The World Health Organization clarifies key facts about monkeypox
The World Health Organization has revealed three main facts about monkeypox, which recently appeared in several countries of the world. The virus is transmitted to humans from a variety of wild animals, but its spread at the secondary level is limited through transmission from one person to another.
The organization stated in a report that it obtained that monkeypox is a rare disease that occurs mainly in remote areas of central and western Africa near tropical rainforests, and that there is no treatment or vaccine available to combat the disease, although the previous vaccination against smallpox proved highly effective in prevention as well. of monkey pox.
The World Health Organization pointed out that monkeypox is a rare viral disease of animal origin (the virus of which is transmitted from animals to humans) and the symptoms of human infection are similar to those witnessed in the past by patients with smallpox, but it is less severe, knowing that smallpox was eradicated in 1980, monkeypox It still appears sporadically in some parts of Africa.
Monkeypox virus belongs to the genus Orthopoxvirus of the smallpoxvirus family. This virus was first detected in 1985 at the State Sera Institute in Copenhagen, Denmark, during the investigation of a smallpox-like disease among monkeys.
disease outbreaks
Monkeypox was first detected in humans in 1970 in the Democratic Republic of the Congo (then known as Zaire) in a 9-year-old boy who lived in an area where smallpox was eradicated in 1968. Most cases have since been reported in rural forested areas Congo Basin and West Africa, particularly in the Democratic Republic of the Congo, in which it was thought to be endemic, where a major outbreak of the disease occurred in 1996 and 1997, and in the fall of 2003 confirmed cases of monkeypox were reported in the western-central United States of America , which indicates that it is the first reported cases of the disease outside the African continent, and it was found that most of the patients infected with it had had close contact with domestic prairie dogs.
"In 2005, an outbreak of monkeypox broke out in Unity State, Sudan, and sporadic cases were reported in other parts of Africa. In 2009, an awareness campaign among refugees from the Democratic Republic of the Congo to the Republic of the Congo identified and confirmed two cases of monkeypox, while Twenty-six cases and two deaths were contained in another outbreak in the Central African Republic between August and October 2016.
disease transmission
The organization clarified that infection with the disease results from indicative cases of direct contact with the blood, body fluids, skin lesions or mucous of infected animals. In Africa, cases of infection caused by handling monkeys, giant gambian rats or squirrels infected with the disease have been documented, bearing in mind that rodents are The main reservoir of the virus.
It is possible that eating undercooked meat from infected animals is a risk factor associated with the disease.
Transmission of the disease at the secondary level or from person to person can result from intimate contact with the respiratory tract secretions of an infected person or its skin lesions, or from contact with objects that have recently been contaminated with the patient's fluids or pest-causing substances.
The disease is transmitted primarily through respiratory particles in the form of droplets that usually require long periods of face-to-face contact, exposing family members of active cases to a high risk of infection.
The disease can also be transmitted through vaccination or through the placenta (congenital monkeypox), and there is still no evidence that monkeypox can persist in human beings simply by transmission from one person to another.
Disease signs and symptoms
The incubation period for monkeypox (which is the interval between the stage of infection and the stage of symptoms appearing) ranges between 6 and 16 days, but it can range from 5 to 21 days, and the infection stage can be divided into two periods as follows: “The invasion period (0 days and 5 days) It is characterized by fever, severe headache, swollen lymph nodes, back and muscle pain, severe weakness (loss of energy), and the “rash period (within 1 to 3 days after the fever) in which the various stages of the rash’s appearance crystallize. It most often starts on the face and then spreads to other parts of the body.
The rash is most severe on the face (in 95% of cases) and on the palms of the hands and soles of the feet (75%).
In about 10 days, the rash develops from macular papules (flat-based lesions) to vesicles (small fluid-filled blisters) and pustules, followed by crusts that may take up to three weeks to disappear completely.
The number of lesions ranges from a few to several thousand, and they affect the mucous membranes of the mouth (in 70% of cases), the genitals (30%) and the conjunctiva of the eye (20%), as well as its cornea (eyeball).
Some patients develop severe swollen lymph nodes before the rash appears, a feature that distinguishes monkeypox from other similar diseases.
Monkeypox is usually a self-limited disease and symptoms last from 14 to 21 days, and severe cases of monkeys are more common in children, depending on the extent of exposure to the virus, the health status of the patient, and the severity of complications resulting from it.
The case fatality rate varies greatly between epidemics, but its rate does not exceed 10% in documented cases, most of which occur among children.
In general, younger groups appear to be more sensitive to monkeypox.
disease diagnosis
Differential diagnoses to be considered include other exanthematous diseases, such as smallpox, chickenpox, measles, bacterial dermatitis, scabies, syphilis, and drug allergies. Enlargement of the lymph nodes during the onset of disease can be a clinical feature that distinguishes it from smallpox.
treatment and vaccine
There are no specific drugs or vaccines available to combat monkeypox infection, but outbreaks can be controlled.
In the past, vaccination against smallpox has been shown to be 85% effective in preventing monkeypox, but this vaccine is no longer available to the general public after vaccination with it was discontinued following the eradication of smallpox from the world.
However, prior vaccination against smallpox is likely to lead to a milder course of the disease.
disease prevention
Preventing the further spread of monkeypox by imposing restrictions on the animal trade, which could contribute to restricting or banning the transfer of small African mammals and monkeys, which would effectively contribute to slowing the spread of the virus outside Africa.
Caged animals should not be vaccinated against smallpox, but rather those potentially infected should be immediately isolated from other animals and quarantined.
All animals in contact with other infected animals should also be quarantined and handled under standard precautions and observed within 30 days for symptoms of monkeypox.
Reducing the risk of people becoming infected with the disease
Close contact with patients during outbreaks of monkeypox is one of the most important risk factors for infection with the virus that causes the disease.
In the absence of a specific treatment or vaccine to combat it, the only way to reduce people's infection is to raise awareness of its associated risk factors and educate people about the measures they can take to reduce exposure.
Surveillance measures and rapid diagnosis of new cases are indispensable to contain outbreaks.
Infection control in healthcare facilities
Health workers should apply standard infection control precautions when caring for patients with suspected or confirmed monkeypox virus infection, or handling samples collected from such patients.
Health workers treating patients with monkeypox, or individuals who have been exposed to them, or samples collected from them, should consider the possibility of receiving smallpox vaccination from their national health authorities, but that old smallpox vaccines should not be given to people with weakened immune systems.
Samples collected from people with suspected monkeypox virus infection and from animals with suspected monkeypox virus should be handled by trained personnel working in appropriately equipped laboratories.
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