A Professor of Public Health/Consultant Public Health Physician at the Department of Epidemiology and Community Health, University of Ilorin, Kwara State, Prof. Tanimola Akande, talks about monkey pox and how to avoid the viral disease with MOTUNRAYO JOEL
what is monkeypox?
Monkey pox is an uncommon viral disease that produces pox lesions similar to smallpox; it occurs mainly in remote parts of central and West Africa, near tropical rainforests. It is a rare zoonotic disease caused by the monkey pox virus, which belongs to the group of orthopox viruses. The orthopox viruses also include the vaccinia, cowpox, variola or small pox viruses. The first confirmed human monkey pox infection was reported in 1970 in Democratic Republic of Congo in a child of nine months.
What are its causes?
Monkey pox is caused monkey pox virus which was first isolated in monkey in the laboratory in 1958. The first human cases were diagnosed in the early 1970s.
How is it transmitted?
The majority of the cases are transmitted from animals (rodents) to humans by direct contact. Person-to-person transfer and probably by droplets can occur infrequently. The virus can be spread by direct contact with body fluids of an infected person and virus contaminated objects like beddings.
What are the symptoms of the disease?
During the first few days of the disease, symptoms are nonspecific and include fever, nausea, and general feeling of discomfort. After about four to seven days, skin lesions in form of pustules and papules (bumps) develop on the face and trunk that ulcerate (opens up), crust over, and begin to clear up after about 14-21 days. The lymph nodes also enlarge. There may be some scarring on the skin. In the skin eruption stage, rashes occur predominantly on the face, soles, palms and the rest of the body including the mucus membranes.
The rash occurs in hundreds to thousands. It begins as small lesions that become blisters and eventually get filled with pus. Finally, crusts appear on these blisters. It takes three weeks for the entire rash to disappear. The patient is infectious in the first week of developing a rash. Rash in the oral membrane can cause lots of difficulties in drinking and swallowing. The skin becomes swollen, painful, and stiff.
How is the disease diagnosed?
The diagnosis of monkey pox is often made clinically from patient’s history and the examination that shows the pox lesions. The confirmatory diagnosis is by laboratory tests through PCR, ELISA or western blotting tests that are usually done in advanced laboratories. The virus can be isolated by cell culture which can only be done in advanced laboratories.
Can the disease lead to death?
Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and severity of complications. The disease can lead to death. The case fatality rate varies widely but has been less than 10 per cent in documented epidemics and deaths are mostly among young children.
How is the disease treated?
There are no specific treatments or vaccines available for monkey pox infection but outbreaks can be controlled. The symptoms can however be treated.
Which doctor should one consult for monkey pox?
Most doctors can treat monkey pox. Where there are complications, some specialists can be consulted; paediatricians if children are affected, Specialists in internal medicine for adults and also dermatologists.
What are the complications for a victim?
Some small pox lesions may become necrotic and destroys sebaceous gland (gland in the skin which secretes a lubricating oily matter that lubricates the hair and skin) and leave behind depression which will usually disappear over a few years.
What is the natural host of the monkey pox virus?
In Africa, monkey pox infection has been found in many animal species like squirrels, Gambian rats, striped mice, dormice and primates. Monkey pox is endemic in rodent population in Africa.
How can the disease be prevented?
Monkey pox is preventable by avoiding direct contacts with infected animals and people. Efforts to prevent transmission in areas where it occurs commonly should focus on thoroughly cooking all animal products (blood, meat) before eating. Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues, and during slaughtering procedures. In healthcare environments, individuals should use proper protective gear before handling infected samples from the patient.
Patients who have the disease should isolate themselves from other people until the pox heals. Gloves and protective equipment should be worn when taking care of ill people. Regular hand washing should be carried out after caring for or visiting sick people.
It is known that vaccination against small pox seems to afford about an 85 per cent chance of avoiding the infection. However, smallpox vaccine is no longer available since smallpox has been eradicated. There is no commercially available vaccine specifically for monkey pox.
How would you advise the Bayelsa State government to tackle the disease since some persons have contracted the virus in the state?
The state government needs to mobilise health workers particularly public health physicians to control the epidemic. The cases in Bayelsa should be isolated. Necessary public health education should be provided to citizens on how to curtail the spread of the disease. There is however no cause for panic. Health workers need to be vigilant and implement standard infection control precautions.
Health facts: About monkey pox
- The disease has never before been reported in the Western Hemisphere. It is usually found in remote villages in Central and West Africa.
- Monkey pox is related to the virus that caused small pox, and smallpox vaccinations also gave protection against it.
- The death rate among those with monkey pox ranges from one to 10 per cent, with the highest rates among young children, but officials say the virus may be less lethal in the United States because of better nourishment and medical technology.
- The disease is usually transmitted to people from squirrels and primates through a bite or contact with the animal’s blood; the Centers for Disease Control says a preliminary investigation showed the virus was transmitted to humans through “close contact” with the infected prairie dogs.
- Infections of index cases result from direct contact with the blood, bodily fluids or rashes of infected animals.
- In Africa, human infections have been documented to have occurred through the handling of infected monkeys, Gambian rats or squirrels.
Source: World Health Organisation