India has placed Kerala on high alert after the second case of monkeypox was detected and the Union Health Ministry has ordered strict screening of all international travelers arriving at airports and ports to reduce the threat of its importation. Symptoms of monkeypox include fever, headache, muscle aches, back pain, chills, fatigue and swollen lymph nodes and a rash on the face and other parts of the body.
The monkeypox virus was discovered in 1958, when two outbreaks of a pox-like disease occurred in lab monkeys kept for study, and the name was derived from them. Monkeypox virus belongs to the genus Orthopoxvirus in the Poxviridae family and is not life-threatening but can be spread from human to human or animal to human.
In an interview with HT Lifestyle, Dr. Rituja Ugalmugal, MBBS, MD- Senior Physician of Internal Medicine at Connect and Heal revealed, “Generally symptoms may start within 5-13 days but may last for 3-21 days of exposure. The first 2-5 days are usually characterized by fever, severe headache, back pain, muscle pain, enlarged lymph nodes and extreme fatigue. A skin rash usually appears within 1 to 4 days and persists for 2-3 weeks. Usually concentrated on the face, palms and soles, but may also affect the oral mucosa, eyes and genitals. Lesions usually start at 2-5 mm in size, then enlarge and become fluid or pus-filled and eventually crust over. These crusts then dry and fall off within 1-2 weeks.
How is monkeypox spread?
Dr Amit P Gande, consultant pulmonologist at Sujay Hospital explained, “Monkeypox can be spread through a number of ways that include infectious rashes, scabs or direct contact with body fluids. It can be spread during chronic respiratory secretions, skin-to-skin contact, and physical intimacy between partners. Touching things like clothing and linen used by an infected person can cause infection. A pregnant person can transmit the disease to their fetus through the placenta. Additionally, it can be spread through animals such as rodents or dead animals, monkey bites or scratches and bushmeat but we have yet to see any such cases.
Dr Tanu Singhal, Consultant Pediatrics and Infectious Diseases, Kokilaben Dhirubhai Ambani Hospital, said, “Monkeypox is caused by the monkeypox virus and is spread between humans through close contact.” Therefore, most patients who get this virus are family members, and it is not usually spread by casual contact. If we are to reduce human-to-human transmission, it is advisable to avoid close contact with suspected monkeypox virus patients. Usually this virus is found in patients who have a history of foreign travel to countries where different types of monkeypox are endemic.
Adding to the list, Dr Rituja Ugalmugle shared:
1. Person-to-person transmission:
· Primarily through direct contact with sores, ulcers and bodily fluids, usually through intimate physical contact such as sexual activity
· Indirect transmission may occur through contact with materials such as clothing and linen contaminated with infectious material from bodily fluids or sores.
· The virus crosses the placenta and is transmitted from mother to fetus
2. Animal to Human Transmission:
· Primarily through physical contact with the bodily fluids or sores or bites of an infected animal
When to seek medical advice?
In severe cases, it can lead to lung infection, sepsis, corneal infection etc. According to Dr. Rituja Ugalmugle, anyone with symptoms and a history of travel to areas where monkeypox outbreaks have been reported or a history of close contact with suspected or confirmed cases of monkeypox should seek medical advice.
Precautions and preventive measures
Dr Amit P Gande advises, “Though monkey pox is in its early stages, it is important to be careful not to spread it excessively. Contact should be avoided if anyone is related to the patient or has met people with any type of rash. Avoid sexual intercourse or close intimacy with an infected person. To prevent the spread of disease, the patient should be given separate plates and cutlery for eating and sleeping. For caregivers, it is recommended that they wash their hands with soap or use an alcohol-based hand sanitizer frequently.
Dr. Rituja Ugalamugle advised.
· Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox
· Do not touch the rash or scabs of a person with monkeypox
· Avoid physical intimacy with anyone with proven or suspected monkeypox infection
· Do not share eating utensils or cups with a person who has monkeypox
· Do not handle or touch bedding, towels or clothing of a person with monkeypox
· Wash your hands frequently with soap and water or use an alcohol-based hand sanitizer
· If you are sick with monkeypox:
· Isolate at home
· If you have an active rash or other symptoms, stay in a separate room or area away from people or pets you live with, when possible, until all rash crusts, dry and fall off.
· Continued use of external protection during sexual activity for 12 weeks after recovery
The CDC recommends the vaccine for people who have been exposed to monkeypox and for people who are at high risk of exposure to monkeypox, including:
1. People identified by public health authorities as having been in contact with a person with mange disease
2. People who have been exposed to monkeypox, such as:
3. People who know that one of their sexual partners has suffered from monkeypox in the last 2 weeks
4. Occupations that may expose them to orthopoxviruses, such as:
a) Laboratory workers conducting tests for orthopoxviruses
b) Laboratory workers handling cultures or animals with orthopoxvirus
c) Certain designated health or public health workers.