On the 14th of August, the World Health Organization (WHO) declared monkeypox a “public health emergency of international concern”. Previously, the disease has been detected in Central and West Africa and has been classified as endemic. After its first case came to prominence in 1970 in the Democratic Republic of the Congo or DRC, monkeypox infections have resurfaced from time to time. However, recently, the disease has been detected in countries outside of Africa thus rendering it a matter of global concern.
But what exactly is monkeypox, how is it transmitted, what are the treatment options, and how can it be prevented? Let us find out in the following article.
Statistics Regarding Monkeypox Infections in the US
In the United States, the clade II subtype of monkeypox is presently active but the number of individuals affected is low. In total, 99,518 cases of the disease have been reported globally. Among these, 32,063 have happened in the US with a death toll of 58.
Since January 2024, approximately 6500 cases of monkeypox have been reported in the Democratic Republic of the Congo (DRC) among whom 345 deaths have occurred. Nearly 50% of these patients were children who were under the age of 15.
World Health Organization
What is Monkeypox or Mpox?
Mpox, formerly known as monkeypox, is a viral disease that causes blisters on the skin. These lesions are similar to those caused by smallpox. When a person gets infected, the flu-like symptoms appear with rashes covering the facial regions, hands, limbs, etc.
Monkeypox Virus
The disease is caused by viruses belonging to the genus Orthopoxvirus and family Poxiviridae. These mpox viruses are often found in monkeys, rodents, as well as other mammals.
Types of Monkeypox Viruses or MPXV
The viruses responsible for monkeypox disease belong to two different groups or clades:
· Clade I
· Clade II
Between these, the pathogens belonging to clade I tend to cause severe infections with a nearly 10% death toll. Clade I is particularly found in the Central African regions. However, the recent global outbreak has been caused by clade II viruses which spread quickly but cause less severe disease with significantly lower risk of mortality. Clade II is active in West Africa.
How Does Monkeypox Get Transmitted?
As monkeypox is a contagious disease, it can easily get transferred from one person to another. By remaining near the patients and touching them, the risk of getting infected tremendously increases. This transmission primarily happens by the following acts:
· Touching the patient (Skin-to-skin transmission)
· Talking or breathing near them (Face-to-face transmission)
· Inhaling the respiratory droplets from the environment where the patient has been kept
· Kissing (Mouth-to-mouth transmission)
· Having sexual intercourse (Skin-to-skin transmission)
· Touching contaminated sheets, clothes, or medical instrument
· From pregnant women to their fetus
In addition, Mpox can also be transmitted from animals to humans. This usually happens when a person gets in touch with an animal’s skin while hunting, skinning, or cooking them.
Who Can Get a Severe Monkeypox Infection?
Despite the fact that monkeypox is not life-threatening, some people can get severe infections which can lead to death. This high-risk group includes:
· Children under the age of 1
· Pregnant individuals
· Subjects with a history of eczema
· People who have compromised or extremely weak immune system
Signs and Symptoms of Mpox Infection
This infection is associated with the appearance of the following Mpox symptoms:
· Fever
· Chills
· Rash
· Sore throat
· Headache
· Muscle aches
· Low energy levels
· Backache
· Swollen lymph nodes
Lesions Associated with Monkeypox Infection
The rash is the most prominent symptom of Mpox infection. It usually starts with flat sores which become bigger with time and cause fluid-filled blisters. These mpox sores are often itchy and the patient also feels pain. However, as soon as the rash starts healing, these blisters become dried and a crust appears which falls off later.
Lesions or blisters usually appear on:
· Facial region
· Mouth
· Throat
· Palms of hands
· Soles of feet
· Groin
· Anus
· Genital areas
Stages of Monkeypox Rashes
The rash associated with Mpox progresses in 5 stages which have been given as follows:
Stage 1: Macules
In the macular phase, the rash starts to appear in the form of red spots which are visible under the skin. This stage lasts for 1 to 2 days after which the macules change into papules.
Stage 2: Papules
Papules are spots that are raised in appearance and prominent. These also appear to be hard and last for the next 2 days.
Stage 3: Vesicles
In the next stage, the papules further increase in size and give rise to blisters which are filled with clear fluid. These blisters remain as such for 1 to 2 days.
Stage 4: Pustules
In stage 4, the fluid in the blisters gets transformed into pus. This stage lasts for up to 5 to 7 days.
Stage 5: Scabs
For the next 7 days, the pus-filled blisters keep getting dried and crust over. As a result, scabs appear on the skin which then fall off. After this phase, the skin becomes clear.
How is Monkeypox Diagnosed?
By their appearance, the lesions associated with Mpox look similar to those caused by chickenpox, measles, scabies, syphilis, herpes, bacterial skin infections, medication-associated allergies, as well as sexually transmittable diseases. Therefore, it is difficult to diagnose mpox virus infection without a test.
