Monkeypox [Mpox] Epidemiology: Keynotes

 What you need to Know About Mpox

Mpox (monkeypox) is a disease caused by the monkeypox virus, an enveloped double-stranded DNA virus of the Orthopoxvirus genus in the Poxviridae family, which includes variola, cowpox, vaccinia and other viruses.

It shares similar symptoms with smallpox but is generally less severe.

The World Health Organization (WHO) has recently declared this Mpox Outbreak (2024) a public health emergency of international concern (PHEIC).

The last Mpox outbreak was in 2022-2023.

WHO is working to phase out the name ‘Monkeypox’ in favor of ‘Mpox’ for several reasons, with one of the main concerns being to avoid racial stigmas

The Different Virus Clades of Monkeypox (MPOX) and Their Impacts:

Clade I and Clade II are the two broad strains of Mpox virus.

Clade II caused the global mpox outbreak in 2022.

Clade I generally causes more severe disease and death.

A new offshoot, Clade Ib, emerged in 2023 and is now spreading through close contact.

Mpox Symptoms:

1. • Fever,
   • Headache,
   • Muscle aches
   • Back pain.
   • An extensive rash or mucosal lesions that could last 2–4 weeks.
   • Swollen lymph nodes.

Transmission of Mpox:

1. • Animal to Human: hunting, eating, or touching infected animals.
   • Human to Animals: infected humans can transfer Mpox to pets or animal husbandry.
   • Human to human: Mpox can be gotten from close contact with an infected person (skin – skin, body fluids, respiratory droplets) and contaminated objects.

Laboratory diagnosis of Mpox:

1. • Polymerase chain reaction (PCR) is presently the best test for diagnosis.
   • Samples are taken directly from the skin rashes or lesions.
   • In the  absence of any skin rash, oropharyngeal swabs or rectal swabs are taken.

Endemic Areas:

1. • Central Africa ( Congo)
   • West Africa ( Nigeria, Ghana)
   • Outside Africa: USA, Sweden recently reported cases of Mpox.

Who Is at Risk of Mpox

 Close Contacts:

• People who have close contact with someone who has Mpox are at risk of infection.
• Skin-to-skin contact (touching or sexual contact).
  • Mouth-to-mouth or mouth-to-skin contact (such as kissing).
  • Being face-to-face with someone who has Mpox (talking or breathing close to each other, which can release infectious respiratory particles).
  • Handling clothing, bedding, towels, objects, and surfaces touched by an infected person.

 Household Contacts:

• Anyone living with someone diagnosed with Mpox should take precautions to reduce the risk of infection.
• Health care providers assess whether the infected person can be cared for at home and if home isolation is safe.

  Immunosuppressed Individuals:

• People living with HIV.
• Pregnant people.
• Individuals with compromised immune system have a higher risk of getting infected.

  Health Workers: Health workers caring for Mpox patients should follow infection prevention and control measures.

This includes wearing appropriate personal protective equipment, also proper handling and disposal of sharps.

What to do when infected with Mpox

     Isolate Yourself:

• Follow your healthcare provider’s advice on whether to recover at home or seek care in a health facility.
• Avoid close contact with others until your lesions have completely healed.

     Isolation Measures at Home:

• Stay in a separate room.
• Use a separate bathroom
• Disinfect frequently touched surfaces with soap and water or household disinfectant.
• Avoid sweeping or vacuuming (as it may disturb virus particles).
• Use separate utensils, objects, and electronics, or clean them thoroughly before sharing.
• Careful handling bedding and towels).
• Open windows for ventilation.
• Encourage everyone in the house to clean their hands regularly.

Care of Mpox infected people

Care and management of individuals with the Mpox disease depends on symptoms and the severity of the disease. Symptoms typically last 2–4 weeks and often resolve on their own with supportive care.

• General Care:
  • Stay hydrated, eat good food, and get enough rest.
  • Prioritize mental wellbeing can also help in recovery process. And by this I mean, staying connected with friends and family and seeking support when needed.
• Managing the Rash:
  • Avoid scratching or busting the skin leisions.
  • Clean hands before and after touching lesions.
  • Keep the rash dry and exposed as much as possible.
  • Rinse mouth sores with saltwater.
  • Warm baths with baking soda and Epsom salts for body sores.
• Pain Management:
  • Paracetamol can help manage pain caused by lesions.
  • Seek advice from a healthcare provider if stronger pain medicine is needed

Treatment For Mpox

Research on smallpox therapeutics has assisted development of products used in treating Mpox.

An antivirus, tecovirimat developed for treating Smallpox was approved by the European Medicines Agency in January 2022 for treating monkeypox under exceptional circumstances.

However, due to the fact that clinical trials are still underway, no conclusive therapeutic resolutions have been made.

Vaccines for Mpox:

Several vaccines developed for smallpox have been used for Mpox. WHO recommends MVA-BN, LC16, or ACAM2000 vaccines for mpox.

Vaccination is primarily for individuals at risk (close contacts or high-risk exposure groups).

Mass vaccination is not currently recommended. And even after vaccination, it is advised to continue to keep precautions until immunity develops (usually several weeks).

Secondary Immunity: This refers to the body’s ability to resist an infection after having been exposed to it previously, as the body develops immunity against that disease. However, in the case of Mpox, this immunity is not yet confirmed, as there have been reports of individuals experiencing reinfection despite having had the disease before.

 

REFERENCE

1. https://www.who.int/health-topics/monkeypox#tab=tab_1

2. https://www.cdc.gov/poxvirus/mpox/about/index.html