A virus, which originated in Africa, monkeypox is now spreading rapidly and has reached Pakistan. Recently, the World Health Organisation (WHO) declared monkeypox or Mpox a public health emergency of international concern. This decision came amid a rapid surge in the spread of the disease in the Eastern Democratic Republic of Congo (DRC) and its detection in neighbouring countries. The virus reaching Pakistan has caused serious concerns in India. Dr Baset Hakim, MD Medicine, Apollo Clinic Viman Nagar, shares how the virus can spread, its symptoms and how India can keep itself safe.
Monkeypox: Mode Of Transmission
Dr Baset Hakim says that the natural reservoir of the virus is yet unknown. When it comes to transmission, Dr Hakim says, “Human-to-human transmission is known to occur primarily through large respiratory droplets generally requiring prolonged close contact. It can also be transmitted through direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens of an infected person.”
The doctor adds that animal-to-human transmission may occur by bite or scratch of infected animals like small mammals including rodents and non-human primates or through bush meat preparation.
Clinical Features Of Monkeypox And Fatality Rate
Monkeypox is usually a self-limited disease with symptoms lasting from 2 to 4 weeks. “Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status, and nature of complications. The case fatality ratio of monkeypox has historically ranged from 0 to 11% in the general population and has been higher among young children. Recently, the case fatality ratio has been around 3-6%,” says Dr Hakim.
Symptoms Of Monkeypox
Dr Hakim lists the common symptoms and signs of the virus:
Prodrome (0-5 days)
a. Fever
b. Lymphadenopathy
c. Headache, muscle aches, exhaustion
d. Chills and/or sweats
e. Sore throat and cough
Skin involvement (rash)
a. Usually begins within 1-3 days of fever onset, lasting for around 2-4 weeks
b. Deep-seated, well-circumscribed, and often develop umbilication
c. Lesions are often described as painful until the healing phase when they become itchy (in the crust stage)
d. Stages of rash (slow evolution)
– Enanthem- first lesions on tongue and mouth
Macules start from the face spreading to arms, legs, palms, and soles (centrifugal distribution), within 24 hours The rash goes through the macular, papular, vesicular, and pustular phases.
– Classic lesion is vesiculopapular
– By 3rd day lesions progress to papules
– By the 4th to 5th day, lesions become vesicles (raised and fluid-filled).
– By the 6th to 7th day lesions become pustular, sharply raised, filled with opaque fluid, firm, and deep-seated. May umbilicate or become confluent
– By the end of 2nd week, they dry up
Also Read: Amid Mpox Scare, AIIMS Delhi Released Protocol For Patients, Doctors
Key Ways In Which India Can Stay Safe From Mpox
Dr Hakim points to vigilance, timely diagnosis and swift action to deal with monkeypox. He mentions the following points:
– Diagnosis by PCR analysis from samples collected from blood, urine, skin lesions, and oral or nasopharyngeal swabs.
– Monitoring and treatment of complications: The patient should closely monitor for the appearance of any of the following symptoms during the period of isolation:
– Pain in the eye or blurring of vision
– Shortness of breath, chest pain, difficulty in breathing
– Altered consciousness, seizure Decrease in urine output
– Poor oral intake
- Lethargy
Dr Hakim says that if any of the above symptoms appear, the patient should immediately contact a nearby healthcare facility/ specialist.
Patient Isolation:
– Isolation of the patient in an isolation room of the hospital/ at home in a separate room with separate ventilation
– The patient is to wear a triple-layer mask
– Skin lesions should be covered to the best extent possible (e.g. long sleeves, long pants) to minimise the risk of contact with others
– Isolation is to be continued until all lesions have resolved and scabs have completely fallen off