Monkey Pox Disease Outbreak
29.08.2022
Monkey pox is a an ongoing disease outbreak which was initially confirmed in May 2022. The first cluster of cases were identified in the United Kingdom, and the first case was confirmed on the 6th of May, in an individual who had recently travelled to Nigeria.
What is this virus? How did this virus come about? How is it transmitted? What symptoms and signs should I watch out for? Who is at risk? What can I do to prevent infection?
The monkeypox disease is a viral disease caused by the monkeypox virus, a type of pox virus closely related with smallpox virus. It is primarily a zoonotic disease since rope squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates and other species are hosts for the virus. The origin of the virus ties in well with the history of vaccines. Like most great discoveries, the discovery of vaccines was a combination of accident and impressive observation. It was in the early times when the first smallpox outbreaks started; then Edward Jenner found out that people who suffered from cowpox were either protected from smallpox infection or experienced less significant symptoms. He then injected people with cowpox virus to prevent them from infection with smallpox virus; it was crude but it worked!
With the elimination of smallpox in most countries by 1980s, the reduction in vaccination efforts is what led to the emergence of the monkeypox virus. However, it was not a global health problem as it was localised in west and central Africa. It wasn’t until 2003 that the first monkeypox outbreak outside of Africa occurred. The outbreak began in the United States of America and was linked to contact with infected pet prairie dogs. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country from Ghana. There have been many cases in the American and European region linked to travellers coming from African countries. In May 2022, multiple cases of monkeypox were identified in several non-endemic countries like the United Kingdom, Spain and Canada.
The World Health Organisation (WHO) has consequently tagged this outbreak as a Public Health Emergency of International Concern because cases of monkeypox have been reported in 93 Member States across all 6 WHO regions. As of August 17 2022, a total of 37,736 laboratory confirmed cases and 179 probable cases, including 12 deaths, have been reported.
There are many routes of transmission of the monkey pox virus. In places that have host animals, infection can occur by direct contact with the blood, bodily fluids and cutaneous or mucosal lesions of infected animals. Similar to Smallpox, Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated things like a mother’s placenta. When infected, the incubation period of the virus is highly variable but generally ranges from 5 to 21 days. Clinical presentations are similar to flu but more intense, in addition, specific features such as lymphadenopathy and painful skin eruptions characterise monkeypox disease. The appearance of the skin eruptions is highly variable depending on the skin, complexion, severity of infection, age etc. They generally appear as bumps, then evolve to a volcano-looking erosion of the skin which crusts with time.
Monkey pox is a self limiting disease, and complications such as secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea with ensuing loss of vision can occur. There is also risk of more severe infection in younger children and immunocompromised individuals particularly people living with HIV/AIDS, men who have sex with men, health workers and immune-compromised individuals. Although there are no specific treatments for monkeypox virus infection, anti-viral drugs used to protect against smallpox may be effective in treating or preventing monkeypox due to the genetic similarity of the two viruses.
Prevention begins with an understanding of the monkeypox disease, and that is the aim of this article. It is also important to cut down on any links to human transmission whether from animals, humans or infected objects. This would involve avoiding rodent meat or cooking meat properly before consumption and wearing masks when necessary. The US Centres for Disease Control and Prevention (CDC) and Public Health Agency of Canada (PHAC) recommend the following:
- Stay at home and isolate if you suspect symptoms
- Maintain good hand hygiene
- Clean and disinfect high touch surfaces
- Practice safe sex
- Prevent travel to high risk countries