculation as the vaccine has only only be available for less then two months and there has not been sufficient time to test their efficacy through mass testing. That will take at least up to a year like the Covid vaccines.

The nurse who gave me the shot yesterday said, the vaccine has been around for a long time now. And that it’s not new like the covid vaccine.

[padel412]

12 minutes ago, caramelsub said:

 

The nurse who gave me the shot yesterday said, the vaccine has been around for a long time now. And that it’s not new like the covid vaccine.

It has never been used in a mass vaccination campaign before and there is no data from humans on its effectiveness against monkeypox specifically that predates the current epidemic. Which is not to say one shouldn’t be confident in getting the vaccine, but there are still a lot of unknowns.

https://www.fda.gov/news-events/press-announcements/fda-approves-first-live-non-replicating-vaccine-prevent-smallpox-and-monkeypox

”The effectiveness of Jynneos for the prevention of monkeypox disease is inferred from the antibody responses in the smallpox clinical study participants and from studies in non-human primates that showed protection of animals vaccinated with Jynneos who were exposed to the monkeypox virus.”

[Luv2play]

20 minutes ago, caramelsub said:

 

The nurse who gave me the shot yesterday said, the vaccine has been around for a long time now. And that it’s not new like the covid vaccine.

Those are words of comfort that the vaccine will not harm you. Nothing to say about it's efficacy since it hasn't been used against Monkeypox in any significant way for decades, if ever. 

Edited August 5, 2022 by Luv2play

[+ nycman]

2 hours ago, SirBillybob said:

I don’t know where you are getting B, C, D, and E. I would be inclined to put those assumptions under A. 

I don’t disagree.

I believe most of the speculation that frames B-E is from data on the older vaccine, cross referenced with antibody titers seen after vaccination with the new vaccine. Also known as a wild fucking guess, but it’s the  best we’ve got at the moment since there are no large "real life" trials of the new vaccine against Monkey Pox in humans that I’m aware of. 

So yes, ”A" is the best answer. 

2 hours ago, SirBillybob said:

I have not used language that has not been seen in media articles or public health briefings. Some of them may be information sources separate from news reports aimed at the broader public.

You’re cute when you get defensive.
In all honesty, it was meant as a compliment. 
You’re wicked smart, it’s just hard for lay people
to understand some of the graphs and charts you post. 

[JUWS]

I got my 1st shot in NYC Saturday July 30th. The injection site has been swollen since then, 1 week. Has anyone else had any reactions with prolonged swelling, rash, pimples etc?  I have an appointment with my doc on Monday, but just wondering if anyone else experiencing anything?

[SirBillybob]

2 hours ago, nycman said:

I don’t disagree.

I believe most of the speculation that frames B-E is from data on the older vaccine, cross referenced with antibody titers seen after vaccination with the new vaccine. Also known as a wild fucking guess, but it’s the  best we’ve got at the moment since there are no large "real life" trials of the new vaccine against Monkey Pox in humans that I’m aware of. 

So yes, ”A" is the best answer. 

You’re cute when you get defensive.
In all honesty, it was meant as a compliment. 
You’re wicked smart, it’s just hard for lay people
to understand some of the graphs and charts you post. 

The graphs and charts are taken from the related literature. I have been mindful of summarizing within this thread the gist of such illustrations. Some readers here will be able to read them. Others won’t. They are added to show that I am not pulling ideas out of my ass. There are ideas presented here on the board that I believe to be inaccurate. This is often a ‘pages passed from hand to hand’ or U of Google & Facebook College phenomenon.

Some readers have little tolerance for grey areas. There are some media articles in which known experts’ views are either inconsistent with the published research and with what other expert reports contain, or perhaps misrepresented by the journalists themselves.   This may reflect both human error and lack of consensus. The latter reminds us that experts fall into the trap of having answers that they sometimes really don’t possess. We should appreciate lack of consensus because it behooves us to develop tolerance for ambiguity and uncertainty. We are often called upon to make nuanced judgements for our personal situations.

