Originating in Africa over 50 years ago, this viral illness, a temperate brother of the deadly smallpox, has captured the attention of health authorities worldwide. With over 100 countries reporting outbreaks this year, monkeypox has emerged as a public health emergency of international concern. Read on to find out more about the disease and what we can do to prevent it.
The Origin of Monkeypox
Monkeypox is caused by a virus of the Poxviridae family, the same as that of smallpox. Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred among monkeys kept for research purposes.
It was first detected among humans in a 9-month-old boy in the Democratic Republic of the Congo in 1970, in a region that had eradicated smallpox two years prior.
The virus remained largely limited to the rural and rainforest regions of central and west Africa until it was first detected overseas in the United States in 2003. Since then, monkeypox has been reported across the nations, with several non-endemic countries reporting outbreaks this year.
The Global Outbreak
The World Health Organization (WHO) has released its November report on the monkeypox situation worldwide. Since January 1, 2022, cases of monkeypox have been reported from 110 countries, with a total of 79,641 laboratory confirmed cases, including 51 deaths.
The worst affected countries include the United States, Brazil, Spain, France, the UK, Germany, and Colombia.
India was the first South Asian country to report a case of monkeypox this year and the cases have climbed up with at least 1 confirmed death.
The WHO’s director-general has stated that monkeypox will continue to remain a public health emergency of international concern.
How does the Virus Spread?
The virus spreads when we come in contact with the blood, bodily fluids and secretions from the lesions of infected animals, most commonly Gambian pouched rats, dormice and certain species of squirrels and monkeys.
Human-to-human transmission is possible through contact with the respiratory secretions and skin lesions of an infected person or via recently contaminated objects.
Due to the similarity between the monkeypox and the smallpox viruses, the smallpox vaccine had provided immunity against both the infectious diseases.
Following the successful eradication of smallpox in 1980, smallpox vaccination was gradually halted across the world. Today, most people in their 50s and younger have never received the smallpox vaccine, leading to an increased susceptibility of the unvaccinated population to monkeypox virus infection.
What are the Symptoms of Monkeypox?
Following contact with an infected person or animal, the symptoms can appear anywhere between 5 and 21 days.
In the initial “invasive” phase of the disease, the affected individual may have fever, intense headaches, muscle aches, back pain and swelling of lymph nodes. The individual may also experience extreme tiredness.
Subsequently, rashes erupt over the face, hands, soles of feet, inside the mouth, eyes and genitalia. The rashes get filled with fluid, pus and form crusts.
The disease is self-limiting and usually resolves on its own within 2-4 weeks.
In severe cases, especially in children, complications such as pneumonia, encephalitis, sepsis and vision loss may ensue.
Diagnosis & Treatment
Monkeypox symptoms closely resemble that of chickenpox and measles.
Individuals suspected of having monkeypox are diagnosed by collecting the infectious fluid from the skin rashes and using PCR (Polymerase Chain Reaction) to confirm the presence of the virus.
The FDA recently issued Emergency Use Authorization (EUA) for Swiss biotech firm Roche’s monkeypox diagnostic test to be run on their cobas systems.
Till date, there is no specific medication for monkeypox. Treatment is aimed at controlling the symptoms and managing the complications.
Tecovirimat, an antiviral drug developed for smallpox, has been licensed for treating monkeypox. However, more clinical data is required for it’s widespread use in patient care.
How can we Prevent the Spread of Monkeypox?
The WHO and the Centres for Disease Control and Prevention (CDC) have made the following recommendations to curb the spread of the disease.
- Avoid close, skin-to-skin contact, including kisses, hugs and intimacy
- Avoid sharing or coming in contact with utensils, bedding, clothing and other objects used by affected individuals
- Isolate the affected person from family members
- Follow good hand hygiene with soap and water or alcohol-based sanitizers when caring for infected persons. Use gloves and face masks. Disinfect objects used by affected individuals
- Thoroughly cook food containing animal meat
- If you’re in central or west Africa, avoid unprotected contact with wild animals and their body fluids, especially if they’re sick or dead, as well as the objects they might have come in contact wit
- Vaccination – Although there are vaccines available (for example, JYNNEOS vaccine in the USA), studies are being done to determine the need for widespread immunisation against the disease
- Monkeypox virus infection is a self-resolving disease, occasionally progressing to complications and death
- Children and immunocompromised individuals are more likely to suffer a severe course of the disease
- Avoiding contact with affected individuals is the mainstay of prevention