Cases of monkeypox virus, which started in the United Kingdom, have now been confirmed in more than 12 countries. While some of the infected people in the UK had travel history to Nigeria, health authorities are yet to ascertain the source of transmission in others. The virus has been termed endemic to Nigeria and is considered “rare and unusual”.
WHO recently said in a statement the recent outbreaks “are atypical, as they are occurring in non-endemic countries”. “There are about 80 confirmed cases so far, and 50 pending investigations. More cases are likely to be reported as surveillance expands,” it stated.
Monkeypox is a zoonosis disease, which is transmitted from animals to humans, it is an orthopoxvirus that causes a disease with symptoms similar, but less severe, to smallpox. “Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae. It was discovered in 1958 when two outbreaks of a pox-like disease occurred in lab monkeys that were kept for research, from which the name has originated,” said Dr Vikrant Shah, consulting physician, intensivist, and infection disease specialist, Zen Multispeciality Hospital Chembur.
According to World Health Organization (WHO), while smallpox was eradicated in 1980, monkeypox continues to occur in countries of Central and West Africa.
On its website, WHO states that cases are often found “close to tropical rainforests where there are animals that carry the virus”. Evidence of monkeypox virus infection has been found in animals including squirrels, Gambian poached rats, dormice, different species of monkeys and others, it reads.
It is transmitted through contact with bodily fluids, lesions on the skin or on internal mucosal surfaces, such as in the mouth or throat, respiratory droplets and contaminated objects.
According to Centers for Disease Control and Prevention (CDC), monkeypox begins with fever, headache, muscle aches, and exhaustion. The incubation period (time from infection to symptoms) for monkeypox is usually 7-14 days but can range from 5-21 days.
Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a rash, often beginning on the face then spreading to other parts of the body.
Detection of viral DNA by polymerase chain reaction (PCR) is the preferred laboratory test for monkeypox, WHO notes. The best diagnostic specimens are directly from the rash – skin, fluid or crusts, or biopsy where feasible. Antigen and antibody detection methods may not be useful as they do not distinguish between orthopoxviruses. “Typically, up to a tenth of persons suffering from monkey pox may die, with most deaths occurring in younger age groups,” said Dr Shuchin Bajaj, founder director, Ujala Cygnus Group of Hospitals.
According to WHO, milder cases of monkeypox may go undetected and represent a risk of person-to-person transmission. There is likely to be little immunity to the infection in those travelling or otherwise exposed, as endemic disease is normally geographically limited to parts of West and Central Africa.
Currently, there is no proven, safe treatment for monkeypox virus infection, notes CDC while mentioning that for purposes of controlling a monkeypox outbreak in the United States, smallpox vaccine, antivirals, and vaccinia immune globulin (VIG) can be used. “There is no treatment for it but vaccination against smallpox can be effective in preventing monkeypox,” said Dr Shah. WHO too states on its website that historically, vaccination against smallpox was shown to be protective against monkeypox. While one vaccine (MVA-BN) and one specific treatment (tecovirimat) were approved for monkeypox, in 2019 and 2022 respectively, these countermeasures are not yet widely available, and populations worldwide under the age of 40 or 50 years no longer benefit from the protection afforded by prior smallpox vaccination programmes.
Source – The Indian Express