In our article on Dalili Medical, we will provide answers to questions such as how to deal with this disease. Monkeypox is a rare disease that occurs frequently in West and Central Africa. Despite the recent increase in the number of cases, the risk of contracting monkeypox remains low.

**What is monkeypox?**

 

Monkeypox, also known as Mpox, is a disease caused by the monkeypox virus. It is a viral infection that can be transmitted between humans, and sometimes from the environment to people via surfaces and objects that an infected person has touched. In areas where the virus is present in some wild animals, it can also be transmitted from infected animals to people who handle them. After consultations with global experts, the World Health Organization has begun using the term "mpox" as an alternative to monkeypox.

**Can children get monkeypox?**

 

Yes, children develop more severe cases depending on their exposure to the virus, their general health condition, and the severity of complications resulting from the infection.

**Why are health officials concerned about the spread of monkeypox?**

 

The concern about the spread of the infection is due to the fact that the pattern of the disease’s appearance and spread is different from what has been observed previously. Although the current strains rarely lead to death, the rash associated with the infection is painful and may leave marks and scars on the skin that persist even after recovery.

**Will monkeypox be like COVID-19?**

 

Monkeypox is not thought to be as dangerous as the COVID-19 pandemic, as it is considered less severe and slower to spread. The medical community has also dealt with this disease in the past and managed to control it. In addition, the existence of an approved drug to treat monkeypox (Tecovirimat) and the availability of a vaccine are reassuring indicators.

**How ​​is it diagnosed?**

 

Monkeypox can only be definitively diagnosed in a laboratory, but a viral infection can be diagnosed through:

- PCR test
- Antibody detection test
- Enzyme immunoassay
- Virus isolation by cell culture

When does a person with monkeypox become contagious?

A person with monkeypox becomes contagious after symptoms appear, not during the incubation period of the virus. A person remains contagious until the scabs of the disease-causing lesions begin to fall off. The contagious period is usually four to five weeks after symptoms appear.

What causes monkeypox?

The disease occurs when the virus enters the body, either through a cut or scratch in the skin, or through the mucous membranes in the eyes, nose, or mouth. This can happen after exposure to the virus in several ways, including:

- Eating undercooked infected animal meat.
- Being bitten or pinched by an infected animal.
- Using personal items of an infected person, such as bed linens or towels.
- Close contact with an infected person for a long period, or a healthy person being exposed to an infected person's sneeze or cough.
- Direct contact with skin lesions or internal mucous membranes of an infected person, such as those in the mouth.

However, it should be noted that most documented cases of infection were the result of transmission of the virus from infected animals to humans, not from one person to another.

The infection is also transmitted through respiratory droplets, which usually require long periods of face-to-face contact, increasing the risk of family members of active cases becoming infected. It can also be transmitted through vaccination or through the placenta (congenital monkeypox), but there is no evidence yet that monkeypox can spread between humans as the coronavirus can once it has been transmitted from person to person.
**How ​​does monkeypox rash occur?**

 

The rash usually appears within one to five days after the initial symptoms appear. The rash usually starts on the face and then spreads to other parts of the body, including the mouth, genitals and anus. You may also experience pain or bleeding in the anal area.

Sometimes, the monkeypox rash can be confused with chickenpox. The rash starts as raised spots and then develops into small, fluid-filled blisters, which then crust over and fall off.

The symptoms of monkeypox usually go away within a few weeks, but there is a chance that you could infect others while the symptoms persist.

**When should you go to the hospital?**

 

You should contact the hospital if you have a rash with blisters, anal pain, or anal bleeding, plus any of the following:

- If you have had close contact, including sexual contact, with someone who has or may have monkeypox in the past three weeks (even if they haven’t been tested yet).
- If you have had one or more new sexual partners in the past three weeks.
- If you have visited West or Central Africa in the past three weeks.

If you have these conditions, it is best to stay home and avoid close contact with others, including sharing towels or bedding, until you receive guidance from a specialist.

It is also advisable to contact the hospital and inform them before visiting the clinic. Share information about any close contact with someone who has or may have had monkeypox, or if you have recently travelled to Central or West Africa.

**How ​​is monkeypox spread?**

 

**From person to person:**

Monkeypox is spread between individuals through close contact with someone who has the virus. Close contact includes direct interaction such as talking or breathing in close proximity to another person, which can produce short-range droplets or aerosols; skin-to-skin contact such as touching or sexual intercourse (vaginal or anal); mouth-to-mouth contact (such as kissing); or mouth-to-skin contact (such as oral sex or skin-to-skin kissing). During the global outbreak that began in 2022, the virus has spread mainly through contactSexually. People with monkeypox are contagious until all of their lesions have crusted over, scabbed over, a new layer of skin has formed, and all sores on the eyes and body (including the mouth, throat, vagina, and anus) have healed, usually 2 to 4 weeks.

