How Disease Names Like Monkeypox Can Mislead And Stigmatize

When it comes to disease, we’re more and more aware of symptoms, prevention, treatments, and long-term effects. But there’s another, often less-considered factor that can have far-reaching consequences for public health: a disease’s name.

What we call a disease—both popularly and officially—can affect how people perceive it, whether they understand how its spread can be prevented, and whether they seek treatment for it.

The fact is, some disease names are misleading. And some are stigmatizing for patients or even entire communities. Both of these issues can lead to worse health outcomes.

In this article, we’ll:

• Examine general practices for naming diseases.
• Explain the reasons behind the movement away from naming diseases after locations, animals, and people.
• Cover notable examples of diseases whose names have been criticized or replaced, including monkeypox, swine flu, AIDS, and others.

How diseases are named

Throughout history, the names given to diseases have been influenced by different things in different places and at different times, leading to a very wide array of naming practices and preferences.

Today, guidelines on the official naming of diseases are provided by the World Health Organization (WHO). In 2015, the WHO released new disease-naming guidelines that aimed to avoid the use of stigmatizing or misleading disease names, including those that refer to geographical places or people. These WHO guidelines specify that diseases should have generally descriptive names. This means that they should focus on the characteristics of the disease, as opposed to being named in other once traditional ways, such as after the place they were first encountered, after common animal vectors, or after doctors or researchers who first documented them. For example, the rare disorder once known as Hallervorden-Spatz syndrome is now referred to as Pantothenate kinase-associated neurodegeneration. There are many, many other examples.

In 2022, amidst the major monkeypox outbreak, the WHO began the process of evaluating its name because it doesn’t follow the 2015 guidelines, which discourage diseases being named after animals. This is just one of the reasons behind calls to replace the name monkeypox.

Renaming monkeypox

The name monkeypox has historically been used for both the disease and the virus that causes it. The disease is similar to smallpox but usually less severe, often involving flu-like symptoms and a rash.

Historically, the disease had been mostly confined to Africa, with a few noted outbreaks in other parts of the world. The 2022 outbreak of monkeypox resulted in cases in more than 80 countries where it was never reported before.

Monkeypox is sometimes abbreviated as MPX, MPOX, MPV (for monkeypox virus), MPXV, or in other ways. Some of these terms are used not just as abbreviations but as alternate ways to refer to the disease.

These alternate terms have been motivated by the fact that the name has been cited as problematic for multiple reasons, many of which involve potential misconceptions.

First, the disease is not caused by monkeys, nor is it restricted to monkeys. Humans can be infected with monkeypox through contact with animals besides monkeys. In fact, the primary animal-to-human vector is hypothesized to be rodents.

In addition, the name could falsely imply that the disease is only prevalent in animals or only spread by contact with animals.

The WHO has announced that it is open to and considering suggestions for renaming the disease. As part of these considerations, the WHO announced that two variants of monkeypox would be known as Clade I and Clade II (instead of Congo Basin and West African clades) to avoid referring to a place. Although monkeypox was first identified in monkeys at a research facility in Denmark, its exact source is not known.

Diseases named after animals

The WHO currently recommends against naming diseases after animals because these names can be misleading or stigmatizing. The presence of an animal’s name in a disease can often lead to the public mistakenly believing that a certain animal causes the disease or is the only animal capable of spreading it. Further, these names can cause stigmatization and prejudice toward people that eat or come into contact with the specific animal.

A prominent example of a name that has come under criticism is swine flu. During an outbreak in 2009, the name was called out as offensive by some Jews and Muslims, who avoid pork for religious reasons. In this case, the particular strain that caused the outbreak can be referred to by the more descriptive name H1N1 (an abbreviation of haemagglutinin type 1 and neuraminidase type 1).

In other cases, the association of an animal with a disease can lead to the indiscriminate killing of such animals.

Diseases named after locations

In addition to cautioning against the use of animals in names, the WHO has also advised against naming diseases after geographic areas.

