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Wednesday, 25 May 2022

Monkeypox

                                                         Monkeypox

 

   Monkeypox was first discovered in 1958 when two outbreaks of pox-like disease occurred in colonies of monkeys kept for research, hence the name "monkeypox". The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. 

 Since then monkeypox has been reported in humans in other central and western African countries. 
 
 About Monkeypox:  
   
    Monkeypox is a rare disease that is caused by infection with the monkeypox virus. The monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae. 
 The Orthopoxvirus genus also includes variola virus(which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus. 
 
  Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ''monkeypox". The first human case of monkeypox was recorded in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox. 

   Since then, monkeypox has been reported in people in several other central-western African countries, including Cameroon, Central African Republic, Cote d'Ivoire, the Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. 
   The majority of infections are in the Democratic Republic of the Congo. Monkeypox cases in people have occurred outside of Africa linked to international travel or imported animals, including cases in the United States, as well as Israel, Singapore, and the United Kingdom.  

    The natural reservoir of monkeypox remains unknown. However, African rodents and non-human primates (like monkeys) may harbor the virus and infect people. 
 
 A child affected with monkeypox. 

Signs and Symptoms

 In humans, the symptoms of monkeypox are similar to but milder than the symptoms of smallpox. Monkeypox begins with fever, headache, muscle aches, and exhaustion. The main difference between the symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not. The incubation period (time from infection to symptoms) for monkeypox is usually 7-14 days but can range from 5-12 days. 

 The illness begins with:

- Fever
- Headache
- Muscle aches
- Backache 
- Swollen lymph nodes
-  Chills
- Chills
- Exhaustion

  Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a rash, often beginning on the face and then spreading to other parts of the body. 

 Lesions progress through the following stages before falling off:

 - Macules
- Papules
- Vesicles 
- Pustules 
- Scabs

   The illness typically lasts for 2-4 weeks. In Africa, monkeypox has been shown to cause death in as many as 1 to 10 persons who contract the disease.

Transmission
 
 Transmission of the monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or mucous membranes (eyes, nose, or mouth). 

   Animal to the human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding. Human-to-human transmission is thought to occur primarily through large respiratory droplets. 
 
  Respiratory droplets generally can't travel more than a few feet, so prolonged face-to-face contact is required. Other human-to-human methods of transmission include direct contact with body fluids or lesion material and indirect contact with lesion material, such as through contaminated clothing or linens. 

   The reservoir host (main disease carrier ) of monkeypox is still unknown although African rodents are suspected to play a part in transmission. The virus that causes monkeypox has only been recovered (isolated) twice from an animal in nature. In the first instance (1985), the virus was recovered from an apparently ill African rodent in the Equateur region of the Democratic Republic of Congo. In the second (2012). the virus was recovered from a dead infant mangabey found in the Tai National park, cote D; Ivoire. 

Prevention:
 
 There are a number of measures that can be taken to prevent infection with the monkeypox virus: 

- Avoid contact with animals that could harbor the virus(including animals that are sick or that have been found dead in areas where monkeypox occurs). 

- Avoid contact with any materials, such as bedding, that have been in contact with a sick animal. 

- Isolated infected patients from others who could be at risk for infection. 

- Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer. 

- Use personal protective equipment (PPE) when caring for patients.

Information for Clinicians:  

 The first symptoms of monkeypox include fever, malaise, headache, and sometimes sore throat and cough. A distinguishing feature of monkeypox from smallpox is lymphadenopathy(swollen lymph nodes). 
 This typically occurs with fever onset, 1 to 2 days before rash onset, or rarely with rash onset. Lymph nodes may swell in the neck(submandibular & cervical), armpits(axillary), or groin(inguinal) and occur on both sides of the body or just one. 


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