All you need to know about Monkeypox

Monkeypox is an illness caused by the monkeypox virus. It is a viral zoonotic infection which can be spread from animals to humans and also spread from person to person.

The disease is called monkeypox because it was first identified in colonies of monkeys and kept for research in 1958; however, it was only later detected in humans in 1970 in the Republic of Congo, which was then called Zaire.

Recently, the World Health Organization declared the growing Monkeypox outbreak as an international public health emergency following concerns that the virus now threatens global health.

This was done to prevent the virus from spreading further and potentially escalating into a pandemic. Although the declaration does not impose requirements on national governments, it serves as an urgent call for action for everyone. Here are things you need to know about Monkeypox

How the virus is spread

Monkeypox could be spread from person to person via close contact with someone who has a monkeypox rash – including through face-to-face, skin-to-skin, mouth-to-mouth or mouth-to-skin contact and sexual contact.

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For example, environments can become contaminated with the monkeypox virus when an infectious person touches objects or surfaces, thereby infecting someone else who touches these items.  It is also possible to get the infection from breathing in skin flakes or virus from clothing, bedding or towels, which is known as fomite transmission.

Also, ulcers, lesions or sores in the mouth can be infectious; this means the virus can spread through direct contact with the mouth, respiratory droplets and possibly through short-range aerosols. However, possible mechanisms of transmission through the air for monkeypox are not yet well understood as investigations and studies are underway to learn more.

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The virus can also spread from a pregnant woman to the fetus, after birth through skin-to-skin contact. This could also be possible from a parent with monkeypox to an infant or child during close contact.

Although asymptomatic infection (when patients experience no symptoms) has been reported, it is, however, unclear whether people without any symptoms can spread the disease or if it can spread through other bodily fluids.  While pieces of DNA from the monkeypox virus have been found in semen, it is yet unknown whether infection can spread through semen, vaginal fluids, amniotic fluids, breastmilk or blood as research is underway to find out more about whether people can spread monkeypox through the exchange of these fluids during and after symptomatic infection.

Monkeypox can also be spread to people when they come into physical contact with an infected animal – animal hosts include rodents and primates. However, the risk of catching monkeypox from animals can be reduced by avoiding unprotected contact with wild animals and especially with those that are sick or dead – this also includes their meat and blood. In endemic countries where animals carry monkeypox, any foods containing animal meat or parts should be cooked thoroughly before eating.

Although instances of people with monkeypox infecting animals have not been documented, it is still regarded as a potential risk. Hence, it is advisable that people who have confirmed or suspected monkeypox should avoid close contact with animals like pets like cats, dogs, hamsters, gerbils etc – including livestock and wildlife. Also, people with monkeypox should be particularly vigilant around animals that are known to be susceptible to the virus-like rodents and non-human primates.

Symptoms of Monkeypox

Symptoms differ from person to person. While some people have mild symptoms, others may develop more serious symptoms and may need the care to seek treatment in a health facility. Those at higher risk for severe disease or complications are people who are pregnant, children and persons that are immunocompromised.

The most common symptoms of monkeypox come in the form of fever, headache, muscle aches, back pain, low energy, as well as swollen lymph nodes, which is usually followed by the development of a rash that can last for two to three weeks. The rash can be spotted on the face, palms of the hands, soles of the feet, eyes, mouth, throat, groin, and genital or anal regions of the body. The number of lesions can range from one to several thousand; lesions begin flat, then fill with liquid before they crust over, dry up and fall off, with a fresh layer of skin forming underneath.

With supportive care like medication for pain or fever, symptoms typically last two to three weeks and usually go away on their own. People usually remain infectious until all of the lesions have crusted over; the scabs falls off and a new layer of skin forms underneath.

In most cases, the symptoms of monkeypox go away on their own within a few weeks. However, in some people, an infection can lead to medical complications and even death. Newborn babies, children and people with underlying immune deficiencies may be at risk of more serious symptoms and death from monkeypox.

Complications from monkeypox include secondary skin infections, pneumonia, confusion, and also eye problems. In the past, between 1% to 10% of people with monkeypox have died.  Meanwhile, death rates in different settings may differ due to a number of factors, such as access to health care. It is believed that these figures may be overstated because surveillance for monkeypox has generally been limited in the past. In the newly affected countries where the current outbreak is taking place, there have been no deaths to date.

Who is at risk?

People who live with or have close contact (including sexual contact) with someone who has monkeypox or who has regular contact with animals who could be infected are most at risk.

Newborn infants, young children and people with underlying immune deficiencies may be at risk of more serious symptoms and in rare cases, death from monkeypox.

While people who were vaccinated against smallpox may have some protection against monkeypox, younger people are unlikely to have been vaccinated against smallpox because smallpox vaccination stopped in most settings worldwide after it was eradicated in 1980.

Is there a vaccine against monkeypox?

A vaccine was recently approved for preventing monkeypox and some countries are recommending vaccination for persons at risk. Similarly, many years of research have led to the development of newer and safer vaccines for an eradicated disease called smallpox, which may also be useful for monkeypox – one of these has been approved for the prevention of monkeypox. Only people who are at risk should be considered for vaccination. Mass vaccination is not recommended at this time.

While the smallpox vaccine was shown to be protective against monkeypox in the past, current data on the effectiveness of newer smallpox/monkeypox vaccines in the prevention of monkeypox in clinical practice and in field settings are limited.

While investigation is still on, it is believed that studying the use of vaccines for monkeypox wherever they are used will allow for rapid generation of additional information on the effectiveness of these vaccines in different settings.

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