Image from Pan American health organisation 

Monkeypox, also known as the Mpox, is a viral illness caused by the monkeypox virus. This virus belongs to the Orthopoxvirus genus, which also includes smallpox and cowpox. Monkeypox was historically rare and mainly found in central and West Africa. However, a global outbreak in 2022-2023 spread the disease to over 120 countries.

What is Monkeypox?

Monkeypox (Mpox) is an infectious disease that causes various symptoms, primarily a painful rash. The rash can appear on the face, palms, soles of the feet, genitals, and throat.

Common symptoms include fever, swollen lymph nodes, headache, back pain, muscle aches, and low energy. The illness usually lasts 2-4 weeks, but can persist in individuals with weak immune systems. In severe cases, it can lead to serious complications.

The virus that causes mpox belongs to the Poxviridae family. It has two distinct clades: clade I (subclades Ia and Ib) and clade II (subclades IIa and IIb). Clade Ilb drove the global outbreak in 2022. The increase in cases in Africa, particularly in the Democratic Republic of the Congo (DRC), has been linked to clades Ia and Ib.

Since its discovery in 1958, mpox has affected regions of Central and West Africa. However, the global outbreak in 2022 led to an unprecedented number of cases in Europe, the Americas, and other regions. By mid-2024, over 100,000 cases were confirmed worldwide, with 220 reported deaths.

Image from Dermnet

How is Monkeypox Transmitted?

Mpox spreads mainly through close contact with an infected person. This includes skin-to-skin contact and touching contaminated objects like clothing. Respiratory droplets during prolonged face to face interactions also transmit the virus.

Sexual contact, especially with multiple partners, has been a key risk factor in the recent global outbreak. During pregnancy, an infected parent can transmit mpox to the fetus, leading to severe complications, including stillbirth or neonatal death.

Animal-to-human transmission of mpox is also possible. Infected animals like squirrels or monkeys can transmit the virus through bites, scratches or contact with bodily fluids. According to WHO more research is needed to understand how mpox spreads during outbreaks in various settings and conditions.

Image from ScienceDirect

Signs And Symptoms of the Monkeypox illness

Mpox symptoms vary among individuals and typically begin within 1-3 weeks but can start anytime between 1-21 days. Symptoms may last 2-4 weeks but can persist longer in people with weakened immune systems.

Common symptoms of mpox include:

• Rash
• Fever
• Sore Throat
• Headache
• Muscle aches
• Back pain
• Low energy
• Swollen lymph nodes.

The mpox rash typically appears a few days after the fever starts and spreads across the body. It begins as flat sores, which later develop into raised, fluid-filled blisters that may be itchy and painful.

Over time, the blisters dry out, crust over, and eventually fall off. Mpox can sometimes lead to complications such as bacterial skin infections, pneumonia, corneal infections, or, in severe cases, sepsis or encephalitis.

Image from Dermnet

Treatment for Monkeypox

The most reliable way to diagnose mpox is through Polymerase Chain Reaction (PCR) testing, which detects the virus’s DNA. Samples are collected from the rash, fluid, or crusts of the lesions. If no rash is present, samples may be taken from the anus.

People with mpox remain contagious until all sores have healed and a new layer of skin has formed. Although rare, asymptomatic individuals can still spread the virus.

According to WHO, there’s no specific antiviral treatment for mpox, though some antivirals have received emergency use authorization in certain countries and are under evaluation in clinical trials.

Supportive care can help manage symptoms and prevent complications. This includes addressing pain, fever, hydration, and preventing secondary infections. Individuals with weakened immune systems, such as with uncontrolled HIV, are at higher risk of severe illness.

Vaccination is a key prevention strategy for mpox. Smallpox vaccines offer protection against mpox, and vaccination is recommended for high-risk groups such as health workers, people with multiple sexual partners, and those in close contact with an infected person.

Post-exposure vaccination is available and should ideally be administered within four days of contact to prevent or reduce the severity of the disease.

Self-care and Safety Measures Against the Monkeypox virus

For most people, mpox is a self-limiting illness that resolves within a few weeks. However, self-care is essential to manage symptoms and prevent the spread of the virus to others.

If you have monkeypox:

Stay isolated at home and in a well ventilated room.

Cover any lesions and wear a mask around others.

Wash your hands frequently and avoid touching shared items in communal spaces.

Use saltwater rinses for sores in the mouth.

Take warm bath with baking soda or Epsom salts for body sores

Take over the counter medications for pain like paracetamol, (acetaminophen) or ibuprofen.

Do not :

Engage in sexual activity until fully recovered, as the virus can spread intimate contact. It is also recommended to use condoms for up to 12 weeks after recovery as a precaution.

Pop blisters and scratch sores, which can slow healing, spread the virus to other parts of the body, and can cause sores to become infected. Or

Do not shave sore areas until scabs have healed and you have a new skin underneath (This can spread the rash to other parts of the body.

Mpox remains a global health concern, especially in vulnerable populations. Preventive measures such as vaccination, proper diagnosis, and supportive care, are crucial to controlling its spread and minimizing impact.

Staying informed about the symptoms and practicing safety precautions can help protect individuals and communities from this emerging threat.