Monkeypox: Symptoms, Causes, Treatment & Prevention

What is monkeypox? It is a rare disease caused by the monkeypox virus. It belongs to the family of viruses which include the ones that incur smallpox and cowpox virus. It is not, however, related to chickenpox. This virus was first discovered in 1958, which occurred in colonies of monkeys. Most cases were linked to central and western African countries. Persons infected with monkeypox have symptoms similar to those seen in smallpox patients, but it can be assumed to be clinically less severe.

Animal hosts of the virus primarily include rodents and primates, such as squirrels, rats and dormice. As of mid-June 2022, approximately 3,000 laboratory confirmed cases and 1 death has been reported to WHO from 50 countries. 

Symptoms of Monkeypox

Swollen lymph nodes caused by monkeypox

For persons afflicted with the monkeypox virus, it usually takes about 1 – 2 weeks before signs and symptoms emerge. According to World Health Organization (WHO), the infection can be divided into two phases:

Phase 1: Otherwise viewed as the invasion period, the initial signs are indicated by:

• Fever
• Intense headache
• Swelling of the lymph nodes
• Back pain
• Muscle aches
• Lack of energy

Experiencing the swelling of the lymph nodes is a particularly distinctive feature compared to other illnesses that may begin similarly (i.e. chickenpox and measles).

Phase 2: Later, the skin is marked by changes such as rashes. Based on the observation in afflicted persons, the rash tends to be more concentrated on the face area, palms of the hands, and soles of the feet. The flat, red bumps turn into blisters, filled with pus. Eventually, the blisters will crust over and fall off.

Causes of Monkeypox

How can monkeypox be caught? It is typically spread if a person gets in close contact with an infected animal or person. Transmission from animals may take place through:

• Broken skin (i.e. bites and scratches)
• Blood
• bodily fluids
• Sores

Example of monkeypox rashes

Meanwhile, it is less common for monkeypox to spread from person to person. This only occurs if you come into direct contact with rashes, scabs, bodily fluids or in close, intimate situations with the infected person such as kissing or prolonged hugging. Contaminated materials such as clothing and bedding may be a potential source of transmission as well.

Risk Factors and Monkeypox Survival Rates

While anyone may get monkeypox (should the virus be present in the community), there are some people groups that are more susceptible to the disease. For instance, most cases in Africa are among children under 15 years old. Meanwhile, outside of Africa, a significant portion of cases reside with men who have had sex with other men. On an overall basis, a person with low immune system would also be significantly at risk. Pregnant women may also be susceptible to the virus.

Complications may also occur during monkeypox infection. As such, these are the possible complications involved:

• Bronchopneumonia (a type of pneumonia that may cause difficulty in breathing, due to constricted airways)
• Sepsis (the body’s response to an infection – which is life-threatening)
• encephalitis, which involves the inflammation of the brain tissue
• infection of the cornea, which may lead to vision loss
• secondary infections
• in severe cases, skin falling off in large pieces when the lesions form together

Most people would recover from the disease on their own, taking about 2 – 4 weeks, depending on the severity. However, in rare cases, some people with monkeypox die (5% and less, depending on the strain involved).

Diagnosing Monkeypox

Monkeypox remains a rare disease. Therefore, your healthcare provider will carry out several diagnosis to exclude the possibilities of other rash illnesses, such as chickenpox, measles, bacterial skin infections, scabies, syphilis, and other diseases The swelling of the lymph nodes (lymphadenopathy) can be a clinical factor to distinguish monkeypox from other illnesses.

Medical History

The doctor may ask for your travel history, to estimate the risk involved in contracting monkeypox. Travels to countries which are experiencing the outbreak or have had cases of monkeypox will be considered in the assessment

Lab Testing

If the doctor suspects that you have a monkeypox infection, they will collect a sample and transport it to the laboratory for analysis. This usually involves testing the fluid from lesions or dry scabs. The virus will be checked for via a polymerase chain reaction (PCR) test.

Biopsy

This involves removing a piece of skin tissue in order to test for the virus. The samples are stored in a dry, sterile tube and kept cold.

