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Monkeypox: Causes, Symptoms, Complications, Diagnosis And Treatment

Another case of human monkeypox was detected in Maryland, the US, the Centers for Disease Control and Prevention (CDC) said on 17 November. According to laboratory testing by the CDC, the patient is infected with a strain of monkeypox most commonly seen in parts of West Africa, including Nigeria. This is a second in nearly two decades, and the person had returned from Nigeria a couple of days ago and is hospitalised [1] - similar to the last case.

What Is Monkeypox?

Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes. The condition then continues to progress to a widespread rash on the face and body.

Monkeypox is in the same family of viruses as smallpox but causes a milder infection and last 2-4 weeks. Infections with this strain of monkeypox are fatal in about 1 in 100 people. However, rates can be higher in people who have weakened immune systems [2].

The virus spreads from person to person mainly through exposure to respiratory droplets, which can enter the body through mucous membranes in the eyes, mouth and nose. It can also be directly transmitted when a person comes in contact with infected lesions or body fluids and indirectly through contact with contaminated clothing or linens [3].

While monkeypox can be transmitted from person to person through respiratory droplets, the CDC said the chances of that happening, in this case, are low, as wearing masks is mandatory on flights and at US airports due to COVID-19, thereby reducing the risk of the pathogen spreading to other passengers or travellers.

The virus lives in animals, including primates and rodents, but it can sometimes 'jump' from animals to people. Monkeypox has never been reported in India.

What Causes Monkeypox?

Monkeypox is caused by the Monkeypox virus, which belongs to the orthopoxvirus group of viruses. The natural reservoir of monkeypox remains unknown. However, African rodent species are suspected of playing a role in transmission [4].

There are two distinct genetic groups of the monkeypox virus: Central African and West African. Human infections with the Central African monkeypox viruses are more severe compared to those with the West African viruses and have a higher mortality rate.

Person-to-person spread is high for Central African monkeypox virus and limited with West African monkeypox.

What Are The Symptoms Of Monkeypox?

The symptoms of monkeypox begin with a fever and headache. The incubation period for monkeypox is usually 7 to 14 days but can range from 5 to 21 days [5].

The signs and symptoms of monkeypox are as follows:

  • Fever
  • Headache
  • Muscle aches
  • Backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion

How Is Monkeypox Different From Smallpox?

The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not. When a person becomes affected with the monkeypox virus, within 1 to 3 days after the appearance of fever, the patient develops a rash, often beginning on the face then spreading to other parts of the body.

The symptoms of monkeypox are similar to but milder than the symptoms of smallpox.

Is Monkeypox Fatal?

Studies of human monkeypox in rural central and west Africa have reported fatality ratios of as high as 10 per cent [6].

How Does Monkeypox Spread?

Transmission of monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus then enters the body through broken skin (even if not visible), respiratory tract, or mucous membranes (eyes, nose, or mouth).

Animal to the human transmission may occur by bite or scratch, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated clothes/linen.

Human-to-human transmission occurs primarily through large respiratory droplets, direct contact with body fluids or lesion material, and indirect contact with lesion material through contaminated clothing or linens [7].

How Is Monkeypox Treated?

Currently, no treatment is available for monkeypox. Smallpox vaccine has been reported to reduce the risk of monkeypox among previously vaccinated individuals in Africa, where it was shown to have been 85 per cent effective in preventing monkeypox [8].

Can Monkeypox Be Prevented?

According to the CDC, a number of measures can be taken to prevent infection with the monkeypox virus, and they are as follows [9].

  • Avoid contact with animals that could harbour the virus.
  • Avoid contact with any materials, such as bedding that has been in contact with a sick animal.
  • Isolate infected patients from others who could be at risk for infection.
  • Practice good hand hygiene after contact with infected animals or humans. For example, wash your hands with soap and water or using an alcohol-based hand sanitiser.
  • Use personal protective equipment (PPE) when caring for patients.

On A Final Note...

Prior to the current case, there have been at least six reported monkeypox cases in travellers returning from Nigeria (including cases in the United Kingdom, Israel, and Singapore).

The CDC is working with the airline and state and local health agencies to contact airline passengers and others who may have been in contact with the patient. Government officials said the lone case of monkeypox is no cause for alarm and poses no threat to the general public.

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