Horrific days of COVID-19 are still fresh in our memory as many of us lost family members, friends, and close acquaintances to the global pandemic. The psychological toll on humanity was even greater, as the mandatory physical distancing regulations brought social life to a complete halt. The recent declaration of Monkeypox as a public health emergency of international concern (PHEIC) by the World Health Organisation (WHO) has revived that nightmare worldwide.
This article discusses everything you need to know about Monkeypox to stay safe and informed about the potential global threat.
What is Monkeypox?
Monkeypox or Mpox, as preferred by WHO, is an infectious zoonotic disease, as the virus was first observed among a few species of monkeys and terrestrial rodents. Physicians and scientists, for the first time, identified the disease among humans in the DRC or Democratic Republic of the Congo in 1970. The monkeypox virus MPXV with a double-stranded DNA is responsible for the infection and mammals are common hosts of this virus. The genus of the Mpox virus is similar to smallpox, cowpox and horsepox.
Based on the genome sequence, Mpox virus can be of 2 distinct categories:
- clade-I (subcategories are clade-Ia and Ib)
- clade-II (subcategories are clade-IIa and IIb)
For a long time, Mpox was endemic to West and Central Africa. Out of these 2 categories, as per WHO data, a global outbreak of Clade-II type Mpox virus can be traced back to 2022.
As of August 2024, scientists are also detecting cases related to viruses of the Clade-Ia and Ib subcategories.
As of 18th September 2024, the second case of Mpox was officially detected in Kerala, India. Several Mpox cases have also been reported in Southeast Asian countries, like
- Thailand
- Philippines
- Sri Lanka
- Indonesia
- Pakistan
What are the symptoms?
Symptoms of Monkeypox can appear within the first week of the infection. However, physicians reported several cases in which signs and symptoms became visible as much as three weeks after exposure to an infected person.
Common symptoms of Mpox include:
- A bad rash
- Sore throat
- Muscle ache
- Headache
- Ebbing energy level
- Back pain
- Swelling in lymph nodes
- Fever
Rashes, in cases of Mpox, can take the form of bumps, blisters or a red spot. The number of rash sores can reach hundreds for a young adult. Sores can be visible in several areas, such as:
- Face
- Palms
- Soles
- Groyne
- Anus
- Genital
- Mouth
- Eyes
- Throat
How does the disease spread?
According to the recent WHO guidelines, Mpox can be transmitted in 3 ways:
- Human to human
- Human to animal
- Animal to human
Human to human—Mpox spreads through close contact, such as touching body parts, kissing, sexual intercourse with, or breathing in proximity to an infected person. According to several scientific observations, the Mpox virus can survive on the surface of everyday-use objects, like linens, bedding, and other household items that have been used by someone who’s infected. Any contact with these affected objects can be the starting point for the infection.
This virus can still spread, regardless of whether the symptoms are visible.
Mpox can also be transmitted to the fetus through the mother during pregnancy. The chances of babies and children getting infected by parents are quite high, based on existing reports.
Human to animal – Mpox is a virus of the Orthopoxvirus genus. So, many animal species are vulnerable to infection from this virus when coming in close contact with infected humans. These infected animals can further increase the transmission of the virus among humans.
Animal to human – Mpox is a zoonotic disease. Exposure to infected animals during hunting, trapping or skinning might cause infection. Animal bites, scratches or open wounds on a person’s body, coming in contact with an infected animal can cause Mpox. Other reasons behind the infection can be not washing hands with soap after handling contaminated meat and eating semi-cooked meat of Mpox-infected animals.
Can it be deadly?
According to recent data, mortality and morbidity from Mpox infection varies widely from country to country depending on the categories and subcategories of the virus. Clade-Ia proves to be more deadlier. Registered cases of death after infection range from 1% to 10% across countries. Infection from Clade-Ia happens mostly through animal-human interaction and has been mostly recorded in forested areas of DRC and other African countries.
However, we cannot ignore the high human-animal interaction in forested areas, and the lack of reliable and timely medical interventions in remote locations may also have contributed to higher mortality numbers.
