Monkeypox is a zoonotic disease caused by monkeypox virus of Orthopox virus genus of Poxviridae family. It was first discovered in monkeys in 1958 hence the name derived as monkeypox. First case among human population was discovered in Congo in 1970. It basically seen in African countries like Congo, Ghana, Cameron, Gabon, Liberia, Nigeria, In 2003, first case was reported in outside of Africa in USA, linked to contact with prairie dogs.
Now it has spread to USA, Europe, Asia including India. First case of monkeypox in India was discovered in Kerala. In July 23, 2022 WHO declared the outbreak as “Public health emergency of International Concern”. Public health emergency of International is declared when a disease affects multiple countries at a time like a pandemic as the case it was declared in Covid-19.
Source- who.int
Host– Certain rodents like tree squirrels, Gambian pouched rats, dormice are are naturally susceptible to monkeypox virus.
Incubation period– Incubation period varies between 5 to 21 days.
Period of Communicability — 1-2 days before rash till all the scab falls off from body.
Mode of Transmission–
• Human to human transmission occurs by large respiratory droplets, direct contact with body fluids or indirect contact of body fluids with linen.
Symptoms of monkeypox — Fever, head ache, body ache, swollen lymph nodes, rash like chicken pox, weakness.
Rash in monkeypox- It starts as enanthem, gradually progressing to macules, papules, vesicles and pustules. It may affect all over the body.
Suspected Case – A case is suspected if he/she has the above symptoms along with history of travel to an endemic area 21 days before.
A confirmed case is detected by laboratory diagnosis of suspected cases by PCR.
Laboratory diagnosis– Diagnosis by real time or conventional PCR, nucleic acid amplification test(NAAT), sequencing of unique viral genomic sequences.
Prevention Measures–
• The monkeypox cases should be isolated to break the chain of propagation. The patients should be confined to special wards or isolation centres designed for monkeypox cases. the health personnel and paramedical staff should be properly trained to deal with cases.
• The patient should wear a protective mask to restrict further spread of virus.
• Health personnel and paramedical staff should wear protective body kits, gloves, N-95 mask, goggles to fully protect themselves and others.
• Precaution while handling the soiled laundry( contaminated linen, dresses) should be taken properly.
• The disposal of kits, gloves, PPE should be according the biomedical waste management rules.
Management —
• Patient isolation– Isolation means separation of such diseased individuals to such an environment that can help in halting spread of the disease to the healthy individuals. It is a method of preventing rapid spread of infectious diseases. Because the infectious diseases have short incubation period. Patients should be isolated to limit the further spread of disease.
• Skin lesions should be cleaned with antiseptics. Skin lesions are the raw sources of infection. The viral spread is rampant on contact with body fluids. Antiseptics are the chemical agents that kill the growing microorganisms. So it is utmost important to prevent the contact of oozing body fluids even with inanimate objects.
• The wounds should be covered with light dressing. Dressing of wounds not only neutralizes the microbes but also prevents contact with body surface.
• Rehydration therapy and nutritional support should be instituted. Viral infections more prevalent in weak immunosuppressed individuals. Rehydration rejuvenates our body and maintains cell turgor. Nutritional suppliments in form of vitamins and minerals support the immune system.
• Systemic signs should be managed accordingly. Antipyretics can be given to reduce the fever, malaise.
Contact tracing
The contacts should be monitored daily till the onset of symptoms for at least 21 days. Contact tracing helps to identify the source of infection, virulence of the disease. It is very important aspect of surveillance. During the time of epidemic, we can easily tackle the problem by early intervention. Those diseases having suspected international spread or potential to cause a pandemic, can be intervened early.
Source– Guidelines for management of monkeypox disease , Ministry of Health and Family welfare, Government of India
