Monkeypox

Introduction

Monkeypox is an animal reservoir disease which affects humans. It is caused by a virus known as monkeypox virus, a variant of variola virus. It was first reported in the year 1970 in the Republic of Congo. It is an emerging disease which can spread from one person to another with a clinical presentation similar to smallpox, but is comparatively less severe.¹ The virus can be spread when a person comes in contact with an infected animal, person or materials contaminated with the virus. The virus can also cross the placenta spreading from mother to her foetus.²

Meaning

Monkeypox is a zoonotic poxvirus infection that can occur in both humans and few other animals. Monkeypox is an orthopox virus, a family that includes the new eradicated smallpox virus. The vaccines and drugs developed to ward off or treat smallpox are expected to offer some protection against monkeypox.³

Causes

Monkeypox virus is the cause for this disease. It is a double stranded DNA virus that causes monkeypox in humans and animals. It belongs to the genus orthopoxvirus, that includes variola, cowpox and vaccinia viruses.⁴

Incubation period

The symptoms usually start within three weeks of exposure to virus. Some patients develop flu-like symptoms after which rashes develop within 1-4 days. The infected person can spread it to others anytime from the start of symptoms until the rash gets fully healed.⁵

Mode of transmission

It is transmitted by close contact from infected person, through respiratory droplets, contact with body fluids like blood or semen and contact with monkeypox lesions on the skin including inside the nose.⁴

Symptoms^2-5

 Increase in body temperature

 Headache, sore throat, nasal congestion and cough

 Muscle pain and backache

 Swollen lymph nodes

 Chills

 Exhaustion

 Fatigue

 Lymph gland enlargement

 Pimple like rash or blisters appears on the face, inside the mouth and other areas of the body, such as hands, feet, chest.

Diagnosis

Sample collection from lesions or fluid vesicles, pustules, dry clusters; Polymerase Chain Reaction testing; blood sampling.³

Management

Monkeypox is a self-limiting disease; the symptoms subside within four weeks. Symptomatic treatment is given to prevent dehydration. Antibiotics are prescribed if a secondary infection occurs.⁴

JYNNEOS, a two dose vaccine can protect against both monkeypox and smallpox. ACAM 2000 is also available to protect from this disease, but is not recommended for pregnant women, and infants.⁶

Prevention

 Immunization or vaccination against smallpox is effective in preventing this disease.

 To prevent an infection, a person should avoid close contact with monkeypox infected humans and animals. 

It is advised to avoid using articles used by the infected person.

 Thorough cooking of all non-vegetarian foods.

 Frequent hand washing with soap and water

 Wearing mask

 Cleaning and disinfecting frequently touched surfaces

Barrier nursing techniques will prevent infection while providing care for the patients.

Statistics

As per WHO, the first case of the monkeypox disease was reported in Southeast Asian region and in India (a 35-year-old man). Kerala has reported five monkeypox cases and one related death. Nobly India has reported seven cases of monkeypox. Globally, monkeypox outbreak has seen more than 21000 cases. WHO has reported 75,348 cases of monkeypox and 33 related deaths in 109 countries.

Summary

Monkeypox is a zoonotic disease caused by monkeypox virus. This infection causes symptoms similar to smallpox. It is preventable by adopting infection control measures and vaccination.

Conflicts of Interest

Nil