Facts about Monkeypox
- The virus was first identified in 1958. Monkeypox is a zoonotic infection, meaning it is transmitted from animals to humans, and less commonly, from human to human. Compared to smallpox, which was eradicated in 1980, monkeypox is less contagious and the course of the disease is less severe
- Rodents and primates are carriers of the infection. Monkeypox is transmitted through respiratory droplets, but only with very close and prolonged face-to-face contact. More commonly, it is spread through contact with skin lesions, contaminated surfaces (such as bedding or clothing), or saliva (through kissing and sexual contact). Based on currently known cases, people who live in the same household or have prolonged close contact with an infected person are more likely to contract the virus
- Close physical contact, including intimate contact, is a risk factor for monkeypox transmission. It is known that the virus can be transmitted from mother to fetus through the placenta, leading to congenital monkeypox
- Complications from monkeypox are rare but can include skin infections, pneumonia, encephalitis, and corneal inflammation, which can lead to vision loss
- According to WHO data, historically, the fatality rate for monkeypox has varied from 0% to 11%. In recent years, the fatality rate has ranged from 3% to 6%. For comparison, the mortality rate for smallpox was higher, with a fatal outcome observed in 30% of cases
Signs of the Disease
The incubation period, from the time of infection to the first symptoms, typically ranges from 1 to 21 days. The development of the infection can be divided into two periods. The first period, the invasion phase (lasting from 0 to 5 days), includes fever, headache, swollen lymph nodes, back pain, muscle pain, and weakness.
The second period, the rash phase, usually begins 1–3 days after the fever starts. Sometimes, the rash appears without prior discomfort. The rash is more commonly found on the face (in 95% of cases) and extremities (in 75% of cases) than on the trunk. It can also appear on mucous membranes. The skin lesions progress through several stages: from spots to fluid-filled blisters, which then crust over, dry out, and fall off. This process takes 2–4 weeks. The number of lesions can vary, ranging from a few to thousands. Monkeypox can resemble other infections, such as chickenpox or measles.
A distinctive feature of the disease is swollen lymph nodes, or lymphadenopathy. The illness is usually mild. Monkeypox is a self-limiting infection, meaning recovery typically occurs without specific treatment within 2–4 weeks from the onset of symptoms. Severe cases usually occur in children and pregnant women.
Treatment Methods
In the United States and Europe, the drug Tecovirimat (TPOXX), developed by American SIGA Technologies, is used for severe cases of the disease. In America, it was approved for the treatment of smallpox in 2018. In Europe, the drug was approved in 2022 for the treatment of smallpox, monkeypox, and cowpox. The drug is not widely available and is not registered in Georgia. Data on its effectiveness and safety are still limited.
A relatively recent study, published in May 2022 in The Lancet, was conducted in the UK, where seven patients with monkeypox were observed from 2018 to 2021. Six of the patients did not receive specific treatment; three were treated with Brincidofovir, known under the trade name Tembexa and developed by American Chimerix. Its use led to elevated liver enzymes, so treatment with it was discontinued. Another patient was treated with Tecovirimat, and no side effects were observed; moreover, the patient recovered faster than the others. Based on this data, scientists concluded that Tecovirimat is effective against monkeypox. Despite the lack of sufficient studies, the US Centers for Disease Control and Prevention (CDC) recommend the drug for certain categories of people most susceptible to severe disease.
Prevention and Precautionary Measures
There are currently two vaccines available for the prevention of monkeypox. One of them (Jynneos by Danish company Bavarian Nordic) has already been approved for monkeypox prevention in the United States. In Europe, this vaccine is known as Imvanex. The drug has already been recommended for use in the UK. Another vaccine (ACAM2000 by Emergent Biosolutions) is used in the US to immunize people at high risk of contracting smallpox.
Vaccination against smallpox was conducted until 1980, when the World Health Organization (WHO) declared the disease eradicated. Therefore, individuals born before 1980 were likely vaccinated against smallpox if it was part of their country's national immunization program. A logical question arises: are these people protected from monkeypox? According to WHO data, these individuals are about 85% protected from monkeypox. However, as we remember, vaccination does not reduce the importance of other preventive measures
People recently returned from Africa may pose a threat to others. After contact with a potential carrier of the disease, thoroughly wash your hands with soap and water. It is advisable to wear a medical mask if you are forced to be in close contact with a possible carrier.
Travelers heading to countries where monkeypox outbreaks have been reported should follow simple precautionary measures. Avoid contact with animals, especially if they appear unwell. It is recommended to eat only well-cooked meat, as monkeypox can also be transmitted through food. Careful attention should also be paid to keeping bed linens clean and changing them as often as possible. Sharing household items is not recommended.
The COVID-19 pandemic has heightened attention to outbreaks of other infections, which is why there is so much talk about monkeypox right now. But for now, there is no reason for alarm: just follow simple precautionary measures