The monkeypox virus can survive on clothing, bedding, towels, objects, electronics, and surfaces that an infected person has touched. Another person can become infected by touching these items, especially if they have cuts or scrapes, or touch their eyes, nose, mouth, or other mucous membranes without washing their hands first. Cleaning and disinfecting surfaces and objects, as well as washing your hands after touching them, helps reduce the risk of transmission.

The virus can also spread from mother to fetus during pregnancy, during or after childbirth through skin-to-skin contact, or from an infected parent to an infant or child during close contact. Although cases of infection from asymptomatic people have been reported, information on the possibility of transmission from infected people before symptoms appear or after their lesions have resolved is still limited. Although live monkeypox virus has been isolated from semen, further research is needed to determine whether the infection can be transmitted via semen, vaginal fluids, amniotic fluid, breast milk, or blood.

**From animals to humans:**

Monkeypox virus can be transmitted to humans through contact with infected animals, such as some species of monkeys and wild rodents (such as squirrels). Physical contact occurs through bites or scratches, or during activities such as hunting, skinning, trapping, or cooking. Infection can also occur through eating undercooked meat from infected animals. To reduce the risk of acquiring monkeypox infection from animals, it is recommended to avoid unprotected contact with wild animals, especially sick or dead animals (including their meat and blood). In countries where animals carry the virus, all foods containing meat or animal parts should be thoroughly cooked before eating.

**From humans to animals:**

Monkeypox virus has been identified in pet dogs, but it is not yet certain whether these cases represent true infection or whether the virus was detected as a result of surface contamination. Because many animal species are susceptible to monkeypox virus, there is a possibility that the virus can be transmitted from humans to animals in different environments. People who have been confirmed or suspected to have monkeypox should avoid close physical contact with animals, including pets (such as cats, dogs, hamsters and gerbils), livestock and wild animals. More detailed advice for pet owners and people working with animals can be found in the document from the World Organisation for Animal Health, entitled “Guidance for managing the risks associated with the reinfection of monkeypox virus”.

**Who is most at risk for monkeypox infection?**

 

People at risk are those who have close contact (including through sexual contact) with a person who has monkeypox. Close contact includes direct contact (such as face-to-face talk), skin-to-skin contact (such as touching or vaginal/anal sex), mouth-to-mouth contact (such as kissing), or mouth-to-skin contact (such as oral sex). People who handle clothing, bedding, towels, objects, electronics, and other surfaces that a person with monkeypox has touched are also at risk of infection. Anyone living with an infected person should take precautions to reduce their risk of infection. A person with monkeypox should consult a health care provider to assess their condition and determine whether they can receive care at home and whether isolation can be managed safely. Health workers should also follow infection prevention and control measures to protect themselves while caring for patients with monkeypox, by wearing appropriate personal protective equipment and adhering to protocols for safe examination of lesions for diagnostic purposes and handling sharp objects such as needles.

**History and spread of monkeypox**

 

Monkeypox was first discovered in 1958 during an outbreak of a smallpox-like disease among a group of monkeys used for scientific research, hence the name "monkeypox". The first human case of this disease was diagnosed in 1970 in the Republic of the Congo, in a 7-year-old boy. Monkeypox was mainly prevalent in Central and West African countries, with cases recorded outside the African continent only three times before 2022, as follows:
- In 2003 in the United States of America.
- In 2018 in England.
- In 2021 in Texas and Maryland.

Monkeypox has been a concern since May 2022, spreading to several non-endemic countries, including Australia, Belgium, Canada, France, Germany, Italy, the Netherlands, Portugal, Spain, Sweden, the United Kingdom, and the United States. At least one case has also been reported in Switzerland, Denmark, and the Canary Islands.

**Types of Monkeypox Virus**

 

Monkeypox virus is divided into two main types, which are:

1. **Central African monkeypox virus (Congo Basin)**: This type is characterized by its more severe symptoms compared to the other type, in addition to the high mortality rate and its ease of transmission between individuals.

2. **West African monkeypox virus**: This is the currently dominant type, characterized by less severe symptoms, and its transmission from person to person through contact is limited.

**Is monkeypox a fatal disease?**

 

Reports indicate that the mortality rate associated with the monkeypox strain in West AfricaAfrica, where it is currently spreading, has an incidence of about 1%. Most people recover within two to four weeks without needing special treatment. If anyone notices an unexplained rash, they should see a healthcare provider.

Not only is an evaluation important for recovery, it is also necessary to confirm the diagnosis and is a critical step in containing the virus. Your doctor can advise you on steps to take to prevent transmission to your loved ones and others in your community.

