KOCHI: M–pox or monkeypox is a viral illness caused by orthopoxvirus. It’s a zoonotic illness first identified in Central and West Africa around 1970. The virus was accidentally identified in the 1950s among monkeys while scientists were researching some other virus.
The smallpox vaccine provided protection for monkeypox. Since the smallpox vaccine was withdrawn after the eradication of the disease in the 1980s, there was an increase in the cases reported for M-pox in the areas where it was endemic. There have been reported cases over a period of time that were associated with travel to endemic areas.
Outbreak of M-pox
This virus came into the limelight once again in 2022 as there were new cases reported in the areas that were non-endemic and were not associated with travel-related spread. The first case in India was diagnosed in July 2022, in a 35-year-old male patient and after that, there were approximately 27 cases which were reported.
Recently, WHO declared an M-pox outbreak in August 2024, as more than 100 confirmed cases were identified in four neighbouring countries of the Democratic Republic of Congo – Burundi, Kenya, Rwanda, and Uganda. This year so far, no case of M-pox has been reported in the Indian Subcontinent.
How does M-pox spread?
The spread is generally associated with coming in direct contact with the infective skin lesions and fomite. This happens when a human comes in contact with an infected animal in the form of secretions and animal bites. It has also been noted that occasionally an infected individual can spread infection four days prior to the symptom onset.
The disease can spread to other individuals through the secretion of the fluid that comes out of skin lesions and pustules of the affected person’s skin. Contaminated surfaces act as one of the prominent modes of transmission. Intimate contact can also lead to the spread of this virus.
Symptoms of M-pox
Symptoms are usually skin-related but can vary in severity. The incubation period of this virus varies from five-13 days but can be as long as three weeks. The most common site is the genital region, implicating the spread through intimate contact. There can be rashes ranging from small red raised lesions to large scabbed necrotic areas. The other systems that can be seen involved in these certain cases, include the central nervous system, eyes, etc.
Treatment and prevention
M-pox can be diagnosed by detecting the DNA of the virus. Antivirals are available with limited data on utilities like Tecovirimat and Cidofovir. Availability of tecovirimat may be an issue. The person with the disease needs to be in isolation to prevent further spread.
Vaccines (MVA and ACAM2000) are also available for this disease. WHO has requested for emergency listing of these vaccinations to accelerate their availability. The complete strategy for managing the disease has been delineated and thus managing the disease is possible if it is diagnosed on time. However, a high index of suspicion is required for proper treatment and prevention of spread.
(The writer is consultant - infectious diseases, Manipal Hospital Old Airport Road)