Historically, diseases have been named for geographic locations because they were first discovered there, first reported there, seem to be endemic to that particular area, or are most commonly reported there.

While it has been common practice to name diseases after places, this convention is now often criticized, and the WHO recommends against it. Many of these names have been criticized for being misleading, offensive, or both. A geographic location in the name of a disease can cause the mistaken belief that a disease is somehow caused by that particular place or is limited to that particular place. Additionally, place-based names can cause others to discriminate against people who come from that place, especially when an outbreak occurs.

Calls for renaming have come for many different diseases named after places, including the Ebola virus (named after the Ebola river in the Democratic Republic of Congo, where an outbreak occurred in 1976).

A prominent and long-lasting name recently proposed for reevaluation is that of the Spanish flu. The pandemic it caused is now sometimes called the 1918 influenza pandemic or similar names that avoid the continued misconception that the outbreak began in Spain, where it was simply first reported.

One naming change accelerated by the COVID-19 pandemic was the use of Greek letters for the names of different strains of the virus, in place of the previous practice of naming variants after the places where they emerged or were first documented.

Sometimes, locations are used in unofficial (and inaccurate) disease names as part of an intentional effort to mislead and stigmatize. During the COVID-19 pandemic, public health officials strongly criticized the use of the term “Chinese flu” and similar names by President Donald Trump and others. Critics said such use had the effect of stigmatizing and placing blame as well as drawing inaccurate parallels to the completely unrelated seasonal flu virus.

Learn more about the meaning behind the name for COVID-19.

Diseases named after people

Many diseases are named for people, typically the scientists that originally discovered or documented the disease. The WHO has also advised against this naming convention. In this case, the issue seems to be mostly focused around misinformation as opposed to stigmatization.

While eponymous disease names (those named after a person) are often helpful in terms of medical shorthand and communication among doctors, researchers, and even patients, there has been some pushback against them in the medical community. The most common argument against such disease names is that they do not provide any information on what the disease actually is or what its symptoms are. For example, a person unfamiliar with Creutzfeldt-Jakob disease would have no way of knowing that it’s a brain disorder just by hearing the name.

One prominent example of a disease whose name has been largely replaced in popular use with a more descriptive one is ALS (amyotrophic lateral sclerosis), formerly commonly referred to as Lou Gehrig’s disease. Still, there are many whose names continue to be well known and widely used, such as Alzheimer’s disease and Parkinson’s disease.

In some cases, an eponymous name can be unintentionally misleading. For example, Charcot-Marie-Tooth disease doesn’t have anything to do with teeth, but is rather named in part for Henry Howard Tooth, one of the physicians who first described it.

Stigmatizing disease names

One of the most is stigmatized diseases in history is AIDS, which has long carried many inaccurate stigmas, including those related to gay men and Africa. In fact, it was originally referred to by health officials as gay-related immune deficiency and was often referred to in the media reports as a “gay disease” and in similar ways. Despite efforts to educate about misconceptions, such stigmas persist today and continue to contribute to the spread of the disease and discrimination against those who have it and against the gay community and others.

Parallels with the HIV/AIDS crisis have been drawn to the monkeypox outbreak and the response to it, particularly in terms of stigmatization and lack of access to preventative measures such as vaccines.

Monkeypox is not unique to gay and bisexual men. The association—and resulting stigmatization—is rooted in the fact that many cases are among men who have sex with men. As a result, much of the initial public health messaging during the 2022 outbreak was aimed at these impacted communities in an attempt to prevent spread within and outside of them.

As public health considerations become more prominent in our everyday discourse, we are likely to encounter more proposals and debates about how diseases are named and discussed. Of course, there are practical considerations that make some public health officials hesitant to rename some diseases. For example, keeping a disease’s name the same can make it easier for researchers to find consistent data about it.

Still, many public health officials, medical experts, and advocates note that the potential risks for patients and communities often outweigh any downsides of changing a disease name after it has become established.