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Monkeypox is caused by the Orthopoxvirus, which is related to the smallpox family of disorders native to the African continent. However, this virus has recently spread throughout Africa and to some countries in Europe.
Monkeypox (mpox)is capable of human-to-human transmission through contact with secretions containing the virus, which can originate from the respiratory system, wounds, or contaminated objects, while infection via prolonged exposure to aerosol particles is also possible.
Dr Orlando Thomas, medical doctor and functional medicine practitioner at Thomas Medical and Shockwave Centre, said the disease can cause a painful rash, enlarged lymph nodes and fever. Most people, he said, fully recover, but some get very sick.
“Anyone can get mpox. It spreads from contact with infected persons, through touch, kissing or sex; animals, when hunting, skinning, or cooking them; materials, such as contaminated sheets, clothes or needles; and pregnant persons, who may pass the virus on to their unborn baby,” Dr Thomas said.
The monkeypox virus was discovered in Denmark (1958) in monkeys kept for research, and the first reported human case of mpox was a nine-month-old boy in the Democratic Republic of the Congo (DRC, 1970). Mpox can spread from person to person or, occasionally, from animals to people.
Following eradication of smallpox in 1980 and the end of smallpox vaccination worldwide, mpox steadily emerged in Central, East and West Africa. A global outbreak occurred in 2022 and 2023. The natural reservoir of the virus is unknown, while various small mammals such as squirrels and monkeys are susceptible.
“Person-to-person transmission of mpox can occur through direct contact with infectious skin or other lesions, such as in the mouth or on genitals; this includes contact which is face-to-face, skin-to-skin, mouth-to-mouth, mouth-to-skin contact, respiratory droplets or short-range aerosols from prolonged close contact,” Dr Thomas said.
“The virus then enters the body through broken skin, mucosal surfaces (oral, pharyngeal, ocular, genital, anorectal), or via the respiratory tract. Mpox can spread to other members of the household and to sex partners. People with multiple sexual partners are at higher risk,” he added.
Animal-to-human transmission of mpox occurs from infected animals to humans from bites or scratches, or during activities such as hunting, skinning, trapping, cooking, playing with carcasses, or eating animals. The extent of viral circulation in animal populations is not entirely known and further studies are under way.
People can contract mpox from contaminated objects such as clothing or linens, through sharps injuries in healthcare, or in community setting such as tattoo parlours.
“Mpox causes signs and symptoms which usually begin within a week but can start one to 21 days after exposure. Symptoms typically last two to four weeks, but may last longer in someone with a weakened immune system. Common symptoms of mpox are rash, fever, sore throat, headache, muscle aches, back pain, low energy and swollen lymph nodes,” Dr Thomas said.
For some people, the first symptom of mpox is a rash, while others may have different symptoms first. The rash begins as a flat sore which develops into a blister filled with liquid and may be itchy or painful. As the rash heals, the lesions dry up, crust over and fall off.
Some people may have one or a few skin lesions, and others have hundreds or more. These can appear anywhere on the body, such as the palms, soles of the feet, face, mouth and throat, groin and genital areas, and anus.Some people also have painful swelling of their rectum or pain and difficulty when peeing.
People with mpox are infectious and can pass the disease on to others until all sores have healed and a new layer of skin has formed. Children, pregnant women and persons with weak immune systems are at risk for complications from mpox.
Identifying mpox can be difficult, as other infections and conditions can look similar. It is important to distinguish mpox from chickenpox, measles, bacterial skin infections, scabies, herpes, syphilis, other sexually transmissible infections, and medication-associated allergies. Someone with mpox may also have another sexually transmissible infection such as herpes. Alternatively, a child with suspected mpox may also have chickenpox. For these reasons, testing is key for people to get treatment as early as possible and prevent further spread.
If you have mpox, tell anyone you have been close to recently, stay at home until all scabs fall off and a new layer of skin forms, cover lesions and wear a well-fitting mask when around other people and avoid physical contact.
“The smallpox vaccine is approximately 85 per cent effective in helping to prevent a monkeypox infection.The goal of treating mpox is to take care of the rash, manage pain, and prevent complications. Early and supportive care is important to help manage symptoms and avoid further problems,” Dr Thomas said.
KEY FACTS:
• Mpox (monkeypox) is a viral illness caused by the monkeypox virus, a species of the genus Orthopoxvirus. Two different clades exist: clade I and clade II.
• Common symptoms of mpox are a skin rash or mucosal lesions which can last two to four weeks accompanied by fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.
• Mpox can be transmitted to humans through physical contact with someone who is infectious, with contaminated materials, or with infected animals.
• Laboratory confirmation of mpox is done by testing skin lesion material by PCR.
• Mpox is treated with supportive care. Vaccines and therapeutics developed for smallpox and approved for use in some countries can be used for mpox in some circumstances.
• In 2022–23, a global outbreak of mpox was caused by a strain known as clade IIb.
• Mpox can be prevented by avoiding physical contact with someone who has mpox. Vaccination can help prevent infection for people at risk.
SOURCE: World Health Organization, Ministry of Health and Wellness
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