For this purpose, a polymerase chain reaction (PCR) test needs to be done for the identification of mpox viral DNA in the patient’s sample. The specimen is taken by swabbing from the following body parts:
· Skin
· Crusts
· Fluid in the lesions
· Oral cavity
· Pharynx
· Rectum
· Anus
Apart from PCR tests, the presence of Mpox antibiotics can also be detected in the patient’s blood.
Treatment Options for Mpox Virus
In patients dealing with monkeypox infections, pain in the blisters and itchiness are major complications. In addition, some patients also report high-grade fever. Therefore, it is necessary to address these issues by providing necessary supportive therapy as soon as the patient reports problems.
Presently, there is no specific medication to treat Mpox. Therefore, antiviral drugs which have been developed for the treatment of smallpox are prescribed. These include medications containing tecovirimat.
For the management of fever, over-the-counter medicines including paracetamol and ibuprofen are prescribed.
Even when the antiviral drugs are not used, the patient recovers within two to four weeks of getting infected.
Monkeypox Vaccines
Monkeypox vaccines are available in many parts of the world where the disease has been affecting people over the past decade. As soon as someone comes into contact with an Mpox patient, a vaccine needs to be administered as a preventive measure. Ideally, if the vaccine is given within 4 days of the contact, it is considered best. However, the jab can be taken within 14 days after coming into contact.
People who are at higher risk of getting infected and therefore must be given preference when it comes to administering vaccine include the following:
· Healthcare staff
· Family members of the patients
· Individuals who have multiple sexual partners e.g. sex workers
· People residing in areas where the infection is highly active
How to Prevent Monkeypox Infection?
Monkeypox infection can be prevented by acting upon the following guidelines presented by the WHO:
· Stay at home as much as you can.
· Avoid close and direct contact with Mpox patients.
· Stay away from infected animals who have an active Mpox virus.
· Wash your hands with soap and water frequently.
· In case of contact, consult a physician immediately to get a vaccine.
· Get vaccinated.
Frequently Asked Questions
The following section covers the frequently asked questions about the recent monkeypox outbreak:
1. Can I get monkeypox from sexual contact or being in direct contact with the patient?
Yes, Mpox is a viral disease that gets transmitted from one person to another due to intimate contact. Apart from sexual intercourse, you can also get infected by kissing, cuddling, or staying close to the infected individual.
2. How can monkeypox be prevented?
Mpox virus can be prevented by avoiding close contact with infected individuals. Washing hands frequently with soap after meeting infected people or playing with animals helps contain the infection. Moreover, the use of alcohol-based sanitizers is also recommended.
3. How long does monkeypox last?
Mpox infection usually lasts for up to 2 to 4 weeks. However, in some patients, the infection can last longer. This is particularly common in people who have weakened immune systems.
4. Is there a vaccine for monkeypox infection?
Yes, the Food and Drug Administration (FDA) has recommended the use of two vaccines for the prevention of Mpox which were originally manufactured for smallpox. These include JYNNEOS and ACAM2000. JYNNEOS, also known as Imvamune or Imvanex, is being used for the high-risk group or for those who already have the infection while ACAM2000 can be taken by most individuals. However, this vaccine is difficult to handle and administer.
5. Is the monkeypox vaccine safe for those with weak immune systems?
Yes, the JYNNEOS vaccine is suitable for those who have compromised immune systems while ACAM2000 should not be given to such individuals. This is because ACAM2000 is a live vaccine i.e. the viral entities present in this vaccine are active and can thus cause an infection in people who have poorly developed immune systems.
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Bottom Line
Monkeypox, abbreviated as mpox, is a viral disease that is emerging in most parts of the world. With recent events where cases have been reported in several countries, the WHO is looking into the matter with grave concern.
However, in most cases, the disease is not fatal and the patient recovers within 2 to 4 weeks. As a supportive therapy, medications like paracetamol and ibuprofen can also be prescribed. In places where Mpox vaccine is available, it is highly encouraged to get vaccinated.
With the availability of proper treatment options as well as by strictly following the precautionary measures, it is possible to recover the ill and prevent the health. It is also advised to keep stock of necessary items such as thermometers, bandages, and other day-to-day medical supplies to deal with such health emergencies.
In this regard, for purchasing different kinds of medical supplies, reliable vendors like Health Supply 770 should be approached. They ensure the provision of quality products along with satisfactory services.
References and Further Reading
https://www.who.int/news-room/fact-sheets/detail/monkeypox
https://www.who.int/health-topics/monkeypox#tab=tab_1
https://www.cdc.gov/poxvirus/mpox/about/index.html
PhD Scholar (Pharmaceutics), MPhil (Pharmaceutics), Pharm D, B. Sc.
Uzma Zafar is a dedicated and highly motivated pharmaceutical professional currently pursuing her PhD in Pharmaceutics at the Punjab University College of Pharmacy, University of the Punjab. With a comprehensive academic and research background, Uzma has consistently excelled in her studies, securing first division throughout her educational journey.
Uzma’s passion for the pharmaceutical field is evident from her active engagement during her Doctor of Pharmacy (Pharm.D) program, where she not only mastered industrial techniques and clinical case studies but also delved into marketing strategies and management skills.