We know how to get and how to avoid Monkeypox. Check. It’s a relatively wimpy virus transmission-wise for adults, all things considered. It may be a challenge for many to refrain from behaviour that upticks the probability of catching it, but by now there is sufficient information regarding what interaction situations should clue us in to being at the point of flirting with the virus. 

MVA-BN and dosing, dose dilution prospects, etc.  Well, I won’t summarize or add more at the present time. I think what is reasonably known has been covered yet there is obviously more to uncover going forward. 

Smallpox inoculation history. In addition to small dated bodies of research supporting the notion that diagnosed cases occur more frequently (aka ‘attack rates’) among the unvaccinated (hence, younger population), we now have tracking data for some 500+ cases, as described in NEJM. The researchers did not wish to interpret attack rate differences and did not explain why. Perhaps because they would have to assume all other infection susceptibility factors were the same between the older historically vaccinated and younger unvaccinated subgroups. However, we know the general population shares of age from census demographics, and can estimate that the total number of males 18-50 is roughly twice that of males 50-70. Therefore, the 10% older male cases occurred in a population subset about half the size of the younger population subset that reflected 9 times the attack rate (prior to adjusting for population share denominators) compared to the older, presumably majority SPXV-vaccinated group. Therefore, if 10 older males out of 1,000 older males were infected while 90 younger males out of 2,000 younger males were infected, this would mean that equivalent attack rates would require 45 (not merely 10) older males within 1,000 older males to be infected. The 4-fold difference is consistent with the Congo basin findings of 35 and 15 years ago. Irrespective of proportions of total population at any time that had had Smallpox vaccination … obviously higher percentages the further back in time to the point of eradication … the attack rates are higher for the unvaccinated. Now we need to patiently wait for comparative attack rates to emerge in real time MVA-BN rollout, or unfortunately in global regions where MPXV incidence occurs across all age groups prior to MVA-BN equity. 

There seems to be no clear way to rate disease severity and cross-reference to vaxx history or current dosing questions. For example, one lesion may simply happen to emerge randomly in a very bad location while another person may have much more acute skin involvement and for a longer period but not threatening vision, breathing, etc. Hospitalization to manage unique challenges may not be a good marker of severity for this reason. Severity of Monkeypox in animal research is based on survival vs mortality. The research reported in NEJM did a lot of detailed quantifying but did not come up with a meaningful way to grade disease severity. 

Edited August 6, 2022 by SirBillybob

[kingsley88]

8 hours ago, Tygerscent said:

I receive my fifth covid pin August 16th and that puts me in track for the improved next gen covid shot in December. 
 
 So, check around and see what’s available in your areas… one may not need to travel to CA to get pinned~ 

When I got my monkeypox jab, they advised us not to get covid booster shot (Pfizer or Moderna) within 4 weeks of getting the monkeypox shot.

[mike carey]

8 hours ago, Tactile Daddy said:

Reduce your risk. Multitudes of sources have confirmed its primarily sexually transmitted 

... At the moment!

A pedantic clarification, it's true that currently the virus is primarily being transmitted sexually, but that relates to the distribution of the disease now, not its general transmissibility. (In April 2020 most cases of Covid in Sydney were in aged care homes, but that didn't mean Covid was primarily transmitted in them. All it meant was that was what was happening then.)

That is in no way to play down the importance of publicising sexual transmission as the greatest current risk. Among gay and MSM, the distinction is less important at the moment because we want to know how best to protect ourselves. What we should avoid is playing down other transmission paths. If your partner has the disease you really need to know that handling bed linen and clothes is a risk.

Precision in language is also important in trying to prevent a false narrative that it's a gay disease.

[Tactile Daddy]

6 hours ago, mike carey said:

... At the moment!

A pedantic clarification, it's true that currently the virus is primarily being transmitted sexually, but that relates to the distribution of the disease now, not its general transmissibility. (In April 2020 most cases of Covid in Sydney were in aged care homes, but that didn't mean Covid was primarily transmitted in them. All it meant was that was what was happening then.)

That is in no way to play down the importance of publicising sexual transmission as the greatest current risk. Among gay and MSM, the distinction is less important at the moment because we want to know how best to protect ourselves. What we should avoid is playing down other transmission paths. If your partner has the disease you really need to know that handling bed linen and clothes is a risk.

