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As it turns out, monkeypox's effect goes much beyond the skin. James Brunton Badenoch, Academic Foundation Doctor, Queen Mary University of London has notified that while monkeypox’s effect on the skin, the disfiguring rashes, and the flu-like symptoms have been well described, few have investigated the neurological and psychiatric problems the virus might cause.
James Brunton Badenoch informed that since there are historic reports of neurological complications in people infected with the related smallpox virus and in people vaccinated against smallpox, so the researchers wanted to know whether monkeypox causes similar problems. They looked at all the evidence from before the current monkeypox pandemic of neurological or psychiatric problems in people with a monkeypox infection and the results are published in the journal eClinicalMedicine.
A small but noticeable proportion of people (2% to 3%) with monkeypox became very unwell and developed serious neurological problems, including seizure and encephalitis (inflammation of the brain that can cause long-term disability), he said.
It’s important to note, though, that these figures are based on a few studies with few participants and “besides the severe and rare brain problems, we found evidence of a broader group of people with monkeypox who had more common neurological symptoms including headache, muscle ache and fatigue."
James Brunton Badenoch said “from looking at the studies, it was unclear how severe these symptoms were and how long they lasted. It was also unclear how many people with monkeypox had psychiatric problems - such as anxiety and depression - as few studies looked into it. Of those that did, low mood was frequently reported."
“Although we found that people with monkeypox infection can have neuropsychiatric symptoms, the studies in our paper cannot say with any certainty that it’s the virus causing these problems. Future research exploring this will need to follow up people with no neuropsychiatric conditions before becoming infected with monkeypox," he said.
Interestingly, a study in the New England Journal of Medicine included over 500 people with monkeypox from 16 countries in the current outbreak which noted that although no cases of encephalitis or seizure were reported, headache and fatigue were found in more than a quarter of people infected with monkeypox and low mood in up to one in ten people.
James Brunton Badenoch further highlighted that although monkeypox mainly causes flu-like symptoms and skin problems, our latest study – and subsequent studies – show that neuropsychiatric symptoms are not uncommon. “We are not expecting a tide of serious brain problems, but complications such as encephalitis and seizure may occur in a small proportion of people. We need more research to find out if these symptoms persist over time and whether they’re caused by monkeypox," he said.
(With inputs from PTI)