CHENNAI: While we still dally toward the containment of one pandemic, it seems another outbreak is on the rise. Since early May of this year, news of Monkeypox has taken over across the world. The infection is being increasingly reported from many countries where it is not endemic. Seeing the rising trend, on July 21, the WHO declared the multi country outbreak of monkeypox as a Public Health Emergency of International Concern. There have been four cases reported in India till date. Here’s all you need to know about this rapidly-spreading viral infection:
What is monkeypox?
Monkey pox is a viral infection characterized by fever with rash. The virus belongs to the same family that houses small pox. It causes a disease similar to but milder than small pox. It is a zoonotic disease (a disease transmitted from animals to humans). It was discovered in 1958 when outbreaks of “pox-like disease” occurred in monkeys kept for research. The first human case was reported in 1970 with cases mostly being reported from Africa. The cases reported outside of Africa were almost always linked to international travel.
What are the features of monkeypox?
It commonly presents with fever followed by rash. Initial symptoms accompanying the fever may include headache, body pain, tiredness and lymph node enlargement. The fever is followed by a rash which usually occurs one to four days following the fever. The rash may occur in the absence of fever or may rarely precede the fever. The rash of monkey pox resembles pimples and blisters and is often confused with chicken pox. The rash is distinctly noted over the face and limbs but spreads all over the body within 24 hours (with a centrifugal distribution). The lesions often have a unique central umblication (central depression) in contrast to chicken pox lesions, although this need not always be present.
How does it spread?
It spreads from person to person through direct contact with the rash/scabs/body fluids. It can also spread by contact with clothes / objects contaminated with body fluids of the patient. Unlike COVID-19, it has been observed that microdroplet/aerosol do not play an important role in its transmission. However, infection may be transmitted by large droplets/respiratory secretions during prolonged face-to-face contact or during intimate physical contact like kissing. It can also spread through sexual intercourse. Infected mothers can transmit the infection to their fetus through the placenta (vertical transmission). Contamination from an infected animal can occur through scratches/bites from the animal or by eating its meat.
What’s the recovery time?
This is a self-limiting infection and takes two to four weeks for complete recovery. The rash and scabs (which occur during the resolution of the rash) are infective and the patient is deemed to have recovered from illness after complete resolution of symptoms and lesions (shedding of scabs from all the lesions).
Who is more susceptible?
Vaccination against smallpox has a protective effect against monkeypox. Hence, persons younger than 40 or 50 years of age (born after 1980), may be at a higher risk due to cessation of smallpox vaccination campaigns after 1980 (post disease eradication).
How can we protect ourselves?
Avoid close skin-to-skin contact and sharing of utensils with any person with rash or with anyone suspected with monkeypox. Maintain hand hygiene and protection (gloves) whenever washing or touching the clothes/linen of patients. And it is important to isolate patients for two to four weeks (until all scabs have fallen off).
Are vaccines useful?
When exposed to the infection, smallpox vaccines may be useful as post-exposure prophylaxis (best when given within four days of exposure). Vaccination may also be prudent in individuals at high risk like laboratory workers and those involved in handling the specimens (as pre-exposure prophylaxis).
Is there a definitive treatment?
This illness is usually self limiting and resolves in two to four weeks without any complications.
(The author is consultant, Internal Medicine, Dr Mehta’s Hospitals.)