We reside within the ocean of microbes; we’re surrounded by numerous forms of micro-organisms. Some unicellular, microscopic organisms pose extreme threats to living organisms, including humans. Among those micro-organisms like bacteria, fungi and protozoa, viruses are the intracellular organisms that usually require some other dwelling frame, known as the host, for their survival, particularly the residing cells of the host. These viruses can invade the cells of animals, plant life and humans. Viruses are the cause of infectious and several deadly illnesses in living organisms. One of those infectious sicknesses is Monkeypox, which has zoonotic origins and is nearly similar to the virus that causes smallpox.
What is Monkeypox?
Monkeypox, presently known as Mpox, is an infectious, however uncommon, viral illness that occurs due to infection as a result of monkeypox virus.
Monkeypox Virus
This virus originates from animals and may infect other animals and humans. That’s why the Mpox virus is associated with many epidemics and pandemics. Monkeypox virus can be abbreviated as MPV, MPXV or hMPXV, and it structurally resembles variola virus (VARV) and cowpox virus (CPX), the causative agent of smallpox and cowpox, respectively. All these viruses belong to the same genus, named as the orthopoxvirus. The MPV virus has an oval shape; its hereditary material is represented by double-stranded DNA. Except for a few viruses, most viruses generate copies of their DNA or hereditary material in the nucleus of their host. In the case of the monkeypox virus, it makes copies of its DNA in the host cell cytoplasm.
Subtypes
MPV virus has two subtypes, the Clade-1 and Clade-II.
- Infections caused by the Clade I subtype have a high case fatality rate (CRF) and are more severe than infections caused by the Clade II subtype.
- The latest MPV virus outbreak, which occurred worldwide and became a pandemic, remained between 2022-2023. The Clade II subtype of the MPV virus was responsible for this pandemic.
History of Monkeypox Virus
A scientist Preben von Magnus from Copenhagen, Denmark, first isolated the MPV or Mpox virus from Macaca fascicularis, the crab-eating monkeys, in 1958. The virus was named Monkeypox, after the name of the monkeys that were carrying it.
Later on, the first human case of monkeypox virus was diagnosed in the Democratic Republic of Congo (DRC) in 1970. After that, almost 300 cases of monkeypox virus were documented in DRC during the time period of five years from 1981 to 1986. These cases were mainly the result of direct contact with animals, probably due to a lack of awareness among local communities and limited research on transmission patterns of the monkeypox virus.
However, the number of cases substantially increased annually during the time period between 2011–2014, and the case fatality rate (CFR) of the Clade-1 subtype was between 1–10%, making it a more severe and highly infectious subtype of the MPV virus. People travelling out of Africa majorly contributed to the spread of the Mpox virus to other regions.
Another outbreak of the Mpox virus began in the United States in 2021. The Clade II subtype of the Mpox virus was responsible for this outbreak. Other than America and Europe, the Mpox cases were also documented in Asia from 18 May 2022 onwards. World Health Organization declared the outbreak a public health emergency of international concern on 23 July 2022. In May 2023, this public health emergency was called off by the World Health Organization.
Transmission of Monkeypox Virus
Animal-to-human transmission
- Any animal infected with MPV can serve as a source of transmission of the virus to other animals as well as to humans.
- Animal-to-human transmission occurs through bite or scratches on the human body by any infected animal.
- Likewise, touching the dead bodies of infected animals, hunting and cooking or using the products made by infected animals are some of the factors which play a role in the transmission of Mpox infection to humans.
Human-to-human Transmission
- Human-to-human transmission occurs in many ways, like touching or coming in direct contact with the lesion, scratches or body fluids of a person with Mpox.
- Coughing, sneezing, or talking generate droplets that contain the Mpox virus; thus, these droplets are also the source behind the spread of the monkeypox virus from one person to another.
- Similarly, the monkeypox virus can cross the placenta; therefore, infected pregnant women can also serve as a source to transfer this virus to the fetus.
- Fomites, such as bedding clothing used by infected humans or animals, can also assist the viral transmission from one person to another.
Symptoms of Monkeypox
Rashes or blisters and flu-like symptoms are the significant signs of Mpox infection. Fever, rash, swollen lymph nodes, headache, lethargy, and muscle pain are some general symptoms associated with Mpox.
- The rash appears red, flat spots during stage 1; stage 1 is also known as macule.
- A papule is a term used for stage 2; in this stage, the red flat spots become stiff and look like raised bumps.