Precision in language is also important in trying to prevent a false narrative that it's a gay disease.

Pedantic? LOL 

so you're telling me that research doctors, the New England Journal of Medicine, the CDC   the WHO and the latest science are being insulting and caring too much about the smaller details. Their language is imprecise? 🤡

I'm speaking to the choir in this forum, no one is going to believe that this is a "gay disease" on this private forum. I believe what my post is trying to do is reinforce the fact that distinct changes to sexual practices are ones that should not be taken lightly, but judging from the mental gymnastics that many within the community are taking to reduce the stigma to our active sexual lives is hilarious and insulting. Many men continue to be very active and the narrative should be on point to highly recomend that practices be curbed quickly. The bleedover otherwise into the Bisexual and heterosexual society will only further enhance any stigma because far too many of us were scared of pumping the brakes on hedonism until more people can get vaccinated. 

The San Francisco AIDS Foundation giving lousy advice to DORE Alley visitors to simply put a bandaid on any suspicious rash or blisters before going out into high contact intimate street fair is mind boggling. Senator Scott Wiener suggesting that men will continue to make personal decisions to go to sex parties flies in the face of the mandated mask police policies he and others wanted mandate two years ago. The Hypocrisy is glaring. Your pearl clutching is palpable. 

Edited August 6, 2022 by Tactile Daddy

[mike carey]

I wasn't challenging the medical consensus, nor was I clutching at pearls, and I'm not the one engaging in condescending dismissals of anyone. You're right, their language is not imprecise and I didn't say it was. I said that yours was. Right now, in rich western countries transmission is primarily as a result of sexual contact, so of course caution and probably abstinence are prudent. Strange as it may seem, 'rich western countries' and 'now' are not the only contexts in which this disease occurs.

[diehard_002]

I found this paper from NEJM to be very helpful , Jump straight to the discussion section if you find the rest of the stuff too detailed.

https://www.nejm.org/doi/10.1056/NEJMoa1817307

Looks like seroconversion happens after 2 weeks of the first shot and invokes an immune response which is comparable to the old smallpox vaccine. This is in line with the current strategy of maximizing the number of recipients of the 1st shot

[+ Lucky]

From today's LA Times:

By Jessica RoyAssistant Editor, Utility Journalism 

Aug. 5, 2022 2:21 PM PT

Los Angeles County’s monkeypox vaccination effort will focus for now on getting first shots into arms.

To be fully vaccinated against monkeypox, people need to get two doses of the Jynneos vaccine four weeks apart. Ward Carpenter, director of health services for the Los Angeles LGBT Center, said Friday that he received new guidance from the L.A. County Department of Public Health advising that giving out first doses should be prioritized over administering the second shot.

On its website with guidance for healthcare professionals, the department said it “asks that all providers prioritize administering first doses of JYNNEOS vaccine to eligible immunocompetent persons to protect as many at-risk people as possible. Second dose appointments should be deferred until more doses of JYNNEOS become available.” A spokesperson confirmed the new vaccine prioritization via email.

“The county is officially changing the strategy to deferring second doses. This is a big change,” Carpenter said. It will help get more people partial protection against monkeypox, but at the same time, “it’s going to create a lot of anguish and concern among people who need their second dose.”

“There is good science” to back that change, he said, and “we are in support of that recommendation, but what that means is the question will be on everyone’s mind: How protected am I with the first dose?”

And the answer to that question is: No one knows right now. The vaccine currently being given for monkeypox is actually a smallpox vaccine (both diseases are caused by orthopoxviruses). Data show the vaccine is safe in humans and effective in animals and in test tubes. But it hasn’t been tested on humans under these circumstances before.

 

 

Sex, ‘casual contact,’ pimples: A California monkeypox guide, separating fact and fiction

Aug. 5, 2022

“We just don’t have good data on vaccine effectiveness, especially as it relates to sexual transmission,” said Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health and a member of the World Health Organization’s emergency committee on monkeypox. “That’s not to say it won’t work. We just don’t have enough data to make definitive statements.”

