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Monkeypox – Symptoms, Causes, and Treatment

Overview

Monkeypox cases have been reported in many countries this month (May 2022). The virus is rapidly spreading across Europe and North America. The United Kingdom (UK) has confirmed 20 cases of the rare virus since the first week of May 2022.

Since 13 May 2022, cases of Monkeypox have been reported to WHO from 20 Member States that are not endemic for the monkeypox virus across three WHO regions.

The World Health Organization (WHO) has called for an emergency meeting to discuss Monkeypox to focus on the transmission and vaccines of this virus.

What is Monkeypox?

Monkeypox is a viral zoonosis transmitted to humans from animals, with symptoms very similar to smallpox but clinically less severe.

According to the Centers for Disease Control and Prevention (CDC), Monkeypox was first identified in 1958 in monkeys in a Danish laboratory and again in 1970 in the humans in the Democratic Republic of the Congo. In the subsequent years, monkeypox outbreaks have cropped up in areas across Central and West Africa

What causes Monkeypox?

Monkeypox is caused by the monkeypox virus (genus Orthopoxvirus of the Poxviridae family). According to the CDC, the virus is related closely to other ‘pox’ viruses like:

  • Vaccinia (used for smallpox vaccine)
  • Variola major and minor (that cause smallpox)
  • Cowpox virus

What are the symptoms of Monkeypox?

The symptoms of Monkeypox in humans are similar to the symptoms of smallpox but are milder. Monkeypox starts with headache, fever, exhaustion, and muscle aches. The main difference between the symptoms of smallpox and Monkeypox is that Monkeypox causes lymphadenopathy (swelling of the lymph nodes), while smallpox does not. The time from infection to symptoms (incubation period) for Monkeypox is generally 7 to 14 days but can range from 5 days to 21 days.

The infection starts with:

  1. Headache
  2. Fever
  3. Backache
  4. Muscle aches
  5. Chills
  6. Exhaustion
  7. Swollen lymph nodes

Within 1 – 3 days (longer, occasionally) following the appearance of fever, the individual develops a rash that most often begins on the face and then spreads to other parts of the body.

How does Monkeypox spread?

Monkeypox virus spreads when an individual comes into contact with the virus from a human, animal, or any materials contaminated with the virus. This virus enters the human body through the respiratory tract, the mucous membranes (mouth, eyes, or nose) or even through broken skin (although not visible). 

  • Animal-to-human transmission

Monkeypox can spread from animal to human through a scratch or a bite, direct contact with lesion material or body fluids, or indirect contacts with lesion material, like contaminated bedding and bushmeat preparation. The term ‘bushmeat’ refers to raw or minimally processed meat that comes from wild animals.  

  • Human-to-human transmission

Monkeypox is thought to spread from human to human mainly through large respiratory droplets. Generally, respiratory droplets cannot travel more than a few feet. Therefore, prolonged face-to-face contact is needed for the virus to spread. Other human-to-human transmission modes include direct contact with lesion material or body fluids and indirect contact with lesion material like linen and clothing contaminated with the virus.

While African rodents are suspected of playing a part in the spread, the monkeypox virus’s main disease carrier (or the reservoir host) is still unknown.

What is the treatment for Monkeypox?

While there is no proven monkeypox-specific treatment, antiviral drugs and vaccinia immunoglobulins used against smallpox are effective in treating this disease along with symptomatic treatment.

How to prevent Monkeypox?

There are many measures to prevent infection with the monkeypox virus:

  1. Avoid direct contact with animals that could harbor the virus. This includes animals that are sick or that have been found dead in the regions where Monkeypox is spreading.
  2. Avoid contact with any material that was in contact with a sick animal.
  3. Isolate the infected person from others who can be at risk.
  4. Practice hand hygiene after coming to contact with infected humans or animals. For instance, wash your hands with soap and water or use an alcohol-based hand sanitizer.
  5. Use personal protective equipment (PPE) when caring for infected patients.
  6. In addition, the vaccine against smallpox is about 85 percent effective at preventing Monkeypox.

How concerned should we be about Monkeypox?

The outbreaks reported so far have been atypical as they are occurring in the countries where the monkeypox virus does not regularly circulate. Most of the reported cases reported have been detected in Spain, Portugal,  the UK, and the US.

However, the mode of transmission for this virus is much easier to prevent and control compared to the virus with aerosolization components like COVID-19 or measles.

The disease prevention strategies in response to COVID-19, such as masking, social distancing, increasing ventilation, and staying home if sick, can also help against Monkeypox. Hand hygiene is also a key as this is a DNA virus, which is better suited to survive on surfaces.

Conclusion

There are increasing cases of Monkeypox in many countries. The disease is similar to smallpox but is less severe. Health experts opine that Monkeypox is spread by contact with bodily fluids having the virus rather than through the air like COVID-19 or measles.

Health experts also say that there is no need for concern just yet since vaccines and treatments against smallpox are effective to some extent against infection. In addition, the strategies used against COVID-19, like social distancing and good hand hygiene, can also help prevent this disease.

Frequently Asked Questions (FAQs)

Is anyone from India infected with Monkeypox?

The outbreaks of Monkeypox are occurring in the countries where the monkeypox virus does not regularly circulate. Most of the reported cases reported have been detected in Spain, Portugal,  the UK and the US. However, no monkeypox case has been reported in India yet.

The Union health ministry has directed the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCdC) to watch this outbreak closely. In addition, if cases increase, the government may start screening of people arriving from the affected countries.

Which doctor should I consult for Monkeypox?

You should consult a general physician if you suspect Monkeypox. The physician will check you before getting the tests done to confirm the diagnosis. Patients infected with Monkeypox will also be quarantined to prevent its spread.

What are the complications of a monkeypox infection?

There may be soft tissue infections during the skin eruption phase of the disease. Other complications like encephalitispneumonitis, and other oculars (eyes) issues are also noted in the monkeypox infection though the severity is not likely to be as high as in smallpox.

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Verified By Dr Ravikiran Abraham Barigala
MBBS, MD (Internal Medicine), MD (Infectious Disease), MPH, Infectious Diseases Specialist, Apollo Hospitals, Jubilee Hills, Hyderabad.
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