By Apekshita Sonowal

Monkeypox : Meaning, history, symptoms and prevention.

Meaning, history of Monkeypox

According to WHO advisory dated 12^th July 2022, “Monkeypox is an illness which is caused by the monkeypox virus. It is a viral zoonotic infection, meaning that it can spread from animals to humans. It can also spread from person to person.”

The rare disease belongs to the same family of viruses as variola virus, the one that is responsible for causing the small pox disease. Monkeypox was originated or rather, detected in many laboratory apes or monkeys back in 1958, hence the name Monkeypox. It was first identified in the year 1970 in humans in the Democratic Republic of the Congo (DRC) in a nine month old baby boy and it was the same place where its close relative, small pox had been removed just two years back i.e., 1968.

Symptoms and severity of the disease

The symptoms of Monkeypox are quite similar to smallpox patients except for the fact that clinically the Monkeypox is less severe and typically last two to three weeks. The symptoms usually go away on their own or with proper medication for pain or fever. People who experiences symptoms of monkeypox should be kept isolated until a new layer of skin forms underneath the infected part. As the people still remain infected until the lesions have crusted over, the scabs fallen off and a new layer of skin can be skin.

Even though it is said to be less severe, but the intensity of the infection depends on person to person. While some people may experience mild symptoms, others might develop serious symptoms and need proper healthcare facility in a health centre like people who are pregnant, children and persons that are immunocompromised are supposed to be at higher risk of the infection.

Historically, it has been recorded that only 1 to 10 percent of those infected with the disease have died and mainly due to lack of access to proper healthcare facilities.

The most common symptoms that can be seen among the people are fever, headache, muscle aches, back pain, low energy, and lymphadenopathy (swollen lymph nodes) which are the initial stage of the symptom. This is accompanied by rashes which can be usually found on the face, palms of the hands, soles of the feet, eyes, mouth, throat, groin, and genital and/or anal regions of the body. Simultaneously, the lesions begins to develop which again progresses through four stages, the macular stage is when the lesions are flat, the second is the papules stage where the lesions have developed and raised from being flat. The fourth is the vesicles stage, here the lesions are not only raised but are filled with clear fluid, and the last is the pustules stage where the lesions are filled with opaque fluid or pus which is followed by crust or scabs.

                                                                            Image showing various stages of Monkeypox. 

How does Monkeypox spread from person to person?

Monkeypox spreads from close contact with the infected person or just being in the infected environment. It includes contact through face-to-face, skin-to-skin, mouth-to-mouth or mouth-to-skin contact, including sexual contact. 

An environment becomes infected by Monkeypox when an infected person touches things around him like clothing, bedding, towels, objects, electronics and surfaces. Further, when a non-infected person touches these items tends to get become infected as well. According to WHO, another possible infection may occur from “breathing in skin flakes or virus from clothing, bedding or towels. This is known as fomite transmission.”

WHO also advises to be careful of the ulcers, lesions or sores developing in the mouth as it can be infectious, which is easily spread through direct contact with the mouth, respiratory droplets and possibly through short-range aerosols. The possible mechanisms of transmission through the air for Monkeypox is yet to be understood well for which studies are in progress to get a better idea of the disease.

Treatment

Even though the infection goes away within two three weeks on their own with basic fever and pain killer medication. But if the symptoms are severe, one should seek medical assistance immediately. It is important for anyone with monkeypox to stay hydrated, eat well, and get enough sleep. People who are self-isolating should take care of their mental health by doing things they find relaxing and enjoyable, staying connected to loved ones using technology, exercising if they feel well enough and can do so while isolating, and asking for support with their mental health if they need it.

People with monkeypox should avoid scratching their skin and take care of their rash by cleaning their hands before and after touching lesions and keeping skin dry and uncovered (unless they are unavoidably in a room with someone else, in which case they should cover it with clothing or a bandage until they are able to isolate again). The rash can be kept clean with sterilised water or antiseptic. Saltwater rinses can be used for lesions in the mouth, and warm baths with baking soda and Epsom salts can help with lesions on the body. Lidocaine can be applied to oral and perianal lesions to relieve pain.

                                                           Representational Image of Self-Isolation. Source- University of Cambridge

Many years of research on therapeutics for smallpox have led to development of products that may also be useful for treating monkeypox.  An antiviral that was developed to treat smallpox (tecovirimat) was approved in January 2022 by the European Medicines Agency for the treatment of monkeypox. Experience with these therapeutics in the context of an outbreak of monkeypox is limited. For this reason, their use is usually accompanied by collection of information that will improve knowledge on how best to use them in future.

Currently there have been 3413 laboratory confirmed cases since of January 1 and as of 22 June, 2022 and one death have been reported to WHO from 50 countries/territories in five WHO Regions.???? 

Since the publication of the last outbreak news of the disease on 17 June, 1310 new cases have been reported and eight new countries have reported cases.