Outbreaks:

Human monkeypox was discovered in a 9-month-old baby in the Democratic Republic of the Congo in 1970, in an area where smallpox had been eradicated in 1968. Since then, the majority of cases have been recorded from the Congo Basin’s rural, rainforest regions, mainly in the Democratic Republic of the Congo, with human cases increasingly being reported from across central and west Africa.

Since 1970, 11 African nations have recorded human cases of monkeypox: Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Cote d’Ivoire, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan. The exact impact of monkeypox is unknown. In 1996-97, for example, an epidemic in the Democratic Republic of the Congo was recorded with a lower-case fatality ratio and a greater attack rate than typical. A concurrent outbreak of chickenpox and monkeypox (produced by the varicella virus, which is not an orthopoxviral) was discovered, which might explain real or perceived variations in transmission dynamics in this instance. Nigeria has been experiencing a major epidemic since 2017, with over 500 suspected cases, over 200 confirmed cases, and a case fatality ratio of roughly 3%. Cases are still being reported today.

Monkeypox is a disease of worldwide public health significance since it affects countries not just in West and Central Africa, but also the rest of the world. The first monkeypox epidemic outside of Africa occurred in the United States of America in 2003, and it was traced back to contact with infected pet prairie dogs. These creatures were kept with Gambian pouched rats and dormice that had been brought from Ghana. This outbreak resulted in about 70 cases of monkeypox in the United States. Travelers from Nigeria to Israel in September 2018, to the United Kingdom in September 2018, December 2019, May 2021, and May 2022, to Singapore in May 2019, and to the United States of America in July and November 2021 have all been reported to have monkeypox. Multiple cases of monkeypox were discovered in many non-endemic countries in May 2022. There are now studies being conducted to better understand the epidemiology, sources of illness, and transmission patterns.

Symptoms:

The infection is separated into two stages. The invasion stage (which lasts between 0 and 5 days) is marked by fever, severe headache, lymphadenopathy (lymph node swelling), back pain, myalgia (muscle pains), and severe asthenia (lack of energy). Lymphadenopathy distinguishes monkeypox from other illnesses that may first seem similar (chickenpox, measles, smallpox). The skin eruption generally develops within 1-3 days after the fever’s emergence. The rash usually appears on the face and extremities rather than the trunk. It affects the face (95% of the time), the palms of the hands, and the soles of the feet (75% of the time). Oral mucous membranes (in 70% of cases), genitalia (30%), conjunctivae (20%), and the cornea are also affected. The rash progresses from macules (flat-based lesions) to papules (slightly raised firm lesions), vesicles (clear fluid-filled lesions), pustules (yellowish fluid-filled lesions), and crusts that dry up and flake off. The number of lesions ranges from a few hundred to thousands. In severe cases, lesions can coalesce until large sections of skin slough off.

Treatments:

There is currently no authorized therapy for monkeypox virus infection. However, there are various antiviral drugs used to treat smallpox and other illnesses that may benefit people infected with monkeypox. Tecovirimat or ST-246 (TPOXX); brincidofovir (Tembexa); and cidofovir (Vistide), an intravenously given antiviral used to treat cytomegalovirus retinitis in AIDS patients. Furthermore, intravenous vaccinia immune globulin (VIGIV), which is already approved for the treatment of problems following smallpox (vaccinia) vaccination, may be approved for use in treating monkeypox and other pox viruses during an epidemic.

Prevention:

To help reduce your risk of becoming infected with or spreading the monkeypox virus by, it is suggested to stay home and limit contact with others if you have symptoms, or as recommended by your health care provider. Avoid close physical contact, including sexual contact, with someone who is infected with or may have been exposed to the monkeypox virus. Maintain good hand hygiene and respiratory etiquette, including covering coughs and sneezes with the bend of your arm or wearing a well-fitting mask, cleaning and disinfecting high-touch surfaces and objects in your home, especially after having visitors.

By Ovidiu Stanica