Monkey pox is a rare disease that occurs primarily in the rainforest countries of Central and West Africa. Monkey pox is similar to smallpox, and the monkey pox virus causes monkeypox. Health researchers have identified the viral infection in laboratory monkeys, African tree squirrels, mice, rats, and rabbits.
Monkey pox is an infectious disease caused by the monkeypox virus that can occur in certain animals, including humans. Monkeypox was first identified in 1958 among laboratory monkeys in Copenhagen, Denmark. Monkeys are not a natural reservoir of the virus. The first cases in humans were found in 1970 in the Democratic Republic of the Congo. An outbreak that occurred in the United States in 2003 was traced to a pet store where rodents imported from Ghana were sold.
The 2022 monkey pox outbreak represents the first incidence of widespread community transmission outside of Africa, which began in the United Kingdom in May 2022, with subsequent cases confirmed in at least 12 countries, including several in Europe, North America, as well as Australia and Israel.
Cause Of Monkey Pox –
Monkey pox is caused by Monkey pox virus, which belongs to the orthopoxvirus group of viruses.
The illness typically lasts for 2 to 4 weeks. The incubation period of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.
Monkey pox is usually self-limiting but may be severe in some individuals, such as children, pregnant women or persons with immune suppression due to other health conditions. Human infections with the West African clade appear to cause less severe disease compared to the Congo Basin clade, with a case fatality rate of 3.6% compared to 10.6% for the Congo Basin clade.
Fatality with monkey pox-
Studies of human monkey pox in rural central and west Africa – where people live in remote areas and are medically underserved – have reported case-fatality ratios of as high as 10%.
Mode of Transmission-
Monkey pox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding. The virus may currently be spreading undetected through community transmission, possibly through a new mechanism or route. Where and how infections are occurring are still under investigation.
How does virus work in humans-?
The virus enters the body through broken skin, inhalation or the mucous membranes in the eyes, nose or mouth. Researchers believe that human-to-human transmission is mostly through inhalation of large respiratory droplets rather than direct contact with bodily fluids or indirect contact through clothes. Human-to-human transmission rates for monkey pox have been limited.
After the virus enters the body, it starts to replicate and spread through the body via the bloodstream. Symptoms usually don’t appear until one to two weeks after infection.
Signs and symptoms-
The disease can initially appear similar to chickenpox, measles and smallpox, but distinguished by the presence of swollen glands. These characteristically appear near the ear and jaw, in the neck or in the groin before the onset of the rash.
• Acute onset of fever (>38.5oC),
• Lymphadenopathy (swollen lymph nodes)
• Myalgia (muscle and body aches)
• Back pain
• Asthenia (profound weakness)
Clinical differential diagnosis must consider other rash illnesses, such as chickenpox, measles, bacterial skin infections, scabies, syphilis and medication-associated allergies.
Polymerase chain reaction (PCR) testing of samples from skin lesions is the preferred laboratory test. To interpret test results information is required on date of onset of fever, date of onset of rash, date of specimen collection, current stage of rash, and patient age.
Treatment Of Monkey Pox-
Currently, no treatment is available for monkeypox. Smallpox vaccine has been reported to reduce the risk of monkey pox among previously vaccinated persons in Africa. It is recommended to use tecovirimat or the smallpox treatment Brin cidofovir as the first line antiviral treatment if required, alongside supportive care (including antipyretic, fluid balance and oxygenation). Empirical antibiotic therapy or aciclovir may be used if secondary bacterial or varicella zoster infection is suspected, respectively.
Preventions to take for avoiding infected from Monkey pox virus –
Evidence suggests that the smallpox vaccine can help prevent monkey pox infections and decrease the severity of the symptoms. One vaccine known as Imvamune or Imvanex is licensed in the U.S. to prevent monkey pox and smallpox. Vaccination after exposure to the virus may also help decrease chances of severe illness.
How to deal with the outbreak of monkey pox-
Prevention – Someone who has direct contact with an infected person, including sexual contact can get monkey pox. Steps for self-protection include avoiding skin to skin or face to face contact with anyone who has symptoms, practicing safer sex, keeping hands clean with water and soap or alcohol-based hand rub, and maintaining respiratory etiquette.
Detection and care – If people develop a rash, accompanied by fever or a feeling of discomfort or illness, they should contact their health care provider and get tested for monkey pox. If someone is suspected or confirmed as having monkey pox, they should isolate until the scabs have fallen off and abstain from sex, including oral sex.
During this period, patients can get supportive treatment to ease monkeypox symptoms. Anyone caring for a person sick with monkey pox should use appropriate personal protective measures, including wearing a mask, and cleaning objects, & surfaces that have been touched.
Reporting – Any rash-like illness during travel or upon return should be immediately reported to a health professional, including information about all recent travel, sexual history and smallpox immunization history. Residents and travelers to monkeypox-endemic countries should avoid contact with sick mammals such as rodents, marsupials, non-human primates (dead or alive) that could harbor monkeypox virus and should refrain from eating or handling wild game (bush meat).
Endemic monkeypox disease is normally geographically limited to West and Central Africa. The identification of confirmed and suspected cases of monkey pox without any travel history to an endemic area in multiple countries is atypical, hence, there is an urgent need to raise awareness about monkeypox and undertake comprehensive case finding and isolation (provided with supportive care), contact tracing and supportive care to limit further onward transmission.