Monkeypox

Monkeypox is a viral zoonotic disease, which means that the infection spreads from animals to humans. The infection is transmitted to humans through scratches or bites from infected rodents such as rats, mice, and squirrels, or by eating bush meat. Monkeypox is commonly found in Central and West Africa, but cases have been identified in other countries due to travel from regions where monkeypox is endemic.

Causes #

Monkeypox is caused by the monkeypox virus that belongs to the Poxviridae family. It is generally acquired through rodents such as rats, mice, and squirrels (who are the carrier of the virus) in parts of West and Central Africa.

Any person can get monkeypox by the following ways:

• Bite from an infected animal or touching its blood, body fluids, spots, blisters, or scabs.

• Eating meat of an infected animal from Central or West Africa that has not been cooked thoroughly.

• Touching the skin or fur of the infected animals.

Transmission #

This infection can spread through direct physical contact with the infected blood, body fluids, skin lesions, blisters, or scabs from an infected animal. The monkeypox virus mainly causes animal-to-human transmission but in rare cases, human-to-human transmission is also possible when there is close contact or large respiratory droplets.

Animal-to-human transmission #

This can happen through the following:

• Coming in close contact with an infected animal.

• Eating meat of an infected animal that is not cooked thoroughly.

• A bite or scratch from animals like rats or squirrels infected by the virus.

Human-to-human transmission #

This occurs through:

• Close physical contact with a person infected by the monkeypox virus.

• Touching clothes, bedding, or towels contaminated with the virus.

• Saliva or respiratory droplets while coughing or sneezing.

• The placenta from mother to fetus.

• Mother to baby during and after childbirth.

• Unprotected sex with an infected person.

• Man to man sex.

Symptoms #

Monkeypox symptoms in humans are similar to smallpox but they are milder. The main symptom that differentiates it from smallpox is lymphadenopathy (enlargement or swelling of the lymph nodes). The incubation period (time taken for the symptoms to appear after being infected) for monkeypox is usually 6−13 days but can range from 5−21 days.

The most common symptoms include:

• Fever

• Headache

• Myalgia (muscle aches)

• Backache

• Lymphadenopathy

• Chills

• Malaise (tiredness)

• Exhaustion

• Sore throat

• Dry cough

• Dyspnea (shortness of breath)

Progression of the disease #

• Lesions appear on the tongue and mouth within 1 to 3 days after fever.

• The patient generally develops a rash, often beginning on the face and then spreading to other parts of the body within 24 hours.

• By the 4th to 5th day, the lesions become raised and filled with pus.

• By the end of the 2nd week, they dry up and crust. The scabs usually remain for a week before they start to fall off.

• This illness typically lasts for about 2-4 weeks and lesions progress through the following stages.

Risk Factors #

Anyone who has close physical contact with an infected animal or someone who has symptoms of monkeypox are at the highest risk of developing the infection. Other people, who are at a greater risk of developing serious symptoms from monkeypox include:

• Newborns

• Children

• Immuno-deficient patients

• Patients with a history of chronic illness

• Healthcare workers

• Laboratory professionals

Diagnosis #

The investigation should consist of the following:

• Examining the patients clinically using appropriate infection prevention and control (IPC) measures.

• Questioning the patient about possible sources of infection and the presence of similar disease or symptoms in the patient’s community and contacts.

• Collecting and dispatching the specimens safely for laboratory examination of monkeypox.

Vaccination #

• There is a vaccine recently approved for monkeypox which is not yet widely available.

• Vaccines used during the smallpox eradication program can be used for protection against this disease.

• However, post 1980, when WHO declared that smallpox was eradicated globally, no vaccine has been manufactured in India.

• Smallpox vaccines can provide protection against monkeypox.

• Certain countries have timely vaccination of close contacts as post-exposure prophylaxis or for certain groups of health care workers for pre-exposure vaccination.

Prevention #

• Avoid contact with infected animals, especially sick or dead ones.

• Cook all foods that contain animal meat or parts thoroughly.

• Avoid any kind of contact with bedding and other materials contaminated with the virus.

• Maintain hygiene by washing your hands with soap and water or alcohol hand rub after coming into contact with an infected animal or person or handling their products.

• Avoid close contact with an infected person.

• Use personal protective equipment (PPE) when caring for an infected person.

• Get vaccinated.