Monkeypox is a disease which is characterized by fever, body aches and typical fluid filled blisters appearing in the body. It is caused by the Monkeypox virus. This virus belongs to the family of Poxviridae. The well-known smallpox also belongs to this virus family. Luckily we don’t see smallpox now as it was eradicated from the world in 1980 due to the successful immunization.
Why has Monkeypox suddenly come in to the limelight?
Several countries have reported cases of Monkeypox in May 2022. By the end of May cases were reported from over 10 countries in non-endemic areas, which mean the disease was not habitually present before. The other interesting fact was these cases were not linked to travel from endemic countries. This has raised some concerns about a possible global spread.
How did the name ‘Monkeypox’ originate?
Actually Monkeypox was first discovered in 1958 when two outbreaks of a smallpox-like disease was reported from monkeys kept for research. Today, we know that, not only monkeys host the virus in nature. All the primates including chimpanzees, gibbons, gorillas and orangutans and rodents such as rats and bandicoots can harbour the virus. As you know human is also a primate. So we also get the disease. The first human case of Monkeypox was recorded in 1970 in the Democratic Republic of the Congo. Since then, Monkeypox has been reported in people in several other Central and Western African countries, while the majority of cases were reported from the Democratic Republic of the Congo.
Symptoms of Monkeypox
Patients infected with Monkeypox often complain of fever, intense headache, muscle aches, back pain and lethargy. They typically show swollen lymph nodes and a skin blisters. These blisters appear one to three days of the start of a fever and filled with clear or yellowish fluid. They gradually crust, dry up and fall off. These blisters are usually concentrated on the face, palms of the hands and soles of the feet. They can also be found on the mouth, genitals and eyes. These blisters look like chickenpox blisters. However, these are little larger. Symptoms usually persist between two to four weeks and go away on their own without treatment.
How does this disease spread?
Monkeypox can spread from animals to humans and between people. An unprotected direct physical contact with wild animal (primate or rodent) can bring the virus to man. The disease can also spread from the meat and blood of dead animals. When it comes to human to human spread, a person can catch Monkeypox through the close physical contact with someone who has the symptoms. The fluids oozing from blisters which include pus or blood and scabs are particularly infectious. The virus can also spread through saliva. Therefore clothing, bedding, towels or objects like eating utensils/dishes that have been contaminated with the virus from contact with an infected person can also infect others. The virus can also spread from someone who is pregnant to the foetus from the placenta, or from an infected parent to child during or after birth through skin-to-skin contact. People with Monkeypox can be infectious while they have symptoms. The infectious period usually lasts between two and four weeks.
Should we be afraid to Monkeypox?
You don’t need to worry too much about Monkeypox. Because in most cases, the symptoms go away on their own within a few weeks. But, sometimes it can lead to deadly complications like skin infections and pneumonia. Rarely does the Monkeypox virus attack the eyes and causes blindness. Specially infants, children, elderly people are at a higher risk of getting these complications. People having underlying chronic diseases like diabetes and kidney disease and those who have immune deficiencies may also be at risk of more serious symptoms and death from Monkeypox. Though it is a self-limiting disease we need to stay watchful about the disease.
What you should do?
If you think you have symptoms that could be Monkeypox, seek advice from your doctor. It is important to inform that you have had close contact with someone who has similar symptoms or suspected or confirmed to have Monkeypox.
How we can prevent the disease?
The best way to prevent the disease is isolation of suspected and confirmed cases. Quarantine of exposed individuals is also important. I should reiterate that the good health habits we had inculcated during the Covid-19 pandemic will definitely prevent you from Monkeypox as well. Hand hygiene and keeping social distancing are two of the key measures to prevent Monkeypox. You should not share any personal object with a suspected case. It is important to thoroughly wash the person’s clothes, towels and bedsheets and eating utensils with warm water and detergent. Clean and disinfect any contaminated surfaces and dispose of contaminated waste are also important. The good news is, unlike COVID-19, you need direct contact to get the infection. But there is a little difference with COVID-19. Monkeypox can spread from animal to humans. In endemic countries where animals carry Monkeypox, any food items containing animal meat or parts should be cooked thoroughly before eating.
Is there a vaccine against Monkeypox?
Yes, a newer vaccine was approved in 2019. This is known as MVA-BN, and produced under the brand names of Imvamune, Imvanex and Jynneos. However, it’s not yet widely available throughout the world. But, with the recent surge of cases, the World Health Organisation is working with the manufacturer to improve access. People who have been vaccinated against smallpox in the past will also have some protection against Monkeypox. But as the smallpox vaccine had discontinued after the global eradication of the disease, most of the younger population are not immune.
What should we do about the disease?
As there is a global rise of the disease, we need to stay on high alert. We were just recovered from COVID-19. We are also facing serious economic and social challenges in the meantime. So I should say, we can’t cope with another large scale epidemic at this point. Therefore, we should take every possible measure to avert the Monkeypox epidemic from entering Sri Lanka. Already the Ministry of Health and Epidemiology Unit stay on high vigilance about the disease. I think the most important response now is that we raise awareness about Monkeypox among general public while not creating an unnecessary panic. It is also important to make public health workers aware to identify and care for patients.
(Dr. Amila Chandrasiri (MBBS (Colombo), MSc, MD (Community Medicine), Diploma in International Relations) is a Consultant Community Physician and Board Certified Specialist in Public Health – Ministry of Health Honorary Fellow (former) -University of Melbourne)
Patients infected with Monkeypox often complain of fever, intense headache, muscle aches, back pain and lethargy. They typically show swollen lymph nodes and a skin blisters. These blisters appear one to three days of the start of a fever and filled with clear or yellowish fluid. They gradually crust, dry up and fall off. These blisters are usually concentrated on the face, palms of the hands and soles of the feet. They can also be found on the mouth, genitals and eyes.
Dr. Amila Chandrasiri via DN