In recent years, global attention has turned to the resurgence of an infectious disease that was once considered rare: monkeypox.
While its name might evoke images of primates, monkeypox is a viral zoonotic disease
that can affect both humans and animals.
It was first identified in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name.
However, the virus is more commonly spread by rodents and other small mammals.
Since then, sporadic outbreaks have been reported, particularly in Central and West Africa, but a more alarming spread has been observed globally since 2022.
What is Monkeypox ?
Monkeypox is caused by the monkeypox virus, a member of the Orthopoxvirus genus
which also includes the variola virus responsible for smallpox.
While monkeypox is less contagious and severe than smallpox, it shares many similarities in symptoms and transmission methods.
Unlike smallpox, which was eradicated in 1980 thanks to a global vaccination campaign, monkeypox remains endemic in several African countries.
Its potential for broader outbreaks has raised concern due to its ability to jump
from animals to humans and spread through human-to-human contact.
Symptoms and Progression
The incubation period for monkeypox is typically 6 to 13 days but can range from 5 to 21 days. The disease often begins with flu-like symptoms: fever, headache, muscle aches, and exhaustion. One distinguishing feature is the swelling of lymph nodes (lymphadenopathy), a trait that sets it apart from other pox-like illnesses such as smallpox.
Within 1 to 3 days after the appearance of fever, a rash develops, often beginning on the face and then spreading to other parts of the body. The rash evolves through several stages – from macules (flat lesions) to papules (raised lesions), vesicles (fluid-filled blisters), pustules (pus-filled lesions), and finally crusts, which fall off as they heal. The rash can be painful and may lead to scarring in some cases.
While most patients recover within 2 to 4 weeks, severe cases can occur, especially in young children, pregnant women, and individuals with weakened immune systems. Complications include secondary infections, pneumonia, and, in rare cases, encephalitis (inflammation of the brain).
Is Monkeypox Deadly ?
For the majority of people, monkeypox is not fatal .
The case fatality rate (CFR) varies depending on the strain of the virus and the region where the outbreak occurs.
There are two distinct strains (clades) of the monkeypox virus: the Central African (Congo Basin) strain and the West African strain.
The Central African strain is known to cause more severe disease and has a higher CFR, estimated at around 10%
while the West African strain, which has been responsible for most cases outside Africa, has a CFR of about 1-3%.
How is Monkeypox Transmitted ?
Monkeypox spreads primarily through close contact with an infected person or animal.
The virus can be transmitted via respiratory droplets, bodily fluids, or direct contact with lesions.
In addition to human-to-human transmission, zoonotic transmission – from animals to humans – can occur through bites, scratches, or the handling of infected animals.
In recent outbreaks, evidence has shown that monkeypox can also spread through respiratory secretions
during prolonged face-to-face contact, sexual contact, and contaminated materials such as bedding or clothing.
Notably, monkeypox is not as easily transmitted as COVID-19 or the flu, and it requires close and prolonged contact to spread efficiently.
Nevertheless, the ability of the virus to persist in the environment for extended periods on surfaces
adds to its potential for widespread transmission in densely populated areas.
Causes and Risk Factors
The primary cause of monkeypox outbreaks is human contact with infected animals or individuals.
In Africa, the hunting and consumption of bushmeat (wild animals) are considered a major risk factor for zoonotic transmission.
International travel and globalization have also played a role in recent outbreaks
as the virus can be transported across borders when infected individuals travel.
Furthermore, since the global eradication of smallpox in the late 20th century
routine smallpox vaccinations have ceased.
This has led to a growing population of individuals who lack immunity to poxviruses, including monkeypox.
As a result, the population’s vulnerability to monkeypox has increased, which may partially explain the recent upsurge in cases outside Africa.
Though the disease can be painful and lead to complications, particularly in immunocompromised individuals
most people recover fully.
However, the recent global spread and the fact that severe cases can occur, especially in vulnerable populations, have raised concerns among public health officials.
The possibility of monkeypox becoming a larger global health threat has spurred efforts to improve surveillance, vaccination, and treatment options.
Prevention and Treatment
Currently, there is no specific treatment for monkeypox, though antiviral drugs like
Tecovirimat have shown promise in treating severe cases.
Supportive care, such as pain management, hydration, and treatment of secondary
infections, remains the primary approach for managing the disease.
Vaccination is another key tool in preventing monkeypox.
The smallpox vaccine, which was used during the global eradication campaign
provides some protection against monkeypox as well.
In recent outbreaks, healthcare workers and high-risk populations have been
offered smallpox vaccines to control the spread.
The availability of a new, safer vaccine (Imvamune or Jynneos) specifically
approved for monkeypox has improved the ability to prevent the disease.
Conclusion
While monkeypox may not have the pandemic potential of more contagious
diseases like COVID-19, its resurgence is a reminder of the unpredictable nature of zoonotic diseases.
Public health vigilance, combined with vaccination and education,is essential in controlling outbreaks and preventing the virus from gaining a stronger foothold.
With continued research, global collaboration, and a focus on protecting vulnerable populations
we can minimize the impact of monkeypox and better prepare for any future outbreaks.
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