The African strain of monkeypox likely won’t cause severe symptoms in most people, and there’s still much to learn about those at higher risk, such as those with immunodeficiencies. There are tools that healthcare providers can use to help control outbreaks if needed.

There is no FDA-approved treatment for monkeypox, but antivirals designed to treat smallpox have been used in some previous cases. Two available vaccines may also be considered.

**Monkeypox Symptoms**

 

Monkeypox symptoms usually appear within a week of exposure to the virus, but may take anywhere from 1 to 21 days. Symptoms develop in two stages:

**Stage 1 (cold-like symptoms):**
- High body temperature.
- Chills.
- Feeling tired and exhausted.
- Muscle and lower back pain.
- Headache.
- Sore throat.
- Cough.
- Congestion and runny nose.
- Swollen lymph nodes.

**Stage 2 (rash):**
- **When the rash appears:** It appears 1-4 days after the fever.
- **Where the rash is located:** It may appear on the hands, feet, chest, face, mouth, genital areas, or anus, and may be confined to a specific area or spread to include large areas of the body.
- **Rash appearance:** It starts as flat red bumps that may be painful or itchy, then turns into blisters filled with fluid or pus, and finally peels off and falls off naturally.
- **Duration of the rash:** It disappears after about 2-4 weeks.

**Important notes:**
- Not all infected people may go through both stages.
- The severity of symptoms may vary from person to person.
- It is recommended to visit a doctor immediately upon the appearance of any of the symptoms of monkeypox, and to avoid mixing with others to reduce the spread of the infection.

**Is there a vaccine to protect against monkeypox?**

 

It is important to note that there are several vaccines available to prevent smallpox, and they have also proven effective in protecting against monkeypox, with the success rate of some reaching 85%. In addition, a new vaccine to prevent smallpox was developed and approved in 2019 to combat monkeypox. Although it is not currently available globally, the World Health Organization is working to provide this vaccine as soon as possible. People who have previously received smallpox vaccine may be better protected against monkeypox, but the original vaccine was no longer available after smallpox was declared eradicated worldwide in 1980, meaning that individuals under the age of 40–50 were likely not to have received this vaccine. Health care workers and laboratories may have received a newer version of the smallpox vaccine as a precaution.

**Can animals get monkeypox?**

 

Several wild mammals have been identified as susceptible to monkeypox virus infection, including rope squirrels, tree squirrels, Gambian rats, dormice, and non-human primates. Although the onset of symptoms may depend on the route of transmission and the infectious dose, some species do not show signs of illness, especially species suspected of being reservoirs of the virus (such as rodents). Other mammals, such as monkeys and apes, develop a rash similar to that experienced by humans. To date, there is no documented evidence of pets, such as cats and dogs, being infected with monkeypox virus, and there are no reports of livestock being infected with this virus.

**How ​​to prevent the virus**

Adhering to some preventive measures can help reduce the risk of contracting monkeypox. These measures include the following:

1. **Receive the smallpox vaccine**: Studies indicate that the smallpox vaccine can reduce the likelihood of contracting monkeypox.

2. **Avoid contact with animals that may carry the virus**: This includes sick animals or those found dead in areas where the virus is prevalent.

3. **Avoid contact with materials that have come into contact with sick animals**: such as bedding, clothing, or any other objects.
4. **Isolation of patients**: People with monkeypox should be isolated from others at risk of infection.
5. **Practice good hygiene**: After contact with infected humans or animals, hands should be washed thoroughly with soap and water or alcohol-based sanitizers.
6. **Use personal protective equipment**: When providing care for infected people.
7. **Imposing restrictions on animal trade**: to limit the spread of the virus.
8. **Reducing the risk of infection**: by taking preventive measures in the community.
9. **Infection control in healthcare facilities**: to ensure the safety of patients and workers.

**Monkeypox treatment**

 

Most cases of monkeypox are mild, and often get better on their own within 2 to 4 weeks. During this period, your doctor may recommend the following to help with recovery and prevent transmission to others:

1. **Taking painkillers**: to relieve symptoms.
2. **Taking a warm bath**: with baking soda or Epsom salt added to relieve the pain of skin ulcers.
3. **Rinsing with salt water**: to relieve the pain of mouth ulcers.
4. **Avoid popping blisters or scratching ulcers**: to maintain skin integrity.
5. **Keeping the skin dry**: to avoid worsening the condition.
6. **Staying at home**: in a separate room as much as possible.
7. **Wash your hands well**: with soap and water or sanitizer, especially before and after touching any sores.
8. **Wear a mask**: Avoid being around others until the rash is gone.
9. **Avoid touching surfaces**: Disinfect them regularly to maintain a clean environment.