How big a threat is monkeypox?
With a recent outbreak of monkeypox confirmed, we would like to share the following information with our members.
What is monkeypox?
Monkeypox is a rare disease that’s caused by infection with monkeypox virus, a member of the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus, which causes smallpox. Monkeypox is endemic (or naturally occurring) in countries from central and western Africa.
Transmission
Monkeypox virus can be transmitted to a person upon contact with the virus from an animal (e.g. rodents and non-human primates), human, or materials (e.g. bedding, towels) contaminated with the virus. Person-to-person transmission of the virus is through close contact. Entry of the virus is through broken skin, respiratory tract, or the mucous membranes (eyes, nose or mouth). In the current outbreak, cases of possible transmission through sexual contact have been reported.
The incubation period of monkeypox is usually between 6 to 14 days, but can also range from 5 to 21 days. A person is contagious from the onset of the rash/lesions through the scab stage. Once all scabs have fallen off, a person is no longer contagious.
Symptoms
Monkeypox starts with fever, intense headache, lymphadenopathy (swollen lymph nodes), back pain, myalgia (muscle aches) and intense asthenia (lack of energy). The skin eruption usually begins within one to three days of appearance of fever. The rash tends to be more concentrated on the face and extremities (palms of the hands and soles of the feet in 75% of cases) rather than on the upper body. Also affected are oral mucous membranes, genitalia and eyes (conjunctivae and cornea). The rash evolves sequentially from macules (lesions with a flat base) to papules (slightly raised firm lesions), vesicles (lesions filled with clear fluid), pustules (lesions filled with yellowish fluid), and crusts which dry up and fall off.
Treatment
Monkeypox is usually mild and most people recover within a few weeks without treatment. Suspected infections should be confirmed by a healthcare provider.
Treatment is supportive (e.g. non-steroidal anti-inflammatory drugs for pain and fever), as with most viral infections. There are, however, anti-viral drugs that a doctor may consider to use for treatment of more severe cases of monkeypox on a case-by-case basis.
Since the infection can spread through close contact, it’s important to isolate if you’re diagnosed.
Additional information sources
Although more people have been diagnosed with monkeypox virus recently, the numbers are small and the risk remains low. Case fatality rate is currently 3-6% in endemic countries, but no deaths were reported for non-endemic countries as of 2 June 2022.
References:
Centers for Disease Control and Prevention (CDC). Monkeypox. Last reviewed: November 23, 2021. Published on https://www.cdc.gov/poxvirus/monkeypox/about.html.
Dean Blumberg. UC Davis Children’s Hospital. Monkeypox: What you need to know about this rare virus.
Children's health. May 24, 2022. Updated: June 2, 2022
NHS. Monkeypox. last reviewed: 01 June 2022. Published on https://www.nhs.uk/conditions/monkeypox/
National Institute For Communicable Diseases Of South Africa (NICD). Monkeypox
Frequently Asked Questions. Updated May 2022. Published on https://www.nicd.ac.za/monkeypox-frequently-asked-questions/
NICD. Monkeypox preparedness. An update for Physicians, Accident & Emergency Practitioners and Laboratorians. 23 May 2022. Published on https://www.nicd.ac.za/situation-update-monkeypox/
World Health Organisation (WHO). Multi-country monkeypox outbreak: situation update. 4 June 2022. Published on https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON390.
