Monkeypox Unmasked: What You Need to Know About This Emerging Viral Threat

Introduction: Monkeypox, a viral zoonotic disease, is caused by the monkeypox virus, a member of the Orthopoxvirus genus, which also includes the variola virus responsible for smallpox. While it is primarily endemic to Central and West Africa, occasional outbreaks have been reported in other regions, including Pakistan, primarily due to human-to-human transmission.

Transmission:

• Animal-to-Human: The virus can spread from infected animals, such as rodents or primates, to humans through direct contact with blood, bodily fluids, or skin and mucosal lesions of infected animals.
• Human-to-Human: Transmission occurs through respiratory droplets during prolonged face-to-face contact, direct contact with bodily fluids or lesion material, and indirect contact via contaminated objects like bedding.

Symptoms:

• Incubation Period: Typically ranges from 6 to 13 days, but can extend from 5 to 21 days.
• Initial Symptoms: Include fever, headache, muscle aches, backache, swollen lymph nodes, chills, and fatigue.
• Rash Development: A rash usually appears 1 to 3 days after the fever begins, often starting on the face and spreading to other parts of the body. The rash progresses from flat lesions (macules) to raised bumps (papules), fluid-filled blisters (vesicles), pus-filled lesions (pustules), and finally scabs that fall off.

Severity and Complications: While typically mild, monkeypox can become severe, particularly in young children, pregnant women, and immunocompromised individuals. Potential complications include secondary bacterial infections, respiratory distress, bronchopneumonia, sepsis, encephalitis, and corneal infections, which can lead to vision loss.

Diagnosis:

• Clinical: Diagnosis is based on the distinctive rash and a history of potential exposure or travel.
• Laboratory: Confirmation is done through PCR (polymerase chain reaction) testing of lesion samples.

Treatment: There is no specific treatment for monkeypox, but the disease is usually self-limiting. Supportive care, such as managing symptoms like fever and pain, is the primary treatment approach. In certain cases, antiviral drugs like Tecovirimat, originally developed for smallpox, may be used.

Prevention:

• Vaccination: The smallpox vaccine offers some protection against monkeypox. In 2019, a specific monkeypox vaccine (Jynneos) was approved for adults at high risk.
• Public Health Measures: Preventive strategies include isolating infected individuals, using personal protective equipment (PPE) for healthcare workers, and thoroughly disinfecting contaminated environments.

Recent Outbreaks: Monkeypox has gained global attention due to outbreaks beyond Africa, particularly in 2022, when clusters of cases were reported in Europe and North America. These outbreaks underscored the importance of vigilant public health measures worldwide, including in Pakistan, to curb the spread of the virus.