What is Mpox (Monkeypox)?

Recently, a virus known as Mpox (formerly called monkeypox) has received more recognition across the globe. This blog post is designed to give a complete review of Mpox with a focus on its history, causes, symptoms, transmission, and treatment.

Dr. Neerav Goyal, Apollo Hospital:

Mpox can potentially affect the liver, causing hepatitis in some cases. Elevated liver enzymes have been observed in patients. However, severe liver complications are rare. Close monitoring is advised during treatment.

History and Name Change

Mpox first came to light in 1958 within a colony of research monkeys, which is why it was initially designated "monkeypox." However, its first instance in humans was not discovered until the year 70 years later in the Democratic Republic of Congo. The disease was largely unrecorded and was confined to the west and central regions of Africa.

2022 In 2022, it was 2022 when the World Health Organization (WHO) officially changed the name of the disease from "monkeypox" to "Mpox" to lessen the stigma and discrimination that was associated with the initial name. This shift reflects an increasing awareness of the significance of non-stigmatizing, neutral diseases' nomenclature.

Cause and Virus Classification

Mpox is caused by the monkeypox virus that belongs to the Orthopoxvirus family of viruses in the family of Poxviridae. It's the same virus family that comprises the variola virus which causes smallpox. But, Mpox tends to be less serious and less infectious than smallpox.

Two distinct genetic clans of the monkeypox virus. The central African (Congo Basin) Clade and the West African clade. This Congo Basin clade has historically resulted in more severe cases of the disease and was believed to be more transmittable.

Symptoms and Disease Progression

The time of incubation for Mpox generally ranges between 6 and 13 days, but it can go up to 21 days. The course of disease progression is divided into two phases:

1. The phase of Invasion (0-5 days) The initial stage is marked by: FeverAn intense headacheLymphadenopathy (swelling of lymph nodes)Back discomfortMuscles pain pronounced insufficiency of energy
2. The Skin Phase of Eruption (1-3 days following onset of fever) This stage includes the development of rashes, which usually begins on the face, and then expands to other areas of the body lesions that progress through various phases: papules, macules pustules and the scabsLesions may be painful or itchy

The condition typically lasts about 2-4 weeks. The majority of patients recover without issues However, serious cases can be seen, especially for pregnant women, children or those with immunocompromised conditions.

Transmission

Mpox may spread through a variety of routes:

1. Animal-to-Human Transmission: It can be caused by direct contact with bodily fluids, blood as well as mucosal or cutaneous lesions that infected animals have. In Africa, there is evidence of infection with the monkeypox virus found in a wide variety of species of animals such as rope squirrels, tree squirrels Gambian Dormice, pouched rats, as well as different species of monkeys.
2. Human-to-human transmission can be the result of close contact with the respiratory secretions of a person, the skin lesions from an infected individual or objects that have recently been contaminated. The transmission of respiratory droplets usually involves prolonged contact with a person which puts health professionals as well as household members and other contacts nearby at risk.
3. Maternal-Fetal Transmission: This virus may be passed on to the fetus through the placenta.

It is important to remember that someone is infectious at the time of onset until all scabs are gone off and a new layer of skin has been formed.

Diagnosis

Mpox is detected through lab tests, usually involving PCR analysis of samples taken of skin lesions. There are other methods, such as electron microscopy as well as histopathology. Differential diagnosis is crucial, as Mpox can be confused with other rash illnesses such as chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies.

Treatment

At present, there isn't a special treatment that is that is approved for Mpox virus infection. However, a variety of antiviral medicines specifically designed for patients suffering from smallpox might be beneficial. This includes:

1. Tecovirimat (TPOXX)
2. Brincidofovir (Tembexa)
3. Cidofovir

The treatment is usually focused on the management of symptoms as well as preventing dehydration and combating secondary bacterial infections as they happen.

Prevention and Control

A variety of steps are available to help prevent Mpox disease:

1. Stay clear of any contact with animals which could be carriers of the virus (including dead or sick animals living in the areas in which Mpox is common).
2. Avoid contact with any material like bedding that may have come in contact with an animal or human.
3. The process of separating patients suffering from infection from those susceptible to infection.
4. Practice good hand hygiene following contact with animals that have been infected or people.
5. Wearing Personal Protective Equipment (PPE) while caring for patients.

It is also possible that vaccination plays an important role in preventing it. Smallpox vaccination is 90% effective in the prevention of Mpox. A newer vaccine, designed specifically designed for Mpox along with smallpox (MVA-BN) was approved in the year 2019. The vaccines are available in both post-exposure and pre-exposure.

Global Impact and Recent Outbreaks

Although Mpox has been prevalent in a variety of African countries for decades, the illness became the focus of attention worldwide in 2022, when an outbreak that was multi-country occurred that affected several countries in which Mpox is not commonly detected. The outbreak revealed the possibility for Mpox to spread across the globe and highlighted the need for greater surveillance and preparation.

In addition, the 2022 epidemic attracted attention to the effects of the disease on different communities, especially those who have sexual relations with males and were particularly affected in a variety of countries. This underscored the importance of targeted interventions for public health, to avoid stigmatization.

Future Outlook

As with other new infectious diseases, the future of Mpox is not certain. Research is currently focusing on gaining a better understanding of the virus improving the diagnostic abilities developing more effective treatments and improving vaccination strategies.

The worldwide response to the outbreak of 2022 highlighted how important international cooperation is to managing infections and threats. It also underscored the importance of investing in infrastructure for public health as well as disease surveillance systems and research into new pathogens.

Conclusion

Mpox, though not a brand new disease has become an important health issue in the world. Knowing the causes of transmission, symptoms and strategies for prevention is vital for both health professionals as well as all of us. As we navigate the challenges of emerging and re-emerging infections keeping well-informed and adhering to the public health guidelines are the best defense against risks such as Mpox.