What you should know about monkeypox

BENGALURU: The US has seen seven cases of monkeypox. This is a virus transmitted from animals to humans and is spread through contact with blood or bodily fluids containing the virus. The first case was detected in May ’22 by a traveller returning from Nigeria. Two weeks later, two more people were diagnosed with monkeypox, but health authorities said that it was not connected with the initial case.

Later, four more cases were found. Here too, no link to the existing cases was observed. The first-generation smallpox vaccines are not available anymore to the public but in 2019, a newer vaccine was accepted for the prevention of smallpox and monkeypox. However, it is not widely available.

Triggered by a smallpox-like virus
Monkeypox is created by a virus of the same name that is closely related to smallpox, which has now been eradicated completely from the planet. Two of them are members of the Orthopoxvirus genus in the family Poxviridae. Monkeypox was first discovered in 1958 when outbursts of a disease-causing pox were discovered in monkeys held in captivity for research. It was first reported in humans in 1970 in the Democratic Republic of the Congo (DRC) and has since been seen in Central and West Africa. In 2020, the World Health Organization (WHO) gave an account of 4,594 suspected cases of monkeypox, including 171 deaths (case fatality ratio of 3.7 percent). These reports are suspect since there was no PCR 
testing facilities available in the area where the cases were detected.

Causes spots all over the body
Indications of the condition occur between five and 13 days of infection, in spite of the fact that it can take up to 21 days for them to appear. Symptoms mostly include fever, headache, backache, muscle ache, swollen lymph nodes, chills, and exhaustion, and with the fever, a rash tends to erupt, concentrated on the hands, face, and feet before spreading to other areas of the body.  It can spread to the inside of the mouth, the cornea, and the genitals. The rash continues until it forms a scab which falls off, and in some cases, large parts of the skin can drop off the body.

Can spread by human-to-human contact
The virus usually spreads from infected wild animals, especially primates and rodents, which is seen in the rainforests of Central and West Africa and it can also spread by human-to-human close contact. Similar to viruses like Ebola, transmission only takes place through closeness, by contact with lesions, body fluids, respiratory droplets, or contaminated materials.

Currently there is no cure, except for an old vaccine
At present, WHO has not suggested any specific treatment for monkeypox. But there are antivirals, such as tecovirimat, licensed to defend against orthopoxviruses. The smallpox vaccine was key to fighting smallpox decades ago, and this vaccine can be highly effective (85 per cent) in preventing monkeypox. However, the first-generation smallpox vaccines are not available now to the public. However, in 2019, 
a newer vaccine was accepted for the prevention of smallpox and monkeypox, but it is not widely available.

Can be diagnosed through PCR tests
Monkeypox can be detected with the help of PCR testing, WHO says, because orthopox viruses can create antigens and trigger antibodies that are similar to other related viruses. Thus, analyses of these cases cannot pinpoint that the virus is monkeypox.

(The writer is consultant internal medicine physician, Manipal Hospital Old Airport Road)