Medical data from other parts of the world shows that recovery from Mpox may significantly vary from person to person, but it usually ranges from 2 to 4 weeks.
Other than clades of the infecting virus, the severity of Mpox depends on many factors, such as:
- Timely access to good healthcare
- Natural immunity response of the infected person
- Ongoing use of immuno-suppressant medicines
- Cases of advanced-stage HIV
How to diagnose Mpox?
Symptoms of Mpox infection can be like those of other viral and non-viral infections, such as chickenpox, measles, syphilis, herpes, and bacterial skin infections. So, it becomes difficult to distinguish Mpox symptoms. The best bet is an external inspection.
As per WHO guidelines, lab testing is the most effective means of Mpox diagnosis, and the detection of Mpox DNA by PCR is the preferred lab test. In this test, lab technicians collect skin, fluids and crust samples from the rashes on the body. When there is no visible body rash, throat or anal swabs can substitute for PCR testing.
Undertaking an HIV test is a standard protocol in case of a severe Mpox infection.
What is the treatment?
Treatments for Mpox-infected patients are usually symptomatic care, such as caring and attending to rashes, pain and other complications. After a thorough medical evaluation, a qualified physician may prescribe antiviral drugs (used in treating chickenpox) to cure severe Mpox-related conditions. HIV patients should continue their antiretroviral therapy if infected with Mpox.
Is there any vaccine for Monkeypox?
Yes, vaccines for Mpox exist. The WHO has already recommended several vaccines, such as MVA-BN, LC16, or ACAM2000, for protection against Mpox infection.
Many of them are approved in several countries. For example, MVA-BN is being used in North America, the EU, and Singapore to treat smallpox in persons with compromised immunity. The ACAM2000 vaccine is FDA-approved and is prescribed to people of any age group against smallpox.
However, unlike the COVID-19 virus, the WHO is not in favor of mass vaccination against Mpox at this moment. Instead, they recommend vaccination of individuals who are at high risk of being infected. For example, travelers to regions with significant Mpox outbreaks and others whom physicians have approved after individual Mpox risk assessments can get vaccinated.
How to self-care to prevent Mpox infection?
- Wear masks during in-person interactions.
- Wash hands with soap or disinfectants if you are in contact with a body rash or open wounds.
- Keep lesions and rashes covered while meeting people
- Rinse mouth with salt water regularly
- Avoid contact with potentially contaminated surfaces
- Avoid touching dead and diseased animals
- Do not scratch any rashes or lesions
- Contact doctors if you suspect potential exposure to an infected person
Conclusion
WHO has declared Mpox a global public health emergency, which means countries must take the strongest public health interventions to avoid an epidemic outbreak. The Mpox outbreak has been rapid in European countries recently. International travel has already reached pre-COVID levels. Spreading the infection to other countries and regions faster can make the situation worse. So, it is our responsibility to adopt preventive practices and follow WHO guidelines.
However, worry not! We have already defeated similar viral infections, like smallpox, which played on humanity for centuries. With better medical interventions and scientific solutions in our arsenal, this time, we are better prepared.
FAQ
Is Monkeypox deadly?
An infected person can recover from Monkeypox, often requiring no major medical interventions. However, in some cases, infection can become severe and, without timely healthcare and medication, it can even lead to death.
Can it reach the level of the Covid pandemic?
Mpox may not reach the severity of the Covid pandemic for several reasons:
- Physicians and scientists have been reporting and researching Mpox-like viruses for quite a long time. We are scientifically much more aware of its transmission characteristics and weaknesses. Comparatively, the understanding of the COVID-19 virus was minimal.
- The genetic and physical construct of Mpox is similar to those of other pox viruses, such as smallpox, cowpox, and horsebox. Effective vaccines for similar viruses are widely available across countries.
- The COVID pandemic improved countries’ healthcare infrastructure preparedness against public health emergencies.
However, despite these advantages, the mass adoption of preventive measures is important. Any lack on that front can make the situation vulnerable.
How many cases have been reported in India?
As of 18th September 2024, 2 cases of Mpox infection have been reported in India.
