Explained: The Call To Change Monkeypox's Name And How Diseases Are Named

As Monkeypox cases cross the 2,000-mark across the world, the World Health Organization (WHO) is working towards changing the name of the disease and its clades —types, in simple terms— after experts said the current nomenclature is "is not only inaccurate but is also discriminatory and stigmatizing".

As per WHO, there are currently two clades —types— of Monkeypox virus, which causes Monkeypox disease. One is "West African" and the "Congo basin (Central African)".

Since the current outbreak is mostly human-to-human outside Africa whereas Monkeypox spreads from animals to humans, experts have said that the continued association of the disease with Africa is wrong. 

Earlier, there was a divisive debate over the naming of novel coronavirus too that causes Covid-19 disease, with some people calling it Wuhan Virus and China virus since it originated in China's Wuhan city. The virus was finally named SARS-CoV-2. 

Here we explain the idea behind renaming Monkeypox, how diseases have been named in past and what's the criteria now, and what has been the recent debate over names, including its politicisation.

How diseases, viruses are named

Diseases have been named after places where they are believed to have originated, such as Spanish flu, West Nile virus, Middle East Respiratory Syndrome (MERS), Zika, and Ebola.

By this logic, it's not strange to name viruses or diseases afer places. But then why it's called SARS-CoV-2 and not China/Wuhan Virus? 

That's because the WHO in 2015 released guidelines for naming a disease, which said names should avoid including:

• Geographic locations — Middle East Respiratory Syndrome, Spanish Flu, etc.
• People’s names — Creutzfeldt-Jakob disease, Chagas disease, etc.
• Species of animal or food — Swine flu, bird flu, Monkeypox, etc. 
• Cultural, population, industry or occupational references — such as legionnaires 

It should be noted that Monkeypox was included in the 2015 guidelines on how to not name diseases, meaning WHO has disagreed with the name of the disease for at least seven years now. 

As per 2015 guidelines, the novel coronavirus should not be named China/Wuhan virus and this is why it was named SARS-CoV-2. Similarly, the two branches of Monkeypox —which itself is named after an animal, going ahead 2015 WHO guidelines— are named after West African and Congo regions of Africa. 

Why diseases shouldn't be named after places, animals

The main reason is to avoid stigmatizing and discriminatory behavior towards those places, people from those places, and animals. Moreover these names can be misleading.

Monkeypox is named after monkeys because the disease was first identified in 1958 in two outbreaks of a pox-like disease in colonies of monkeys kept for research, according to US Centres for Disease Control and Prevention (CDC). 

US CDS adds, "Despite being named 'monkeypox', the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) may harbour the virus and infect people."

Even Spanish Flu is named incorrectly because the disease was not first discovered in the country. Spain was just the first country to publicly report the disease in 1918. 

"It created the false perception that the virus originated in Spain — and that the Spaniards bore the brunt of the disease. In reality, out of the estimated 50 million people who died of the virus, less than 260,000 were likely from Spain," noted CNN in an article. 

CNN further noted about the Spanish Flu, "Though the virus had been circulating around the world, nations such as Germany, France, the United Kingdom and the United States, were reluctant to disseminate news on outbreaks within their own borders because they didn't want the other side to know their soldiers were sick [as it was the time of First World War]."

Names after regions invoke racism, stereotypes

There is also a fear of such names encouraging racist behaviour against people. Pew Research surveys have shown that discrimination against Asian people or Asian-Americans in the United States has increased during the coronavirus pandemic, which originated in China.

As many as 81 per cent Asian adults in the United States said violence against them is increasing, with 20 per cent directly citing former President Donald Trump's rhetoric involving calling coronavirus "kung flu" or Chinese flu", reported Pew Research in April 2021. 

Pew Research further reported, "Another 15 per cent said the rise in violence is due to Covid-19 and its impacts on the nation. An additional 12 per cent said scapegoating and blaming Asian people for the pandemic has been responsible for the rise in violence against the US Asian population."

Decades before Covid-19, HIV —which causes AIDS— also played out on similar lines.

"In 1981, when reports of this syndrome [AIDS] first appeared in the scientific literature, the popular press and the general public quickly tied the disease to men who have sex with men, using names like gay cancer and gay-related immune deficiency, or GRID," noted infectious disease expert Dr Dave Wessner in an article for Forbes.

He further noted that this led to the disease's association with "4 Hs — homosexuals, heroin users, Haitians, and hemophiliacs. The name AIDS was adopted by US CDC in 1982. 

Incorrect depiction of current Monkeypox outbreak

More than 2,000 cases of Monkeypox have been detected in over 40 countries, with Europe reporting most of the infections. The disease is rare outside Africa.

While the current outbreak is concentrated outside Africa, experts have highlighted that media has used African patients' photos in stories on the current outbreak, which leads to a perception that the disease and the outbreak being reported are African, which would be an incorrect depiction.

Earlier, in case of Covid-19 variants as well, the WHO adopted names such as Delta and Omicron after Greek alphabet's letters, rather than naming them after countries where they were first discovered. Delta variant was first identified in India and was called the "Indian variant" for some time. It is believed to be behind India's deadly second coronavirus wave. 

Moreover, it has been reported that the current outbreak began at two rave parties in Spain and Belgium, according to Dr David Heymann, a leading adviser to WHO.