Monkeypox

By Dr Peter Odutola 

Monkeypox 

It is a rare condition brought on by infection with the Monkeypox virus. The Smallpox virus and the Monkeypox virus both belong to the same family of viruses and have similar symptomatology.

A lot of viruses belong to this pox family including Cowpox, Horsepox, Camelpox, and Alaskapox and Smallpox virus is the commonest of this group.

Though Smallpox symptoms are comparable to those of Monkeypox, the presentation in the case of Monkeypox is milder, and Monkeypox rarely results in death. The risk of mortality and contact transmission from Monkeypox are significantly lower than that of Smallpox.

There were two outbreaks of the disease in 1958 in monkeys that were being used for research but despite being called “monkeypox”, scientists working on the disease have not agreed on its origin. What can be agreed upon however is that the virus can be transmitted by African rodents and non-human primates to humans.

Symptoms

It presents primarily with a rash which can be in locations such as the penis and testicles in males, labia, and vagina in females. Other locations are the face, mouth, chest, hands, and feet. The rash may be blistering or pimple - like and can be painful and itchy. The presence of flu - like symptoms is not a criterion for diagnosis but could be important for treatment purposes. These include headache, sore throat, cough, fever, chills, and muscle aches. The flu-like symptoms may be present before the rash appears and disappears afterward or could follow the rash.

Incubation period

The period between exposure to the virus and manifestation of the disease is usually about three weeks. The symptoms usually last for 4 weeks.

How is Monkeypox virus transmitted

There are two ways Monkeypox virus can be transmitted 

1.Animal to Human Transmission

This occurs when infected animals’ body fluids come in contact with humans, or an uninfected human is bitten by an infected animal.  

2. Human to Human Transmission can occur through various means

Direct contact : A non-infected human comes in contact with infected body fluids during sexual activities.

Indirect contact : A non-infected human comes in contact with an infected material which had earlier been contaminated by infected body fluid.

Respiratory droplets: A non-infected human is infected by respiratory droplets which comes from coughing or sneezing.

Vertical transmission : Mother to child transmission through the placenta.

Diagnosis

Monkeypox infection is diagnosed through polymerase chain reaction (PCR) test.

Treatment

Some patients do have mild symptoms and usually make a full recovery. Other patients with moderate to severe disease may need hospitalization. Management is based on the presenting symptoms. Due to the similarity of Smallpox and Monkeypox, some antiviral drugs that were developed for the treatment of Smallpox have been used to some varying degree of success for Monkeypox. 

Prevention

Pre - exposure prophylaxis vaccine is important for those in the high-risk groups of gay, bisexual men and men who have sex with other men as well as those who comes in contact with a person infected with Monkeypox.

There should be increased community awareness of the disease and surveillance to detect current cases. Contact tracing is a valuable tool in this regard. As we learned during the time Covid started, there is a lot of the unknown with Monkeypox but as more information is unearthed, the world will be able to deal with this disease better.

Dr. Odutola, a Physician and Researcher,  sent in this piece from Chicago, USA.