Monkeypox

Causative Agents

Monkeypox is a rare disease that is caused by infection with monkeypox virus. Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae which is double-stranded DNA genome [1]. 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 [2].

In humans, monkeypox begins with fever, headache, muscle aches, exhaustion, backache, swollen lymph nodes, chills, exhaustion. The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days. The patient develops a rash, often beginning on the face then spreading to other parts of the body. The illness typically lasts for 2−4 weeks. In Africa, monkeypox has been shown to cause death in as many as 1 in 10 persons who contract the disease [3].

Epidemiology

Monkeypox is a disease of global public health importance as it not only affects countries in West and Central Africa, but the rest of the world. In 2003, the first monkeypox outbreak outside of Africa was in the United States of America and was linked to contact with infected pet prairie dogs. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country from Ghana. This outbreak led to over 70 cases of monkeypox in the U.S. monkeypox has also been reported in travelers from Nigeria to Israel in September 2018, to the United Kingdom in September 2018, December 2019, May 2021, and May 2022, to Singapore in May 2019, and to the United States of America in July and November 2021. In May 2022, multiple cases of monkeypox were identified in several non-endemic countries. Studies are currently underway to further understand the epidemiology, sources of infection, and transmission patterns [4].

Modes of Transmission

Animal-to-human (zoonotic) transmission can occur from direct contact with the blood, body fluids, or cutaneous or mucosal lesions of infected animals. Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects. Transmission via droplet respiratory particles usually requires prolonged face-to-face contact, which puts health workers, household members and other close contacts of active cases at greater risk [5].

References

  1. Kugelman JR, Johnston SC, Mulembakani PM, Kisalu N, Lee MS, Koroleva G, et al. Genomic Variability of Monkeypox Virus among Humans, Democratic Republic of the Congo. Emerg Infect Dis. 2014 Feb; 20(2): 232–239. 48. doi: 10.3201/eid2002.130118
  2. https://www.cdc.gov/poxvirus/monkeypox/about.html. 25 May 2022
  3. https://www.cdc.gov/poxvirus/monkeypox/symptoms.html. 25May 2022
  4. https://www.who.int/news-room/fact-sheets/detail/monkeypox. 25 May 2022
  5. https://www.who.int/news-room/fact-sheets/detail/monkeypox. 25 May 2022

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