Monkeypox is a potentially fatal and Zoonotic viral disease that can transmit from animals to humans. It’s similar to smallpox, though less in severity. The latest outbreak of Monkeypox disease has raised alarms worldwide. The outbreak was classified as a Public Health Emergency of International Concern (PHEIC) for monkeypox by the World Health Organization (WHO) in July 2022. (who.int). The first case of Monkeypox in Pakistan appeared in April 2023, when the health authorities found the monkeypox virus in a 25-year-old individual who recently came from Saudi Arabia.
Despite the commendable performance of Pakistan in the COVID-19 Pandemic, Health authorities in Pakistan are concerned about making the requisite arrangements to provide a large population with treatment for Monkeypox.
What is Monkeypox?
Mpox is an infectious disease that can cause a painful rash, enlarged lymph nodes, and fever. However, most people recover from mpox in 2-4 weeks.
The virus that causes monkeypox is an enveloped double-stranded DNA virus belonging to the same virus family as smallpox, cowpox, and vaccinia, the Orthopoxvirus Genus. Based on genetic differences in the virus’ DNA, reflected in the protein sequence of the virus, virologists have recognized four clades of the Monkeypox virus, designated as Clades 1 – 4. Clade 1 is associated with the 2003 outbreak of mpox in the USA, and Clade-4 is associated with the 2017 outbreak.
How did it get to Humans?
There is no credible information or report about the origin of the Monkeypox virus. However, the Monkeypox virus emerged in 1958 among monkeys kept in a research facility in Denmark. The first human case occurred in the Democratic Republic of the Congo in 1970, when the Monkeypox virus affected a nine-year-old boy. The first appearance among monkeys is the reason for the name of the disease, though research has revealed rodents to be the primary carriers of the disease instead of monkeys. The mpox emerged gradually after the elimination of smallpox disease and its vaccine in 1980.
What are the signs and symptoms of monkeypox?
The incubation period of Monkeypox disease is long and may take about four to 21 days to show signs of illness in someone exposed to the virus. Usually, Monkeypox lasts from two to four weeks, though people with weak immunity may suffer longer.
The rash is the manifestation of monkeypox that is most noticeable. It begins as a flat sore and gradually turns into itchy or painful blisters filled with liquid. The number of skin lesions may vary from person to person, ranging from one to a few or even hundreds. The lesions can appear on the face, throat, mouth, palms of hands, soles of feet, groin, genital area, or anus.
Usually, the face is where the mpox rash first appears before spreading to the rest of the body, including the palms of the hands and soles of the feet. The four clinical stages of a lesion’s development are macules, papules, vesicles, and pustules.
Swollen lymph nodes are another very peculiar symptom of MPOX disease. Lymphadenopathy can occur on one or both sides of the body in the neck, armpits, and groin. Swelling on lymph nodes appears in almost half of the patients with mpox.
People affected by MPOX disease have also reported rectal pain and rectal bleeding in the current outbreak.
Other common symptoms of mpox include headaches, sore throats, muscle aches, back pain, and low energy.
In rare cases, when complications develop during treatment for monkeypox, patients can suffer severe illnesses. These complications can lead to serious skin diseases, pneumonia, pain in swallowing, encephalitis (inflammation of the brain), Myocarditis (heart disease), Proctitis (rectum disease), balanitis (genital organ disease), Urethritis (urinary passage disease), or even death.
|Enanthem||Lesions in the mouth or on the tongue.|
|Macules||1-2 days||Flat lesions appear.|
|Papules||1-2 days||Lesions progress from being flat to raised|
|Vesicles||1-2 days||Lesions are filled with clear fluid.|
|Scabs||7-14 days||Pustules turn into scabs by the end of the second week and remain for about another week before they begin to fall.|
Who is at risk from monkeypox disease?
The most vulnerable people to mpox are those who have weak immunity. Immune suppression due to a medical condition makes them prone to a higher risk of illness and death. Children or pregnant women are also at a higher risk of developing complications due to mpox.
HIV-affected individuals are also likely to develop severe disease due to mpox.
Apart from people with weak immune systems, anyone in physical contact with a person affected by the mpox virus or an infected animal is at increased risk of suffering from mpox.
Cure and Treatment of Monkeypox
The MPOX disease is treatable. Though the recent outbreak of Monkeypox in Pakistan 2023 has raised alarms, the availability of treatment for monkeypox disease is reassuring. Many people suffering from mpox don’t require medication, but severely affected people can be treated with various antiviral agents. Smallpox medications are often effective as a treatment for monkeypox, but there is not enough data to establish their usefulness.
The Mpox vaccine can avert the infection if the patient is administered the vaccine within four days of coming into contact with a person affected by the mpox virus. Medical experts recommend the vaccination against mpox for people who are at high risk.
A monkeypox alert was sent to health authorities and professionals, and screening procedures were put in place at airports on Monday to look for suspected cases. The National Command and Operation Centre (NCOC) for Covid-19 has been reconstituted at the National Institute of Health (NIH) on the prime minister’s instruction.
Staff Reporter, The Newspaper’s. “NCOC for Covid-19 Reconstituted; Alert Issued for Monkeypox.” DAWN.COM, 24 May 2022, www.dawn.com/news/1691227.
The focus of treatment for monkeypox is to prevent complications, administer the rash, and manage the pain. Most people recover in 2-4 weeks; however, supportive care is fruitful for managing the symptoms of mpox.
Prevention is better than cure; one must take care of the following aspects to avoid falling sick with mpox disease.
- Restrict your contact with people and their belongings who are infected with mpox.
- Wash your hands frequently and use protective gear such as a mask and gloves.
- Limiting the sex partners.
Monkeypox in Pakistan is a rare but potentially fatal disease caused by the MPOX virus. While there is no cure for monkeypox, vaccination and supportive care can help manage the symptoms and prevent the spread of the virus. Preventive measures such as avoiding contact with infected individuals and animals, using protective gear, and practicing good hygiene can also help prevent the spread of the virus.
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