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Monkeypox: symptoms, history, treatment, vaccine


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 It is a zoonotic viral infection that can spread from animals to humans, however, it is also contagious among humans.

 With over 16,000 cases and five deaths being reported from around 75 countries due to Monkeypox, the World Health Organisation (WHO) finally declared the outbreak a global health emergency on Saturday. Meanwhile, four cases have been reported in India, one from Delhi and the other three from Kerala. 

 Here’s all you need to know about the virus, its symptoms, treatment, history, etc.

how is monkeypox spread from human to human

1- What is Monkeypox? 

 Monkeypox is an illness caused by a virus of the same name. It is a zoonotic viral infection that can spread from animals to humans, however, it is also contagious among humans. This virus is transmitted via direct or indirect contact through infectious skin or lesions, face-to-face and skin-to-skin contacts, and the exchange of respiratory droplets.

 Monkeypox virus is part of the variola virus family of viruses, the same virus that causes smallpox. Its symptoms are similar to smallpox but milder, and it is rarely fatal and not related to chickenpox.

2- History

 The first documented case in humans was in 1970, in six unvaccinated children during the smallpox eradication efforts; the first being a 9-month-old boy in the Democratic Republic of the Congo (formerly Zaire). The others, including three who were playmates, were in Liberia and Sierra Leone. It was noted to be less easily transmissible than smallpox. From 1981 to 1986, over 300 cases of human monkeypox were reported in the DRC, the majority being due to contact with animals. In 1996, the disease reemerged in the DRC with 88% of cases resulting from human-to-human transmission. Small viral outbreaks with a death rate in the range of 10% and a secondary human-to-human infection rate of about the same amount occur routinely in equatorial Central and West Africa. In humans, the disease remained confined to the rain forests of Western and Central Africa until 2003, when an outbreak of monkeypox occurred in the US. All cases were traced to sick rodents imported from Ghana. Local prairie dogs caught the infection and passed it on to their owners. The disease was found to be mild and there were no deaths. Between 1970 and 2019 the disease was reported in 10 African countries; mostly in Central and West Africa.

 In 2018, cases of monkeypox were diagnosed in the UK by two unrelated travelers from Nigeria. That year the first human-to-human transmission outside of Africa was confirmed in the UK. This person was a healthcare worker who possibly contracted the disease from contaminated bedlinen. Cases were also reported in travelers to Israel and Singapore. The UK saw further cases in 2019 and 2021.

3- Symptoms

 Monkeypox can cause a range of signs and symptoms.  While some people have mild symptoms, others may develop more serious symptoms and need care in a health facility.

 Those at higher risk for severe disease or complications include pregnant women, children, and people who are immunocompromised.

 The most common symptoms of monkeypox include fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes. This is followed or accompanied by the development of a rash which can last for two to three weeks. The rash can be 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.

 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.

 Symptoms typically last two to three weeks and usually go away on their own or with supportive care, such as medication for pain or fever. People remain infectious until all of the lesions have crusted over, the scabs fallen off and a new layer of skin has formed underneath.

 Anyone who has symptoms that could be monkeypox or who has been in contact with someone who has monkeypox should call or visit a health care provider and seek their advice.

4- Vaccine 

 WHO recently approved a vaccine for the prevention of Monkeypox. Some countries are recommending vaccination for persons at risk. 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. Only people who are at risk (for example someone who has been in close contact with someone who has the virus) should be considered for vaccination. Mass vaccination is not recommended at this time.

5- Treatment

 the European Union and the United States, tecovirimat is approved for the treatment of several poxviruses, including monkeypox. BMJ Best Practice recommends tecovirimat or the smallpox treatment brincidofovir as the first line antiviral treatment if required, alongside supportive care (including antipyretic, fluid balance, and oxygenation). Empirical antibiotic therapy or aciclovir may be used if secondary bacterial or varicella zoster infection is suspected, respectively.

 The WHO recommends that people with monkeypox should follow the advice of their health care provider. Symptoms normally resolve on their own without the need for treatment. If needed, medication for pain (analgesics) and fever (antipyretics) can be used to relieve some symptoms

 It is important for anyone with monkeypox to stay well-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.

 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 sterilized 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.

 Many years of research on therapeutics for smallpox have led to the 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.