The health department reopened its list of pre-registration slots for monkeypox vaccination appointments on Friday afternoon. If you are eligible and there are still appointments available, you can click this link to sign up: https://lacpublichealth.sjc1.qualtrics.com/jfe/form/SV_aY96Sxs2lUgUZb8.

 

 

The list closes when no more spots are available. The county has a newsletter that will send you an email when more spots have opened. You can sign up for that at the top of the page here: http://publichealth.lacounty.gov/media/monkeypox.

You must be 18 years or older and meet at least one of the following criteria to be eligible:

• You are a gay or bisexual man or a transgender person who has had multiple sex partners in the last 14 days, including (but not limited to) having sex in exchange for food, shelter or other goods or needs.
• You are on HIV PrEP medication.
• You’ve had anonymous sex or sex with multiple people within the last 21 days at a commercial sex venue or other venue.
• You’ve had high or intermediate exposure to monkeypox (the CDC has a list of what qualifies as exposure at those levels).
• You’ve attended an event or venue where there was a high risk of exposure via skin-to-skin or sexual contact with people with monkeypox.
• You are experiencing homelessness and engaging in high-risk behaviors.
• You are a gay or bisexual man or a transgender person who’s had gonorrhea or early syphilis in the last 12 months.
• You are in jail and have been identified as high-risk by clinical staff.
• You are severely immunocompromised — for instance, if you are undergoing chemotherapy, are on high-dose steroids or other immunosuppressants, or have advanced or uncontrolled HIV.

Right now, Carpenter said, your best bet for getting a monkeypox vaccine is to sign up for the county’s alert newsletter and check the pre-registration link frequently for availability.

[Luv2play]

36 minutes ago, Lucky said:

From today's LA Times:

By Jessica RoyAssistant Editor, Utility Journalism 

Aug. 5, 2022 2:21 PM PT

Los Angeles County’s monkeypox vaccination effort will focus for now on getting first shots into arms.

To be fully vaccinated against monkeypox, people need to get two doses of the Jynneos vaccine four weeks apart. Ward Carpenter, director of health services for the Los Angeles LGBT Center, said Friday that he received new guidance from the L.A. County Department of Public Health advising that giving out first doses should be prioritized over administering the second shot.

On its website with guidance for healthcare professionals, the department said it “asks that all providers prioritize administering first doses of JYNNEOS vaccine to eligible immunocompetent persons to protect as many at-risk people as possible. Second dose appointments should be deferred until more doses of JYNNEOS become available.” A spokesperson confirmed the new vaccine prioritization via email.

“The county is officially changing the strategy to deferring second doses. This is a big change,” Carpenter said. It will help get more people partial protection against monkeypox, but at the same time, “it’s going to create a lot of anguish and concern among people who need their second dose.”

“There is good science” to back that change, he said, and “we are in support of that recommendation, but what that means is the question will be on everyone’s mind: How protected am I with the first dose?”

And the answer to that question is: No one knows right now. The vaccine currently being given for monkeypox is actually a smallpox vaccine (both diseases are caused by orthopoxviruses). Data show the vaccine is safe in humans and effective in animals and in test tubes. But it hasn’t been tested on humans under these circumstances before.

 

 

Sex, ‘casual contact,’ pimples: A California monkeypox guide, separating fact and fiction

Aug. 5, 2022

“We just don’t have good data on vaccine effectiveness, especially as it relates to sexual transmission,” said Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health and a member of the World Health Organization’s emergency committee on monkeypox. “That’s not to say it won’t work. We just don’t have enough data to make definitive statements.”

The health department reopened its list of pre-registration slots for monkeypox vaccination appointments on Friday afternoon. If you are eligible and there are still appointments available, you can click this link to sign up: https://lacpublichealth.sjc1.qualtrics.com/jfe/form/SV_aY96Sxs2lUgUZb8.

 

 

The list closes when no more spots are available. The county has a newsletter that will send you an email when more spots have opened. You can sign up for that at the top of the page here: http://publichealth.lacounty.gov/media/monkeypox.

