By: Dr Badreyya Al-Harmi, Consultant Public Health, Emirates Public Health Association
Monkeypox, also known as “Simian Pox,” is a rare disease caused by the Monkeypox virus, which belongs to the Orthopoxvirus genus within the Poxviridae family.
Although less severe than smallpox, monkeypox affects various age groups. The disease is classified into two types:
– The First Type spreads in West Africa, though its transmission between humans is limited and typically occurs through direct contact.
– The Second Type spreads in Central Africa (The Democratic Republic of the Congo) causing more severe symptoms and higher mortality rates than the West African type and is more easily transmissible.
The History of Monkeypox
Monkeypox was first identified in 1958 when two outbreaks of a pox-like disease occurred among laboratory monkeys.
The first human case was diagnosed in 1970 in the Democratic Republic of the Congo, involving a seven-year-old child infected through contact with wild animals and rodents.
Since then, small outbreaks have been periodically reported in a few African countries. However, a global outbreak of Monkeypox occurred between 2022 and 2023, spreading to non-endemic countries in Europe, the Americas, and East Asia due to travel or imported animals.
Modes of Transmission
The Monkeypox virus commonly spreads from person to person through:
– Direct Contact: Physical contact with an infected person, including touching, kissing, or sexual contact, as well as contact with their skin lesions or bodily fluids.
– Animal Contact: Close contact with infected animals, such as monkeys or rodents (like rats and squirrels), through bites, scratches, or exposure to their blood, secretions, or open wounds during hunting, skinning, cooking, or consuming raw meat.
– Contaminated Surfaces and Objects: Touching surfaces and items contaminated with the virus, such as clothing, bedding, or contaminated needles.
– Mother-to-Child Transmission: The virus can be transmitted from an infected mother to her child during pregnancy or after birth.
Symptoms of Monkeypox
Symptoms usually appear within a week of exposure but can range from one to 21 days. They typically last between two to four weeks and are divided into two stages:
– Stage 1 (First Five Days): Initial symptoms include fever, headache, fatigue, and muscle aches, followed by swollen lymph nodes—a key symptom distinguishing monkeypox from smallpox, which does not cause lymph node swelling.
– Stage 2 (After Five Days): A rash develops, starting on the face and spreading to other body parts, including the palms, soles, and genital area. The rash begins as red spots and sores that evolve into fluid-filled blisters, causing itching and pain. Over time, these blisters dry up, scab over, and eventually fall off.
It is important to note that not all patients exhibit all symptoms. Infected individuals can spread the virus to others until all scabs have healed and new skin has formed.
Complications of Monkeypox
Children, pregnant women, and immunocompromised individuals are at higher risk for complications, which may include:
– Pneumonia
– Encephalitis
– Blood infections
– Nervous system infections
– Vision loss due to eye infections
– Severe dehydration or malnutrition from difficulty swallowing, vomiting, or diarrhoea
– In rare cases, death
Diagnosis
Diagnosis is made through a clinical examination by a specialist who can distinguish monkeypox from other types of pox diseases by observing swollen lymph nodes. Laboratory tests are also conducted to confirm the type of virus causing the disease.
Treatment
Most people with monkeypox recover within two to four weeks. However, some may develop severe complications. Currently, there is no specific treatment for monkeypox. The primary goal of care is to manage symptoms, alleviate pain, and prevent complications and the spread of the disease. Recommendations for those infected include:
– Isolating the infected person throughout the infectious period
– Regular hand washing
– Wearing masks and covering the nose and mouth when coughing or sneezing
– Covering skin lesions until they heal
– Avoiding contact with immunocompromised individuals, children, and pregnant women
– Maintaining cleanliness of surfaces and objects
– Avoiding opening blisters or sores to prevent the rash from spreading to other body parts
Prevention
- Avoid direct physical or sexual contact with infected individuals.
- Avoid contact with infected animals.
- Wash hands regularly.
- Wear gloves and masks when caring for infected individuals.
- Disinfect surfaces and objects that may carry the virus.
- Use personal protective equipment (PPE) for healthcare workers at risk of exposure.
- Obtain vaccination to prevent infection among those at risk.
