Houston, USA: The WHO has declared the current Monkeypox outbreak a public health emergency. As of August 9, 2022, nearly 32,000 cases have been reported globally, including in India and the United States. Various health agencies around the world are responding to contain the spread and prevent infections.
Monkeypox is caused by a virus that is much more difficult to contract from person to person. Monkeypox is part of the genus Orthopoxvirus, which includes the virus that causes smallpox. Although the risk of contracting monkeypox is low, this infection is a public health problem whose burden can be reduced through good practices.
Q1. How is monkeypox spread? Monkeypox virus is usually spread through direct contact with respiratory secretions, such as mucus or saliva, or skin lesions (eg, sexual contact). Some very common occurrences include air travel, large gatherings, and sex with multiple partners.
Q2. Who is at risk of contracting Monkeypox? Anyone who has prolonged and close contact with an infected person is at risk. The virus can be spread through close skin-to-skin contact. Although monkeypox can be transmitted during sexual activity (in young men and adults), it is not considered a sexually transmitted infection (STI) because it can be contracted from other sources. Common modes of transmission include close contact with infected people or contaminated items used in offices, restaurants and parties.
Q3. What are the symptoms of monkeypox? Symptoms of monkeypox are similar to symptoms of smallpox, but milder. The incubation period for monkeypox is around 7 days and symptoms develop within 17 days. Most patients have mild “flu-like” symptoms with fever, malaise, headache, and fatigue, often with swollen lymph nodes. Skin lesions appear after infection as a rash with small, firm or “rubbery” pimples on the face, mouth, eyes, hands, or genitals. In addition to pain in the anorectal and sexual regions, sore throat and tonsillitis have also been reported.
Q4. How to prevent the spread of infection? With good personal hygiene, the risk of transmission of monkeypox is low. Patients with suspected or confirmed monkeypox infection should be masked immediately, have lesions covered with a sheet and placed in isolation. They should avoid close contact with others until the skin lesions have completely healed, which may take several weeks.
Q5. Are there tests for Monkeypox? Screening for monkeypox is limited; thus, individual diagnosis, containment and prevention are difficult. Any unusual “skin lesions” on the face, mouth, hands and genitals, especially in the anogenital area, should be investigated. As with smallpox, people infected with monkeypox should remain in isolation for the duration of the illness, which typically lasts 2-4 weeks.
Q6. What is the current treatment for Monkeypox? For most patients, monkeypox is not life threatening. Mortality is rare. Treatment is symptomatic, including analgesics. Currently, there are no approved antivirals for monkeypox. Tecovirimat, a smallpox drug, is being studied for severe illness or cases with comorbid risk factors. This drug is available under an expanded access or “compassionate use” program from the FDA.
Currently, 2 vaccines can be used to prevent monkeypox: JYNNEOS vaccine (FDA approved for smallpox and monkeypox) and ACAM2000 (approved only for smallpox but with expanded access for use against monkeypox ). Both vaccines can be administered for post-exposure prophylaxis up to 4 days after exposure.
The virus is not transmitted by casual contact. Research is ongoing on the potential spread of monkeypox airborne and respiratory droplets. Overall, good hygiene and healthy lifestyle habits (such as those learned from COVID-19) can protect people from viral illness.
Dr. Samba Reddy (USA)