You must be 18 years or older and meet at least one of the following criteria to be eligible:

• You are a gay or bisexual man or a transgender person who has had multiple sex partners in the last 14 days, including (but not limited to) having sex in exchange for food, shelter or other goods or needs.
• You are on HIV PrEP medication.
• You’ve had anonymous sex or sex with multiple people within the last 21 days at a commercial sex venue or other venue.
• You’ve had high or intermediate exposure to monkeypox (the CDC has a list of what qualifies as exposure at those levels).
• You’ve attended an event or venue where there was a high risk of exposure via skin-to-skin or sexual contact with people with monkeypox.
• You are experiencing homelessness and engaging in high-risk behaviors.
• You are a gay or bisexual man or a transgender person who’s had gonorrhea or early syphilis in the last 12 months.
• You are in jail and have been identified as high-risk by clinical staff.
• You are severely immunocompromised — for instance, if you are undergoing chemotherapy, are on high-dose steroids or other immunosuppressants, or have advanced or uncontrolled HIV.

Right now, Carpenter said, your best bet for getting a monkeypox vaccine is to sign up for the county’s alert newsletter and check the pre-registration link frequently for availability.

Interesting how the criteria are spelled out. It would appear to exclude a gay man who limited himself to a single provider and had sex with him on an infrequent but regular basis, say twice in one month and only once the next.

The provider is clearly included even if he doesn't get much business because the sex he has is to provide food, etc for his needs.

[Wolfer]

I got my first shot today. I took the train from Antwerp all the way to France as the city of Lille was having an open walk-in day with the only restriction being you had to be a gay MSM. A friend and I took the first train out. Many, many of the men in the line were from Belgium as the vaccine supply (and rollout) is extremely limited, as are the restrictions for qualifying . Two of our national tv stations even came to France to interview the Belgians there. 

There were not enough vaccines for everyone that showed up and the organization seemed overwhelmed by the amount that showed up and how many of them were from Belgium. Every single worker there was incredibly friendly and they were very patient with my limited French.

Edited August 6, 2022 by Wolfer

[kingsley88]

I just read this article from a few days ago about the recent Monkeypox deaths in Spain. Both were young, healthy, and not immunocompromised.

"In a report to the World Health Organization (WHO), Dr. Isabel Jado, director of Spain's National Center for Microbiology, outlined details of the two deaths that had occurred in the country, including that they developed encephalitis—a swelling of the brain."

https://www.newsweek.com/monkeypox-deaths-spain-healthy-risk-factors-1730385

[+ Bryan Dube]

15 hours ago, JUWS said:

I got my 1st shot in NYC Saturday July 30th. The injection site has been swollen since then, 1 week. Has anyone else had any reactions with prolonged swelling, rash, pimples etc?  I have an appointment with my doc on Monday, but just wondering if anyone else experiencing anything?

It seems like it has been pretty common to still have some tenderness and slight swelling even a week out. I had a small bump form after about 6-7 days. And the tenderness (felt kind of like a bruise) remained for another 3-5 days after which the bump went away. 

[JUWS]

5 minutes ago, Bryan Dube said:

It seems like it has been pretty common to still have some tenderness and slight swelling even a week out. I had a small bump form after about 6-7 days. And the tenderness (felt kind of like a bruise) remained for another 3-5 days after which the bump went away. 

Thanks for your reply. I am experiencing the same and also had 2 "pimples" near to the injection site appear, one of which is puffy looks like a "boil". I'm seeing doc on Monday see if anything to be concerned about 🤷‍♂️

[Luv2play]

8 hours ago, kingsley88 said:

I just read this article from a few days ago about the recent Monkeypox deaths in Spain. Both were young, healthy, and not immunocompromised.

"In a report to the World Health Organization (WHO), Dr. Isabel Jado, director of Spain's National Center for Microbiology, outlined details of the two deaths that had occurred in the country, including that they developed encephalitis—a swelling of the brain."

https://www.newsweek.com/monkeypox-deaths-spain-healthy-risk-factors-1730385

That link doesn't deal with the two deaths.