About Monkeypox disease

Monkeypox is a disease caused by a virus called orthopoxvirus. This virus is also a causative agent of some diseases like smallpox, chickenpox, measles etc.

This disease was called “monkeypox disease” because the lesion or pox is seen on infected monkeys developed like other known pox-forming diseases and because it was slightly different from the diseases it was therefore named specifically in relation to infected monkeys.

As time went on, studies showed that the monkeypox virus was actually seen in rodents. The pox or lesion often break open, ulcerate and form scars on the skin after a period of time.

Monkeypox is closely related to smallpox because it has the same signs and symptoms, just that the pox is slightly different from smallpox. Vaccines used for smallpox can also be used to prevent the spread of monkeypox because these vaccines have the same anti-viral properties against monkeypox.

Monkeypox is less severe than smallpox and can sometimes be confused with chickenpox. It is much less easily transmitted than smallpox and have much lower fatality rate.

EPIDEMIOLOGY/TRANSMISSION

Monkeypox disease is relatively uncommon. In 1958, it was discovered in monkeys. In 1970, it was then discovered in humans in an outbreak in Africa. This discovery confirmed the transmission of monkeypox as the direct contact between infected animals and non-infected individuals. Smallpox vaccination was used against monkeypox, but it was later discontinued in the late 1970s. People under the age of 16 and those born after the smallpox vaccination ended were susceptible to monkeypox in 1970.

Between February 1996 and October 1997, there were 511 suspected cases of monkeypox in the Democratic Republic of Congo (DRC). This outbreak was the largest ever recorded. In late 1997, the United States Center for Disease Control (CDC) and World Health Organisation (WHO) announced that this outbreak was likely due to human behavior rather than the mutation of this virus.

During the outbreak, the DRC was involved in a civil war; Food shortages increased reliance on hunting activities and increased the chances of people coming in contact with infected animals.

Before the year, 2003, most monkeypox cases were diagnosed in remote areas of central and west Africa. Then it was later confirmed in the United States in 2003.

In 2005, a monkeypox outbreak occurred in Sudan and sporadic cases had been reported from other parts of Africa. In 2009, an outbreak campaign among refugees from the DRC into the Republic of Congo identified and confirmed two cases of monkeypox disease. Between August and October 2016, a monkeypox outbreak in the Central African Republic had 26 cases and 2 deaths.

The disease then re-emerged in Nigeria in 2017, 39 years after the first reported case.

Transmission of the monkeypox virus is usually by direct contact with infected animals. Consumption of poorly cooked rodent or monkey meats can help transmit this virus.

Transmission from person-person can be achieved when an infected person with broken lesions (due to accidental bites or scratches) touch an uninfected person. Children are likely to contract the diseases if not vaccination due to the non-fully development of their immune system and they have the highest death rate. The death rate among children may reach up to 2-10%.

Images of children with monkeypox lesions from CDC.gov

SIGNS AND SYMPTOMS

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The signs of the presence of monkeypox can start with fever, profuse sweating, cough, nausea and shortness of breath. Two to four days after the fever develops, a rash with poxes develops most often on the face and the chest and later to other parts of the body. As the poxes develop, they ulcerate, crust over and begin to heal in about 14-21 days. After healing, the lesions leave a pox-scar like smallpox.

DIAGNOSIS

Monkeypox can be diagnosed by diagnosed through physical examination of the poxes since its initial signs and symptoms can be related to other diseases like smallpox.

TREATMENT

CDC recommends that smallpox vaccination should be administered to individuals affected within 2 weeks of exposure to monkeypox. Smallpox vaccination is administered because of the close relation between smallpox and monkeypox.

Studies have shown that people vaccinated against smallpox have about an 85 % chance of being protected from monkeypox.

Cidofovir is an antiviral drug suggested for patients with severe, life-threatening symptoms.

PREVENTION

This disease can be prevented by

· Avoiding infected animals known to have the virus.

· Avoiding close contact with infected persons. Patients who have this disease should physically isolate themselves until all the pox lesions have healed.

· Eating properly cooked rodent or monkey meats or even total abstinence from these meats.

· People who take care of the infected patients should properly guard themselves using barriers such as gloves and face masks to avoid direct contact with the lesions and should also ensure being vaccinated.

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