After coronavirus, now we are amid monkeypox, and it is spreading from Europe to Asia. The monkeypox disease is expected to spread to more places and therefore countries should start paying attention to monkeypox precautionary measures.
As
per the World Health Organization [WHO] avers, A global outbreak of monkeypox has
grown to nearly 14,000 cases, including 5 deaths.
Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox,” the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) might carry the virus and infect people.
The first human case of monkeypox was recorded in 1970. Prior to the 2022 outbreak, monkeypox had been reported in people in several central and western African countries. Previously, almost all monkeypox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs or through imported animals. These cases occurred on multiple continents.
What is Monkey Pox?
Monkeypox is a rare disease caused by infection with the monkeypox virus. The monkeypox virus is part of the same family of viruses as the variola virus, the virus that causes smallpox. Monkeypox symptoms are similar to smallpox symptoms but milder, and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.
The 2022 Monkeypox outbreak
The 2022 outbreak has a different pattern of spread compared to prior monkeypox outbreaks outside Africa. Genetic evidence suggests the outbreak likely started in Nigeria. Then, it spread to European countries, and the first case of monkeypox appear in Singapore and Australia. Since 1 January and as of 22 June 2022, 3413 laboratory-confirmed cases and one death have been reported to WHO from 50 countries/territories in five WHO Regions. Since the previous Disease Outbreak News of 17 June was published, 1310 new cases have been reported and eight new countries have reported cases.
What is the variola virus?
Variola virus or smallpox virus is a contagious disease that would be transmitted from one medium to another medium through contact and even inhalation of airborne saliva containing large variola virus. There is no evidence showing that the variola virus would be transmitted through the air like coronavirus.
Before smallpox was eradicated, it was a serious infectious disease caused by the variola virus. It was contagious meaning, it spread from one person to another. People who had smallpox had a fever and a distinctive, progressive skin rash. Most people with smallpox recover, but about 3 out of every 10 people with the disease die. Many smallpox survivors have permanent scars over large areas of their bodies, especially their faces.
Where does monkeypox exist?
Everywhere! At places where the monkeypox virus carriers have contacted on. The natural host of monkeypox includes rope squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates, and other species.
The transmission and key symptoms of MonkeyPox
Monkeypox virus is one of the variola viruses, therefore inherited the same transmission method as the variola virus- physical contact and liquid but not through the air. For example, sharing the same utensils with monkeypox patients, drinking the leftover water from monkeypox patients, and even touching the same place contacted by monkeypox patients before. However, the longest documented chain of transmission in a community has risen in recent years from 6 to 9 successive person-to-person infections. This may reflect declining immunity in all communities due to the cessation of smallpox vaccination. Transmission can also occur via the placenta from mother to fetus (which can lead to congenital monkeypox) or during close contact during and after birth.
According to World Health Organization (WHO), the
incubation period (interval from infection to onset of symptoms) of monkeypox
is usually from 6 to 13 days but can range from 5 to 21 days.
The main symptoms of monkeypox include
- Fever
- Rash
- intense headache
- lymphadenopathy (swelling of the lymph nodes)
- back pain
- myalgia (muscle aches), and
- intense asthenia (lack of energy)
Things started to be obvious within 1-3 days of fever, which includes macules (lesions with a flat base) to papules (slightly raised firm lesions), vesicles (lesions filled with clear fluid), pustules (lesions filled with yellowish fluid), and crusts which dry up and fall off. The number of lesions varies from a few to several thousand. According to WHO, in severe cases, lesions can coalesce until large sections of skin slough off.
Effectiveness of vaccines
Because the Monkeypox virus is closely related to the virus that causes smallpox, the smallpox vaccine can protect people from getting monkeypox. Past data from Africa suggests that the smallpox vaccine is at least 85% effective in preventing monkeypox. Smallpox and monkeypox vaccines are effective at protecting people against monkeypox when given before exposure to monkeypox. Experts also believe that vaccination after a monkeypox exposure may help prevent the disease or make it less severe.
According to the CDC (Centers for Disease Control and Prevention), vaccines should be given within 4 days from the date of exposure in order to prevent the onset of the disease. If Monkey Pox- The fundamental origin and its development is given between 4–14 days after the date of exposure, vaccination may reduce the symptoms of the disease, but may not prevent the disease.
Prevention of MonkeyPox
First, reduce human-to-human transmission by preventing physical contact with monkeypox patients. Besides, having separate utensils, clothes and towels with monkeypox patients and maintaining hygiene by washing hands frequently with soap using correct steps. During human monkeypox outbreaks, close contact with infected persons is the most significant risk factor for monkeypox virus infection. Therefore, frequent monitoring and surveillance should be carried out on those in close contact.
Secondly, reduce animal-to-human transmission by maintaining hygiene by washing hands with soap after contact with animals. Over time, most human infections have resulted from a primary, animal-to-human transmission. Unprotected contact with wild animals, especially those that are sick or dead, including their meat, blood and other parts must be avoided. Additionally, all foods containing animal meat or parts must be thoroughly cooked before eating.
Strategy in tackling Monkeypox
- To tackle the sudden outbreak of monkeypox, the Ministry of Health (MOH) has prepared a series of the action plan to tackle if an infection of monkeypox occurs.
- First, guidelines were sent out to health facilities on case detection and notification, collecting samples for lab testing, managing and investigating cases or close contacts, prevention and control plus surveillance at international entry points.
- Next, the Institute for Medical Research (IMR) and National Public Health Laboratory (NPHL) would test humans for the monkeypox virus.
- Besides, diagnostic and case management competencies will be strengthened among public and private healthcare personnel. The hospitals should be ready to receive monkeypox patients for isolation and treatment. Importance would be given to infection prevention and control during patient care.
- From an awareness aspect, mass and social media would be utilised to disseminate health information and infographic related to monkeypox for general education to the public regarding monkeypox.
To prevent travellers from carrying monkeypox from abroad, they must fill in a pre-departure form. Those from monkeypox endemic & outbreak countries will receive a reminder to monitor their health.
Main challenges in tackling monkeypox
The existence of vaccines
Despite the fact that we have vaccines before which could treat monkeypox, the disappearance of smallpox diseases for a long time caused the countries to pay less attention to this disease, and of course the development of its vaccines. Following the monkeypox boom and the high demand from every country, the suppliers would be pressurised to produce enough vaccines (started from zero). This would definitely consume a long time.
The mutation of the monkeypox virus
It is the nature of a virus to undergo mutation to adapt to the changing environment. Therefore, there is little evidence to guarantee that the monkeypox virus would mutate over time. Similar to COVID-19, the monkeypox virus would mutate, either becoming stronger or weaker. Besides, due to the mutation, different vaccines or stronger vaccines might need to be developed to correspond to different mutants of the virus. It is also uncertain for the medical field.
The coverage area of vaccines
Due to the high demand and low supply of vaccines, a shortage of vaccines would definitely happen. The same scenario during the early stage of COVID-19 vaccine sales will occur. Developed countries with more wealth will exploit the existing vaccines by buying them in a very large amount, but it will cause the underdeveloped countries or the third-world countries to end up having insufficient vaccines for the treatment of monkeypox.
In this situation, these countries would be facing a great loss in public health and the economy. Things become worse when the price of the monkeypox vaccines increases exponentially till it could not be afforded by underdeveloped countries due to the extreme shortage occurs.
