All You Need to Know About Monkeypox

On May 24th, 2022, the UAE became the second Gulf nation after Israel to report the first case of Monkeypox. The first case was detected in a 29-year-old woman who came from West Africa. This case caught the headline and brought the know-how of the disease to the light. Monkeypox is a transmittable disease that is not necessarily fatal. The common symptoms of this disease are fever, swollen lymph nodes, rashes on hands and faces, chills, muscle aches, and exhaustion. This write-up offers in-depth information about the disease, its cause, symptoms, and preventions if any.

What is Monkeypox?

Monkeypox is a zoonotic viral disease (transmitted from animals to humans) and has symptoms like that of smallpox although less severe. This disease first came to light in 1958 when there was an outbreak of a pox-like disease in the colonies of apes kept for research. The first case of a monkeypox outbreak in humans was found in 1970 in the Democratic Republic of Congo (DRC). 

The monkeypox virus is a double-stranded DNA virus that comes from the Orthopoxvirus genus of the Poxviridae family. The natural hosts of this virus are - 

• Rope squirrels
• Tree squirrels
• Dormice
• Gambian pouched rats
• Non-human primates

Monkeypox Outbreak: Timeline

• 1970 - The first case of human monkeypox was reported in a 9-month-old baby in DRC, an area where smallpox was eradicated in 1968. Since then, cases have been discovered in the rural and tropical rainforest regions of the Congo Basin. 

The cases of the disease in humans have been discovered in 11 other African nations, namely -  

• Benin
• Liberia
• Cote d'Ivoire 
• The Central African Republic
• DRC
• Gabon
• Nigeria
• Republic of Congo
• South Sudan 
• Sierra Leone
• 1996-97 - Lower fatality cases were reported in DRC but the spread was higher than usual. 
• 2003 - First case of monkeypox outbreak outside Africa in the United States of America. About 70 confirmed cases were reported for the disease. 
• 2017 - Nigeria has the largest outbreak of Monkeypox with 200 confirmed cases of the disease and a mortality rate of 3%.
• 2018 - Cases of the disease were reported in tourists coming from Nigeria to Israel and the United Kingdom.
• 2019 - Cases of monkeypox outbreak were reported in Singapore
• 2022 - The UAE became the second Middle-East country to report cases of the Monkeypox outbreak. 

Signs and Symptoms of Monkeypox

The incubation period for the virus is usually between six to 13 days, however, it can also range between 5 to 21 days. The infection is divided in two stages - 

• The Invasion Period - This is the first five days and often includes symptoms like fever, extreme headache, back pain, muscle pain, lymphadenopathy, and intense asthenia. The initial symptoms are similar to those of diseases like chickenpox, measles, and smallpox. 
• The skin rashes begin to appear within the first three days when the patient experiences fever. The rashes are more extreme on the face and limbs than on the trunk. 
• The extreme yet rare symptoms of the disease are bronchopneumonia, encephalitis, sepsis, and infection in the cornea that can cause blindness. 

Like chickenpox, Monkeypox occurs when you are in close contact with the patient. The virus enters your body via cracks on the skin, the oesophagus or through the eyes, nose, or mouth. It can also be vector-borne and spread through monkeys, squirrels, rats and infected inanimate objects like bedding and clothing or inhale the infected respiratory droplets.

How is the Disease Diagnosed?

The preferred laboratory test for Monkeypox is Polymerase Chain Reaction (PCR) for its accuracy and sensitivity. The samples are taken from the lesions on the skin - it could be the fluid from vesicles and pustules and dry crusts. The PCR tests are generally inconclusive as there is a short duration of viremia as compared to the duration of specimen collection. To interpret the test result, the patient needs to provide-

• Date when the fever started
• Date for the onset of rash
• The time when the specimen was collected
• The current stage of rash
• Age of the patient

Preventive Measures to Consider

Experts are considering the smallpox vaccine for protecting against monkeypox outbreaks. Preventive measures are necessary to decrease the chances of spread of the disease in case you come in contact with an infected animal or for limiting the human-to-human spread. Mentioned below are the measures to prevent the spread of monkeypox:

• Avoid contact with infected animals (particularly dead ones)
• Do not touch the bedding or garments of an infected person.
• Wash your hands thoroughly if you touch an infected animal or human.
• Make sure the meat dishes are cooked properly.
• Wear a PPE kit when taking care of an infected person. 

Another important precaution is to restrict the animal trade. Several countries have already prohibited the import of animals like rodents and non-human primates. The animals in captivity are prone to the disease and should be isolated from other animals. Any animal that came in contact with the infected animal should be put under quarantine for at least 30 days and should be observed closely. 

Role of Vaccination in preventing Monkeypox

Studies have demonstrated that the smallpox vaccine is 85% effective in preventing the spread of monkeypox. A prior dose of the vaccine can result in milder symptoms. Though the genuine or the first-generation vaccines for smallpox are no longer available, healthcare providers are not receiving a more recent version of this vaccination. 

Another vaccination that got approval for preventing monkeypox, is the vaccine based on reduced vaccinia virus (an Ankara strain), in 2019. This is a double dose vaccination that is not easily available. Monkeypox and smallpox vaccinations are developed using the formula based on the vaccinia virus as it offers cross-protection to the immune system against any orthopoxvirus. 

Measures by the UAE Authorities to Control the Spread of Monkeypox

The UAE reported the first case of monkeypox on May 24th. By May 29th, 2022, the count increased to three confirmed cases. The government is working in association with other health authorities to execute an epidemiological surveillance system that is based on the global practices of ensuring efficiency and community protection of transmittable diseases. People who came in touch with the infected people are being asked to quarantine for at least 21 days at home and observe their health. 

Frequently Asked Questions about Monkeypox

Q1: What is the cure for monkeypox?

Ans: Right now, there is no cure or particular treatment that has gained approval to treat the monkeypox virus. However, the authorities are considering the use of antivirals that were developed for smallpox treatment as they’ve proved to be helpful to an extent. 

Q2: Currently, how many cases of monkeypox are recorded worldwide?

Ans: The record for monkeypox cases has passed 800 and is increasing continuously in more than 24 nations. 

Q3: What is the difference between Chickenpox and Monkeypox?

Ans: The major difference between chickenpox and monkeypox is the cause. Monkeypox is an orthopoxvirus genus whereas chickenpox is caused by varicella-zoster virus. 

Q4: Can smallpox vaccination protect you against monkeypox?

Ans: The smallpox vaccination is about 85% effective in protecting against monkeypox. 

Q5: What is the incubation period for the infection?

Ans: The period of incubation is usually between 6 to 13 days but could also go up to 21 days. 

Q6: Is monkeypox same as smallpox?

Ans: The symptoms for these two diseases are similar, but monkeypox is milder than smallpox. 

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