The World Health Organization (WHO) has declare Monkeypox a global health emergency . Monkeypox is not a new disease but in some African countries it is endemic. The WHO declared it a global emergency after the international breakout of the disease.
MONKEYPOX; CURRENT OUTBREAK
The disease was reported from ten countries in non-endemic areas in May 2022. , cases were reported in more than 10 countries Additional cases are being investigated. The WHO says that since January 1 and as of June 22, 2022, 3413 confirmed cases and one death have been reported from 50 countries/territories in five WHO Regions. It said that majority of confirmed cases (2933/3413; 86%) were reported from the WHO European Region. Other regions reporting cases include: the African Region (73/3413, 2%), Region of the Americas (381/3413, 11%), Eastern Mediterranean Region (15/3413, <1%) and Western Pacific Region (11/3413, <1%). One death was reported in Nigeria in the second quarter of 2022.
WHAT IS MONKEYPOX?
Monkeypox is a zoonotic viral disease, which means it can be transmitted from animals to humans. It can also pass from human to human. Monkeypox in humans was first detected in 1970 in the Democratic Republic of the Congo (DRC) in a 9-month-old boy. The symptoms are similar to smallpox patients, but it is clinically less severe. The first Monkeypox outbreak outside Africa was reported in the United States in 2003 and was linked to contact with infected pet prairie dogs.
Despite the name, most of the animals susceptible to contracting the disease, and then infecting people, are rodents. This includes Gambian giant rats, dormice, or tree squirrels.
MONKEYPOX; WHERE IS IT TYPICALLY FOUND?
It is mostly found in the rain forests of central and western Africa,. In these countries, it is increasingly appearing in urban areas. On occasion, it can also be found elsewhere, in people who could have been infected after visiting these countries.
Fever, severe headache, muscle aches, back pain, low energy, swollen lymph nodes, and skin rashes or lesions are some of the usual symptoms.
Rashes usually start on the first or third day of the onset of fever. The lesions may be flat or slightly raised, filled with clear or yellowish fluid, then crust over, dry up, and fall off.
The number of lesions varies, from a few to several thousand. The rash tends to appear on the face, the palms of the hands, and the soles of the feet. They can also be found in the mouth, genitals, and eyes.
MONKEYPOX; WILL PEOPLE DIE?
In majority of the cases, the symptoms go away on their own within a few weeks. However, in between three and six per cent of cases reported in countries where it is endemic, it can lead to medical complications and even death. New-born babies, children, and people with immune system deficiencies may be at risk of more severe symptoms and death from the disease.
In severe cases, symptoms include skin infections, pneumonia, confusion, and eye infections that can lead to vision loss.
Many of the fatal cases are children or people who may have other health conditions
The virus may spread when people come into physical contact with infected animals, which include rodents and primates. The risk of contracting it from animals can be reduced by avoiding unprotected contact with wild animals. It is better to avoid sick or dead animals (including contact with their flesh and blood).
Any food containing meat or animal parts should be cooked, especially in countries where Monkeypox is endemic. The virus is spread through physical contact with someone who has symptoms. Rashes, body fluids (such as fluids, pus, or blood from skin lesions), and scabs are particularly infectious.
Ulcers, lesions or sores can also be infectious since the virus can be spread through saliva. Contact with objects that have been in contact with the infected person – such as clothing, bedding, towels – or objects such as eating utensils can also represent a source of infection.
People who have the disease are contagious while they have symptoms (usually within the first two to four weeks). It is not clear whether or not people who are asymptomatic can transmit the disease.
MONKEYPOX; WHO IS AT RISK?
Anyone who comes into physical contact with someone with symptoms or an infected animal, is at increased risk of infection. The people who live with infected people have a high risk of infection. Health workers, by the very nature of their job, are at risk of exposure.
Children are often more likely to have severe symptoms than teens and adults.
The virus can also be transmitted from a pregnant woman to the foetus through the placenta. It can alo pass through contact of an infected parent with the child, during or after delivery, through skin-to-skin contact.
MONKEYPOX; HOW CAN I PROTECT MYSELF AND OTHERS?
