MONKEYPOX
Source-indianexpress
Context:
The detection of monkeypox in a Delhi resident with no history of international travel marks India’s 1st case of human-to-human transmission.
WHO declared the outbreak a Public Health Emergency of International Concern(PHEIC).
History
- Since the first case of monkeypox in humans was identified in 1970, the virus has become endemic in parts of Central & West Africa.
- It is an uncommon viral infection which was restricted to some African countries but is now spread throughout the world by zoonotic events.
- Till now the disease is spread with over 16,000 cases in 75 countries to date, primarily driven by human contact.
- Most infections initially were caused in rural, rainforest regions of the Congo Basin.
- The 1st outbreak outside Africa happened in 2003, in the US with over 70 cases.
Monkeypox
- Monkeypox was 1st discovered in 1958, in monkeys at Denmark, Statens Serum Institute.
- Monkeypox is caused by a zoonotic virus that can infect humans as well as other animals like rodents, and other primate species.
- The virus belongs to the same family of viruses as a variola-the virus that causes smallpox.
- It is a self-limiting viral infection with symptoms lasting 2-4 weeks and a fatality ratio ranges between 0-11%.
- The common symptoms of monkeypox include fever, headache, muscle pain, lethargy with rashes and blisters commonly on the face, palm, feet, mouth, eyes or genitalia.
- Complications include pneumonia, sepsis, secondary skin infections, encephalitis, and infection in the cornea leading to blindness.
Declaration of PHEIC
A PHEIC is declared for “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease & to potentially require a coordinated international response”.
There have been 14,533 probable confirmed monkeypox cases reported from 72countries till July 2022, according to WHO increasing from 3,040 cases across 47 countries recorded at the beginning of May.
Transmission
- The virus can be transmitted from both animals to humans and between humans.
- Animal-to-human transmission of the virus can result from close contact with blood, fluids or skin lesions of infected animals.
- Human to-human transmission could happen through close contact, through body secretions, skin lesions or contaminated articles of infected individuals.
- Although the WHO says it is unclear if the infection is transmitted sexually, it is under investigation with cases in the current outbreak being reported in gay or bisexual men.
- A recent analysis of 528 men from London, shows 98% of those infected were gay or bisexual men, suggesting transmission in 95% happened through sexual activity.
- In 29 out of 32 persons whose semen was analysed, monkeypox DNA was found.
- It is unclear whether it is sexually transmitted, but the infection might be transmitted more while having sex due to increased skin contact & many people with the infection reported lesions in the genital regions.
Treatment
- Monkeypox virus belongs to the family of Orthopoxviruses as smallpox.
- Orthopoxviruses are cross-reactive, meaning that existing smallpox vaccines and therapeutics can be used for monkeypox.
- Most monkeypox cases are treated symptomatically and an antiviral agent known as Tecovirimat developed for smallpox may be used.
- The US, which recorded 2800 cases, is using two vaccines for smallpox. Jynneos with 2doses is allowed for adults; ACAM2000 uses a live attenuated form of a different orthopoxvirus and is meant for the protection of high-risk individuals for smallpox.
- WHO reports that vaccination against smallpox is approximately 85% effective in preventing monkeypox.
Different outbreak
- In May 2022, several cases of the disease were reported from regions where monkeypox was not endemic and most cases had a history of travelling to Europe, North America and not Africa.
- The number of confirmed monkeypox cases increased more 70%from late June through early July 2022.
- There is limited knowledge about the source & transmission routes of the 2022 outbreak and also the changes in the virus that helped it infect humans more than before, making monkeypox a disease of global public health importance.
Present Scenario
- From animals to humans, the infection is known transmitted through direct contact with blood, bodily fluid, and lesions.
- Unlike influenza, COVID-19, the transmission of monkeypox through respiratory droplets needs prolonged face-to-face contact that usually happens in families and healthcare workers.
- Over the years, the transmission chain-the number of successive person-to-person infections, increased from 6-9.
Conclusion
There was a call for research from WHO to see whether there was a change in the virus or because of the declining number of people immunized against smallpox.
