Monkeypox

 Know about Monkeypox Virus

Dr K S Prasanna, Dermatologist, Institute of Applied Dermatology, Kasaragod, Kerala

The world is still suffering from COVID 19, and we hear news of a new viral infection, the monkey pox. The monkey pox virus is a part of the orthopox virus family, belonging to the same group as smallpox, a dreaded virus which has been eradicated from the world and is now present only in research labs. Being of a similar group, the manifestation of the diseases is also like smallpox, but luckily, the monkeypox is not as lethal as smallpox. It was first identified in 1958 as an illness of monkeys, hence its name. Monkeypox was first documented to cause human illness in 1970 in Zaire, when it was isolated from a patient with suspected smallpox.

Causes and Symptoms of Monkeypox

The disease spreads mainly through infected animals, skin to skin contact or via sexual contact (mainly men who have sex with men). It can also spread through respiratory drops, fomites such as patient’s clothes, brush etc, and placenta (mother to baby).

Symptoms of Monkeypox manifest after 7-17 days of contact (incubation period). Symptoms begins with fever, chills, weakness, headache, body ache, back ache, and lymph node swelling (It is the indicative of Monkey pox). It lasts for 1-4 days. Some individuals experience sore throat, cough, or shortness of breath, diarrhoea, and abdominal pain

 Monkeypox is restricted mainly to the skin and genitals and presents as a small, flat change in colour of the skin(macule), which then starts to raise(papule). It develops 1 to 3 days after the onset of fever. As it raises, it starts to get filled with fluid (vesicle) in a few days, and again, a few days later, starts to contain pus (pustule with umbilication). This then leads to scab formation and finally, the scab falls off. These skin lesions tend to occur in the face first and then move on to affect the limb. It may affect any part of the body, including the genitals. When it occurs on genitals it is very difficult to differentiate it from genital herpes clinically.

The disease takes about 3 weeks to appear and leads to a stage of fever and weakness which lasts for about 5 days, before forming the rash. The disease is infectious, or spreads, two days before the rash starts till the last scab falls off. History of recent travel from another country is also important. The disease may cause a few complications, such as pneumonia, encephalitis, blindness, and, very rarely, death. Once the diagnosis of the disease is made using PCR test from nasopharyngeal, and skin lesion swab, the patient should be isolated for 21 days, and surveillance of patient’s immediate contacts is very important.

There is no specific treatment for Monkey pox. The treatment is only symptomatic with adequate food and fluid. Isolation of the patient is very important. Tecovirimat is the drug which can be used under an Investigational New Drug to treat monkey pox infection, but it is not available in India.