The transmission of the virus can be restricted by limiting contact with people suspect of having disease, or are confirmed cases.
Those who live with infected people should encourage them to self-isolate. If possible, cover any breaks in the skin (for example, by wearing clothing over the rash). Wearing a face mask is good when in close proximity to infected person. This is good if they are coughing or have mouth sores, and when touching the clothing/bedding of an infected person. Avoid skin-to-skin contact by wearing disposable gloves.
Wash hands frequently with soap and water or use an alcohol-based hand sanitizer, especially after coming into contact with the infected person, with their clothing (including sheets and towels), or touching other items or surfaces (such as utensils or dishes) that may have come into contact with rashes or respiratory secretions.
Clean and disinfect any contaminated surfaces and dispose of contaminated waste (such as dressings) properly. Wash the infected person’s clothing, towels, sheets, and eating utensils with warm water and detergent.
MONKEYPOX; WHAT TO DO IF SUSPECT HAVING INFECTED?
If you think your symptoms might be related to Monkeypox, or if you have had close contact with someone who has these symptoms, or suspects that there is a possibility of being infected, notify the doctor immediately.
Isolate at once from others and avoid close contact with other people. Wash hands frequently.
MONKEYPOX; IS THERE A VACCINE?
Several vaccines, developed for prevention of smallpox, also provide some protection for Monkeypox. A smallpox vaccine (MVA-BN, also known as Imvamune, Imvanex, or Jynneos) was recently developed and approved in 2019 for use in preventing Monkeypox. But it is not yet widely available.
The World Health Organization (WHO) is working with the manufacturer of the vaccine to improve access to it.
MONKEYPOX; IS THERE ANY TREATMENT?
Symptoms often go away on their own without the need for treatment. Better to let the rash dry. If possible cover it with a moist bandage if necessary to protect the area.
Avoid touching any eye or mouth sores. Mouthwashes and eye drops can be used as long as products containing cortisone are avoided.
For severe cases, an antiviral agent known as tecovirimat, that was developed for smallpox, was licensed by the European Medicines Agencyfor Monkeypox in 2022, based on data in animal and human studies. It is not yet widely available.
MONKEYPOX; BIGGER OUTBREAK?
The disease is generally not considered highly contagious as it requires close physical contact with someone who is contagious. The risk to public is low.
However, the WHO has given high priority to prevent further spread.
MONKEYPOX; SEXUALLY TRANSMITTED?
The virus spread from one person to another through close physical contact, including sexual contact. However, it is not known if the disease can be spread through sexual transmission. But direct skin-to-skin contact with lesions during sexual activities can spread the virus.
Rashes can sometimes appear on the genitals and in the mouth, which probably contributes to transmission during sexual contact. Therefore, mouth-to-skin contact could cause transmission when there are lesions in one of these parts.
The rashes can also resemble some sexually transmitted diseases, such as herpes and syphilis.
The WHOsaid on July 26, 2022, that the rapidly spreading Monkeypox outbreak can be stopped “with the right strategies in the right groups”.
But “time is going by and we all need to pull together to make that happen”, warned Dr Rosamund Lewis, WHO Technical Lead on Monkeypox,
She pointed out that stigma and discrimination must be avoided, as that would harm the response to the disease. “At the moment the outbreak is still concentrated in groups of men who have sex with men in some countries, but that is not the case everywhere,” she said. “It is really important to appreciate also that stigma and discrimination can be very damaging and as dangerous as any virus itself,” she said.
Lewis explained that some 16.4 million vaccines were currently available in bulk but needed to be finished. The countries currently producing vaccines are Denmark, Japan, and the United States.
She reminded that the current recommendation for persons with Monkeypox was to isolate and not travel until they recovered. She said that contact cases should be checking their temperature frequently. They should also monitoring possible other symptoms for the period of 9 to 21 days.
“When someone is vaccinated it takes several weeks for the immune response to be generated by the body”, she said.
WHO Director General Tedros Adhanom Ghebreyesus said that Monkey Pox affected the most in Europe and the Americas. He said that the two regions reported 95 per cent of the diagnosed cases. When Europe reported 70 per cent cases, Americas recorded 25 per cent.