What Is Monkeypox? Transmission, Symptoms, Treatment & Vaccine For Rare Viral Disease In UK

Two cases of the rare disease Monkeypox have been detected in north Wales this week. Public Health Wales officials have confirmed that two members of the same household were affected recently and both patients have been admitted to hospital in England as a precaution. 

Richard Firth Consultant in Health Protection at the PHW in a statement said that the monitoring and contact tracing is going on, and the risk to the general public is very low.

What is Monkeypox?

Monkeypox is a virus transmitted from animals to humans  with symptoms similar to those seen in the past in smallpox patients, although it is clinically less severe. Monkeypox is caused by Monkeypox virus, a member of the Orthopoxvirus genus in the family Poxviridae. As stated by World Health Organisation (WHO), the rare disease occurs primarily in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions.

Human cases of Monkeypox have been reported from 11 African countries. The first case of Human Monkeypox was identified in humans in 1970 in the Democratic Republic of the Congo. 39 years later in 2017, Nigeria experienced the largest documented outbreak.  In the spring of 2003, Monkeypox cases were confirmed in the United States of America. Recently, Monkeypox was carried to Israel in September 2018, to the United Kingdom in September 2018 and December 2019 and to Singapore in May 2019 by travelers from Nigeria who fell ill with Monkeypox after arrival.

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Transmission of Monkeypox

The true burden of Monkeypox is not known. According to WHO, the infection of index cases results from direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. Experts of the belief that rodents are the most likely the natural reservoir of Monkeypox. Eating inadequately cooked meat and other animal products of infected animals is a possible risk factor.

As far as the human-to-human transmission is considered, it is relatively limited. Infection can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects. Transmission can also occur via the placenta from mother to fetus. 

Signs & Symptoms of Monkeypox 

Fever, intense headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle aches) and an intense asthenia (lack of energy) may start to appear during the invasion period which usually lasts between 0-5 days.  

The body starts developing rashes after 3 days of contact, with fever kicking in. The rash tends to be more concentrated on the face. It usually affects the face, palms of hands and soles of feet. Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. 

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Diagnosis, Treatment & Vaccine Against Monkeypox

The clinical diagnosis that must be considered includes rash illnesses, such as chickenpox, measles, bacterial skin infections, scabies. In order to distinguish Monkeypox from chickenpox or smallpox, Lymphadenopathy during the prodromal stage of illness should be looked upon as a clinical feature of Monkeypox. 

If Monkeypox is suspected, health workers should collect an appropriate sample and transport it safely to a laboratory. Polymerase chain reaction (PCR) is the preferred laboratory test given its accuracy and sensitivity. 

There is no specific treatment recommended for Monkeypox currently. As of now, no dedicated vaccine against Monkeypox has been developed however vaccination against smallpox with vaccinia vaccine has been observed to be about 85% effective in preventing Monkeypox. 

Preventive Measures

• Raising awareness of risk factors and educating people about the measures they can take to reduce exposure to the virus 
• Unprotected contact with wild animals, especially those sick or dead, including their meat, blood and other parts must be avoided.
• Eating inadequately cooked meat and other animal products of infected animals is a possible risk factor. Hence, all foods containing animal meat must be thoroughly cooked before eating.
• In order to avoid human-to-human transmission, an appropiate distance must be maintained from monkeypox patients. 
• Health workers and household members are at a greater risk of infection. Hence, they should implement standard infection control precautions. 
• Countries may frame regulations restricting importation of rodents and non-human primates in order to avoid monkeypox expansion. 
• Potentially infected animals should be isolated from other animals and placed into quarantine.

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