Ten Things to Know About Monkeypox

Peaceful Hawaii ocean. (Dr. Noorali Bharwani)
Peaceful Hawaii ocean. (Dr. Noorali Bharwani)

In July, the World Health Organization (WHO) classified the escalating outbreak of the once- rare disease (monkeypox) as an international emergency. The outbreak marked the first time monkeypox has spread widely outside Central and West Africa.

The initial cluster of cases was found in the United Kingdom, where the first case was detected on 6 May 2022 in an individual with travel links to Nigeria. Since then, more than 18,000 people across 78 countries have been infected with monkeypox virus. So far, only five people have died, and no one outside of Central and West Africa.

1. What is monkeypox?

Monkeypox is a viral infection that manifests a week or two after exposure with fever and other non-specific symptoms. Then it produces a rash with lesions that usually last for two to four weeks before drying up, crusting and falling off.

Monkeypox belongs to the family of poxviruses, which includes smallpox. The disease got its name after scientists discovered it among laboratory monkeys in 1958. The first monkeypox case in a human was diagnosed in 1970.

2. Who is getting monkeypox?

According to WHO officials 99 per cent of all the monkeypox cases beyond Africa were in men and that of those, 98 per cent involved men who have sex with men. Experts suspect that monkeypox outbreaks in Europe and North America were ignited by sex at two raves in Belgium and Spain. Cases have emerged in other groups too, including few children.

3. Is this another pandemic?

No, this is not a pandemic (prevalent over a whole country or the world). Monkeypox has been endemic (prevalent in a particular area) for decades in parts of central and west Africa, where people have mostly been sickened after contact with infected wild animals like rodents and squirrels.

4. How does it spread?

Monkeypox spread typically requires skin-to-skin or skin-to-mouth contact with an infected patient’s lesions. People can also be infected through contact with the clothing or bedsheets of someone who has monkeypox lesions.

5. What are the signs and symptoms of monkeypox?

Fever, swollen lymph nodes, and a rash that forms blisters and then crusts over. The time from exposure to onset of symptoms ranges from five to twenty-one days. The duration of symptoms is typically two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.

6. How is it diagnosed?

The U.S. Food and Drug Administration is advising people to use swab samples taken directly from a lesion (rash or growth) when testing for the monkeypox virus.

7. Is there a vaccine?

IMVAMUNE vaccine has been authorized by Health Canada for active immunization against smallpox, monkeypox and related orthopoxviral infection.

With supplies limited, health officials are not recommending mass vaccination. They are suggesting the shots for health workers, people who have been in close contact with an infected person, and men at high risk of catching monkeypox.

8. Prevention

Prevention is always better than treatment. Get vaccinated. Maintain good hand hygiene and respiratory etiquette, including wearing a mask or covering coughs, along with limiting sexual partners and practising safer sex. Anyone with monkeypox lesions should isolate until they are completely healed, which can take up to three weeks.

9. What is the treatment?

There is no known cure. A study in 1988 found that the smallpox vaccine was around 85 per cent protective in preventing infection in close contacts and in lessening the severity of the disease.

Other measures include regular hand washing and avoiding sick people and animals.  Antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin may be used during outbreaks.

10. What is the prognosis?

The illness is usually mild and most of those infected will recover within a few weeks without treatment. Estimates of the risk of death vary from one per cent to 10 per cent.

Monkeypox can be serious in children, pregnant women and people with underlying health conditions, like cancer, tuberculosis or HIV.

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