It is necessary to note that blood tests are not recommended as the monkeypox virus does not stay in the blood for a long time. It would not be an accurate way to measure the presence of the virus. Otherwise, a person who is recently vaccinated for monkeypox or its similar illnesses may lead to false positive results, if tested via the following means.

As a solution to this, it is vital for the patient to provide the following information (wherever possible):

• When the fever began
• When the rash began
• When the specimen was collected
• What stage of rash is the individual experiencing
• Age of the individual

Other questions may follow in order to carry out an accurate diagnosis.

Treating Monkeypox

While most people with monkeypox recover on their own without treatment, there are some ways to alleviate the symptoms. Generally, it is necessary to prevent dehydration and receive antibiotics to combat secondary bacterial infections (if this occurs). Although research is being carried, as of to date, there is no approved antiviral treatment for monkeypox.

These are some remedies that can help you feel better during the infection period:

• Over-the-counter medications, for pain relievers and fever reducers
• Oatmeal baths, to relief the dry, itchy feeling that skin rashes give
• Covering lesions to limit spreads to others and into the environment
• Wearing a mask and drinking plenty of fluids

In addition, if you are infected, it is highly advised to isolate to avoid contact with other persons and pets (especially rodents). Since there is no current cure, prevention is required in order to prevent any possible outbreaks with the monkeypox virus.

Monkeypox Prevention and Vaccination

The prevention of monkeypox may be sufficiently effective with taking the smallpox vaccination. This is due to the fact that monkeypox is caused by a similar virus to smallpox.

Otherwise, these are some useful hygiene measures to take to reduce risk of getting monkeypox:

• Wash your hands thoroughly with soap and water whenever possible. If not, wash using an alcohol-based hand sanitiser. This is crucial, especially in situations such as eating, using the bathroom, and handling laundry.
• Clean surfaces that have been frequently touched. This would include door handles, devices, tabletops and other common touch areas.
• Handle soiled laundry with care, by wearing gloves to prevent direct contact. Wash the affected clothes with sufficient detergent.
• Avoid sharing cutleries and toiletries. Always clean affected eating utensils with hot water and soap.

When To See A Doctor

Seek medical treatment and advice if you have symptoms of monkeypox. There is greater risk of contracting the illness if you:

• Have travelled to a region where there are monkeypox cases
• Have been in close contact with a person infected with the monkeypox virus
• Work with animals that may transmit monkeypox (i.e. rodents and primates)

It may be best for you to confirm the next course of action with the doctor over the telephone or online appointment first before visiting in person, unless you have been instructed to do so. This is due to the illness’ contagious nature.

Nonetheless, seek immediate emergency care if you develop the following conditions:

• Difficulty in breathing
• New or worsening chest pains
• Stiff neck
• Feeling confused or cannot think clearly
• Difficulty in speaking or moving
• Loss of consciousness
• Seizures

2022 Monkeypox Outbreak

In the wake of the COVID-19 pandemic, there has also been an outbreak of monkeypox. While monkeypox is endemic in West and Central Africa, at least 350 cases were reported in two dozen countries in the Americas, Europe, North Africa, the Middle East, and Australia. Originally, this virus is rare outside of Africa. The WHO has also declared the rapidly spreading outbreak a global health emergency.

However, researchers expect the outbreak to be containable with proper international coordination. Nonetheless, the United Kingdom has already begun offering smallpox vaccines to their healthcare workers.

The spread of the current outbreak is linked to close contact with other infected persons. Although many of the affected persons are gay, bisexual, and men with sexual relations with other men, anyone can get the illness.

Centers for Disease Control and Prevention (CDC) has partnered and collaborated with other countries experiencing monkeypox. This includes Nigeria Centers for Disease Control to test and understand the virus better in the current outbreak. Investigations are carried out to learn:

• How long has the virus been circulating?
• How was the virus introduced in the current cluster of cases?
• What is the clinical course of illness?
• Is the virus being spread through contact with semen or vaginal fluids?

As a general guideline, it is important to practice good hygiene measures and avoid mingling with others who are suspected or confirmed to be ill.

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