Monkeypox is a rare viral zoonosis (a virus transmitted to humans from animals) with symptoms in humans similar to those seen in the past in smallpox patients, although less severe.
Smallpox was eradicated in 1980. However, monkeypox still occurs sporadically in some parts of Africa.
What we know.
Monkeypox is a rare disease that occurs primarily in remote parts of Central and West Africa, near tropical rainforests.
The monkeypox virus can cause a fatal illness in humans and, although it is similar to human smallpox which has been eradicated, it is much milder.
The monkeypox virus is transmitted to people from various wild animals but has limited secondary spread through human-to-human transmission.
Typically, case fatality in monkeypox outbreaks has been between 1% and 10%, with most deaths occurring in younger age groups.
There is no treatment or vaccine available although prior smallpox vaccination was highly effective in preventing monkeypox as well.
Infection of index cases results from direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals.
In Africa, human infections have been documented through the handling of infected primates (monkeys), Gambian giant rats and squirrels, with rodents being the major reservoir of the virus. Eating inadequately cooked meat of infected animals is a possible risk factor.
Secondary, or human-to-human, transmission can result from close contact with infected respiratory tract secretions, skin lesions of an infected person or objects recently contaminated by patient fluids or lesion materials.
Transmission occurs primarily via droplet respiratory particles usually requiring prolonged face-to-face contact, which puts household members of active cases at greater risk of infection.
Transmission can also occur by inoculation or via the placenta (congenital monkeypox).
There is no evidence, to date, that person-to-person transmission alone can sustain monkeypox infections in the human population.
Signs and Symptoms
The incubation period (interval from infection to onset of symptoms) of monkeypox is usually from 6 to 16 days but can range from 5 to 21 days.
The infection can be divided into two periods:
The invasion period (0-5 days) characterized by fever, intense headache, lymphadenopathy (swelling of the lymph node), back pain, myalgia (muscle ache) and an intense asthenia (lack of energy);
The skin eruption period (within 1-3 days after appearance of fever) where the various stages of the rash appears, often beginning on the face and then spreading elsewhere on the body. The face (in 95% of cases), and palms of the hands and soles of the feet (75%) are most affected.
Evolution of the rash from maculopapules (lesions with a flat bases) to vesicles (small fluid-filled blisters), pustules, followed by crusts occurs in approximately 10 days.
Three weeks might be necessary before the complete disappearance of the crusts.
Treatment and Vaccine
There are no specific treatments or vaccines available for monkeypox infection, but outbreaks can be controlled. Vaccination against smallpox has been proven to be 85% effective in preventing monkeypox in the past but the vaccine is no longer available to the general public after it was discontinued following global smallpox eradication. Nevertheless, prior smallpox vaccination will likely result in a milder disease course.
Preventive & Control measures
Close physical contact with monkeypox infected people should be avoided.
Gloves and protective equipment should be worn when taking care of ill people.
Regular hand washing should be carried out after caring for or visiting sick people.
Ensure thorough cooking of all animal products (blood, meat) before eating.
Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues, and during slaughtering procedures.
We will like to reiterate need for good hygiene practices at home, at work ashore and onboard.