- These bumps then turn into blisters during stage 3, the vesicle stage. These blisters contain thin, transparent liquid and become enlarged in size. These three stages last for 4–6 days.
- Stage 4 is the pustule stage of the infection, characterized by pus formation in the blisters.
- The last stage of infection, stage 5, is also called the scabs stage. In this stage, the blisters become hard and start to fall off. These blisters appear on the mouth, hands, feet, face and anus.
All five stages of the Mpox infection take nearly two weeks to a month to complete.
The onset of symptoms in people infected with Mpox greatly vary, as follows:
Infected people do not tend to develop all the symptoms, but sometimes, a few patients reveal rashes and other symptoms at later stages.
Some people do not develop rash but only have flu-like symptoms.
Some individuals do not show symptoms but serve as a carrier for virus transmission.
People who are immunocompromised also suffer from other complications like pneumonia, sepsis, and encephalitis.
Infection during pregnancy will consequently lead to stillbirth.
Diagnosis of Monkeypox
Lymphadenopathy or swollen lymph nodes are characteristic features of Mpox virus infections and assist in its diagnosis. These symptoms are also helpful in differentiating Mpox infection from other similar pox viral infections like smallpox and chickenpox.
- Real-time polymerase chain reaction (PCR) is a preferred diagnostic method for detecting the Mpox virus.
- RayBiotech monkeypox virus (MPXV) PCR nucleic acid detection kit is used to identify monkeypox virus DNA in liquid samples collected from infected patients.
- This assay detects the J2R gene associated with monkeypox virus DNA.
Treatment of Monkeypox
Symptoms of Mpox infection typically go away on their own within 2–4 weeks, and many patients recover independently. Therefore, no specific drug is designed to treat Mpox infection; however, antiviral medications used to treat smallpox, such as Cidofovir and Tecovirimat, are prescribed to alleviate symptoms.
Besides, supportive care is also recommended, such as:
- Use salt water to rinse your mouth if you have mouth sores.
- Excessive fluid intake
- Taking rest
- Taking an oatmeal bath to mitigate dry, itchy rashes
- Using pain and fever relievers such as paracetamol
Vaccination against Mpox: The Food and Drug Administration (FDA) has approved two vaccines, JYNNEOS and ACAM2000, for preventing smallpox; these vaccines can also be used against Mpox. JYNNEOS vaccine is also known as Imvamune or Imvanex.
Preventive measures for Monkeypox
- Do not touch or pop sores or blisters; bursting blisters may spread infection to other bodily parts.
- Wash your hands properly after touching blisters.
- Keep skin uncovered and dry.
- Stay at home and even at your houses
- Wear a mask
- Take a warm bath or with Epsom salt until the rash heals
- Oatmeal or Epsom salt bath can be a helpful remedy for faster relief from itchy and dry rashes.
- Infected people must be isolated from others in separate rooms to prevent the spread of infection.
- Use an N95 mask to limit the spread of virus-containing respiratory droplets.
- Avoid contact with infected animals.
To stop spreading Monkeypox to other people, take proper isolation in the house or the hospital if required, and always wear a mask and cover lesions whenever you are with anyone else.
Final Thoughts
Monkeypox is not an abundant infection, yet it is prevalent in central and west Africa. It was first discovered by Preben von Magnus in Denmark in 1958. After that, an outbreak has been reached various other countries. The symptoms of this illness are associated with smallpox, and additional are fever, rash, and swallow lymph nodes. Other animals, such as rodents and primates, cause the transmission of this disease.
Frequently Asked Questions – FAQs
Who is at risk of Monkeypox?
Anyone, regardless of gender identity or sexual orientation, is at greater risk of Monkeypox if he is in direct contact with an infected monkeypox person.
Can Monkeypox be cured?
Usually, a Monkeypox person has recovered himself at home without any treatment.
How long does Monkeypox last?
The people who get monkeypox experience symptoms within 5 to 21 days after its exposure. It could last for 2 to 4 weeks and may occupy several stages.
About the author
Dr Madilyn Adams is a PhD in molecular medicine from Harvard University and has been working as a medical blogger for seven years.
References
- https://www.who.int/news-room/fact-sheets/detail/monkeypox
- https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/monkeypox
- https://www.mayoclinic.org/diseases-conditions/infectious-diseases/expert-answers/monkeypox-faq/faq-20533608
- https://www.cdc.gov/poxvirus/mpox/symptoms/index.html
