There are so many questions that pop up in our minds when we hear of “monkeypox”. Medbound Times sat down with Dr. Mangala Bote, Associate professor of Community Medicine, TNMC Mumbai to get an expert opinion on this disease which has spooked everyone.
Tanisha Jindal (TJ): So many news outlets are mentioning this disease called monkeypox which was previously almost unheard of. What is it exactly?
Dr. Mangala: Monkeypox (MPX) is a viral zoonotic disease with symptoms similar to smallpox, although with less clinical severity. MPX was first discovered in 1958 in colonies of monkeys kept for research, hence the name ‘monkeypox.’ The first human case of monkeypox was reported from Democratic Republic of the Congo (DRC) in 1970. According to the World Health Organization (WHO), in the present series of outbreaks being reported, this is the first time that chains of transmission are reported in Europe without known epidemiological links to West or Central Africa. Monkeypox has been reported as endemic in several other central and western African countries
TJ: How does monkeypox spread? Is it going to be the “next covid”?
Dr. Mangala: Human-to-human transmission is known to occur primarily through large respiratory droplets generally requiring a prolonged close contact. It can also be transmitted through direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens of an infected person. Animal-to-human transmission may occur by bite or scratch of infected animals like small mammals including rodents (rats, squirrels) and non-human primates (monkeys, apes) or through bush meat preparation. Monkeypox, though an airborne infection will still be less contagious than airborne viruses like COVID-19 and the flu. A smallpox vaccine could also protect against monkeypox because of the similarities between the two viruses, according to the CDC. At least two vaccines and two antivirals have been approved against monkeypox. It is less likely to be like COVID-19.
TJ: What are the symptoms of this disease? If someone shows the symptoms, what should they do?
Dr. Mangala:
Fever
Lymphadenopathy - Typically occurs with fever onset -Periauricular, axillary, cervical or inguinal -Unilateral or bilateral
Headache, muscle aches, exhaustion
Chills and/or sweats
Sore throat and cough
Skin involvement (rash)
Symptoms should be reported to the nearest public health facility.
TJ: How is it diagnosed?
Dr. Mangala: PCR for Orthopoxvirus genus [Cowpox, Buffalopox, Camelpox, Monkeypox] will be done. If the specimen will show positivity for the Orthopoxvirus, it would be further confirmed by Monkeypox specific conventional PCR or real time PCR for Monkeypox DNA. Additionally, virus isolation and the Next Generation Sequencing of clinical samples (Miniseq and Nextseq) will be used for characterization of the positive clinical specimens.
TJ: How dangerous is this disease? Is it very severe?
Dr. Mangala: Monkeypox is usually a self-limited disease with symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3–6%.
Interviewer: Is there any cure or treatment for monkeypox?
Dr. Mangala:
Patient isolation
Protection of compromised skin and mucous membranes
Rehydration therapy and Nutritional support
Symptom alleviation
Monitoring and treatment of complications
Symptomatic treatment and few antivirals
TJ: What can one do to prevent oneself from this disease?
Dr. Mangala: Raising awareness of risk factors and educating people about the measures they can take to reduce exposure to the virus is the main prevention strategy for monkeypox.
There are number of measures that can be taken to prevent infection with monkeypox virus:
Avoid contact with any materials, such as bedding, that has been in contact with a sick person.
Isolate infected patients from others.
Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer.
Use appropriate personal protective equipment (PPE) when caring for patients.
TJ: Is the threat of this disease real? Or is it just a media driven frenzy?
Dr. Mangala: 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 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.
MedBound Times is grateful to Dr. Mangala Bote for taking the time to do this interview which will help spread awareness among the masses.
