Monkeypox
Monkeypox belongs to the same viral family as smallpox, causing fever, rash but a much less severe disease. Monkeypox is a viral zoonotic infection which is a subset of orthopoxvirus. Monkeypox was first isolated in the late 1950s from sick monkeys in the Lab. Monkeypox is mainly found in sub-Saharan Africa; currently, there are two strains of monkeypox, including Western African and Central African monkeypox virus. The Central African strain is more severe and can be fatal, with a 10% mortality rate.
The first case of human infection was found during the 1970s in the Democratic Republic of the Congo. All human cases had a history of exposure to small forest animals (e.g., rodents, squirrels, and monkeys). Later in 2003, the first human monkeypox infection in the Western Hemisphere, caused by imported rodents from Western Africa, was encountered. More recently, in May 2022, an outbreak of monkeypox in several European countries was reported, with over 90 confirmed cases. In this outbreak, close contact with patients with skin rash during sex may be the likely cause.
Transmission
- Animal-to-human transmission – contact with an infected animal's bodily fluids or through a bite or scratch, direct contact with blood, body fluids, or pox lesions of infected animals.
- Human-to-human transmission – close contact with infectious skin rash, bodily fluid. You can also get infected if you have direct or indirect contact with contaminated materials such as clothing or bedding used by infected people. Respiratory droplet transmission is less common but possible if you are exposed to infected people coughing or sneezing. If you breathe in or get these droplets in your eyes or nose, you can get infected.
The classic incubation period of monkeypox virus infection is usually from 7 to 14 days but can range from 5 to 21 days.
Symptoms
At the early stage, you may develop flu-like symptoms, including:
- Fever and chills
- Headache and muscle aches
- Fatigue
- Swollen lymph nodes
Fever starts approximately two days before the development of rash and lasts about 8-12 days. The rash subsequently evolved into vesicles, then pustules, which eventually crusted within two to three weeks. Once infected, you will be monitored for 21 days.
Diagnosis
Monkeypox is rare unless you have symptoms and an epidemiological link to the infected person or travel history to a country with reported cases. You will usually be checked and diagnosed for other rash diseases such as herpes, chickenpox, and other pox diseases when you have the symptoms. However, if you have swollen lymph nodes, this could be a sign of monkeypox.
A biopsy and blood test are required to diagnose monkeypox. Your tissue sample will be assessed under a microscope and by real-time polymerase chain reaction (PCR), or your blood sample will be checked for the virus or antibodies.
Treatment
Currently, there is no clinically proven treatment for monkeypox. In most cases, the symptoms can resolve on their own. The doctor mainly prescribed medication to control symptoms and other supportive therapies. Current antiviral treatment for smallpox is theoretically active for monkeypox; however, clinical data is limited.
Prevention
Getting a smallpox vaccine is an effective preventive measure; however, there is no available smallpox immunization to the public after the eradication of smallpox; WHO discontinued smallpox immunization (i.e., vaccinia virus vaccine). The vaccine is no longer administered in Thailand and may be given only to those who work with the smallpox virus in the lab.
Human contact with the infected animal should be minimized to prevent and restrict monkeypox's spread among humans.
Monkeypox can be prevented by:
- Refrain from contacting people who may be infected
- Avoid importing or contacting exotic animals from Africa
- Avoid exposure to infected animals – sick or dead
- Avoid exposure to contaminated materials with the monkeypox virus
- Clean your hands with soap and water after being exposed to an infected animal
- Eat only well-cooked food which contains animal meat or parts
- Wear personal protective equipment (PPE) if you need to care for infected people
Prognosis
Monkeypox can be fatal though its symptoms are usually not as severe as smallpox. The mortality rate is around 10% of infected people. Monkeypox is rare and primarily found in Africa. Due to recent outbreaks on other continents, learning and knowing about the disease and its symptoms is helpful. At the early symptomatic stage, you experience fever and chills like you have the flu. Then, you start to develop a rash. The symptoms are usually mild and can go away on their own, but it is crucial to see your doctor if you have these symptoms.
