MONKEYPOX: UNDERSTANDING THE DISEASE

What is Monkeypox?

Monkeypox is a viral zoonosis (transmitted from animals to humans) with symptoms similar to those seen in the past in smallpox patients, although it is clinically less severe. With the eradication of smallpox in 1980 and subsequent cessation of smallpox vaccination, monkeypox has emerged as the most clinically relevant pox virus disease of public health concern. Monkeypox primarily occurs in Central and West Africa, often in regions with a prevalence of tropical rainforests, and has been increasingly appearing in urban areas. Animal hosts of the disease include a range of rodents and non-human primates (Monkeys, Chimpanzees, etc), and can be transmitted to humans. Monkeypox infections occur in humans across all age ranges, however, it is more common in children, as about 90% of the cases in Africa were among children under 15 years of age.

What causes Monkeypox and how does it spread?

Monkeypox is caused by the monkeypox virus, which is part of the orthopoxvirus genus that includes the smallpox virus. Scientists first identified the disease in 1958 when there was an outbreak of the disease among laboratory monkeys being used for research, hence, the name monkeypox. The first case of monkeypox in a human happened in 1970 in the Democratic Republic of the Congo, and the country happens to have the highest prevalence of the disease currently. There are two types of monkeypox virus – the Central African and West African virus strains. Central African monkeypox virus causes more severe infections and is more likely to cause death than the West African strain.

Monkeypox is spread when one comes in contact with an animal or a person infected with the virus. Animal-to-person transmission (more common) occurs through broken skin or injuries such as bites or scratches, or through direct contact with an infected animal’s blood, bodily fluids or pox lesions. Transmission also occurs by eating the meat of an infected animal. Monkeypox can spread from person to person as well, but this is less common. Person-to-person transmission can occur through airborne droplets when an infected person coughs or sneezes and a healthy person inhales the droplets, but this requires prolonged face-to-face contact. It can also be gotten directly from touching the lesions on an infected person or coming into direct or indirect contact with materials contaminated with the virus. These materials can include clothing, bedding and other linens used by an infected person or animal. The main disease carrier is unknown, but it is thought that African rodents are involved.

What are the signs and symptoms of Monkeypox?

The symptoms of monkeypox are similar to those of smallpox, but monkeypox symptoms are typically milder. After infection with the monkeypox virus, it can take 5 to 21 days for the first symptoms to appear, but in many cases, it takes 7 to 14 days on average. The first symptoms include fever, headache, muscle aches, fatigue and swollen lymph nodes. As the disease progresses, it causes a rash on the face and extremities, sometimes involving the genitalia. The rash consists of lesions that turn into fluid-filled blisters, which then dry up and fall off. The rash typically starts off on the face and then progresses downward, usually to the arms and legs. However, it can occur in other parts of the body as well. The symptoms of monkeypox generally last 2 to 4 weeks and go away without treatment, however, the disease is fatal (causes death) in about 10% of cases.

Possible complications of monkeypox include bronchopneumonia, sepsis, inflammation of the brain tissue (encephalitis), infection of the cornea, and other secondary infections. An infection in the cornea may lead to vision loss, and also, in severe cases, the lesions on the skin might form together and cause the skin to fall off in large pieces. Severe cases are more likely to cause death. The risk factors for severe cases include prolonged exposure to the virus, poor overall health, and being younger, due to the weaker immune system in children below age 15.

How can Monkeypox be diagnosed?

Diagnosis of monkeypox can be done through various means. The Doctor can take into account a patient’s travel history or earlier infectious contacts in order to determine the risk of infection. This is followed by laboratory tests that require the extraction of fluid from the lesions or scabs, or a biopsy involving the removal of a piece of skin tissue, and testing it for the virus using a polymerase chain reaction (PCR) test. Blood tests are not usually recommended because the monkeypox virus stays in the blood for a short time, therefore, it is not an accurate test for diagnosing monkeypox.

Source: Newsweek. https://bit.ly/3MkdP7I

How can Monkeypox be treated?

There is currently no treatment for monkeypox. However, monkeypox is self-limiting, which means it can get better without treatment. Some medications can be used to control an outbreak and prevent the disease from spreading. They include:

1. Vaccinia vaccine (smallpox vaccine)

2. Vaccinia immunoglobulin (VIG)

3. Antiviral medications (in animals)

According to the World Health Organization (WHO), the smallpox vaccine is 85% effective in preventing the development of monkeypox. If you received the smallpox vaccine as a child and contract the monkeypox virus, you may either be immune to the disease or the symptoms may be mild.

How can Monkey be prevented?

A smallpox vaccine can provide protection against monkeypox, but its use is currently limited to people who work in a lab with the variola (smallpox) virus. Prevention depends on decreasing human contact with infected animals and limiting person-to-person spread. You can prevent monkeypox virus by:

Avoiding contact with infected animals (especially sick or dead animals)

Avoiding contact with bedding and other materials contaminated with the virus

Washing your hands with soap and water after coming in contact with an infected animal

Thoroughly cooking all foods that contain animal meat or parts

Avoiding contact with people who may be infected with the virus

Using personal protective equipment (PPE) when caring for people infected with the virus.

References

  1. World Health Organization (2022). Monkeypox. https://www.who.int/news-room/fact-sheets/detail/monkeypox

2. Nunez K (2022). All About Monkeypox. Healthline. https://www.healthline.com/health/monkeypox

3. Cleveland Clinic (2022). Monkeypox. https://my.clevelandclinic.org/health/diseases/22371-monkeypox

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