What is Monkeypox Virus (MPOX)?
The monkeypox virus, now referred to as MPOX in medical literature, is an infectious disease characterized by skin lesions caused by the virus from which it derives its name. Monkeypox virus leads to symptoms such as swollen lymph nodes, fever, headache, and muscle aches. This zoonotic disease can be transmitted to humans primarily through direct contact with the skin lesions or body fluids of an infected person or animal.
Monkeypox disease (MPOX) can spread through close and prolonged contact with an infected patient, sexual intercourse, contact with lesions, and respiratory droplets. It can also be transmitted from animals to humans through direct contact with infected animals’ blood, body fluids, skin, or mucosal lesions, as well as through bites and scratches.
Monkeypox virus (MPOX) belongs to the orthopoxvirus family. Outbreaks in endemic countries have occurred due to direct contact with infected animals and animal products, with person-to-person transmission typically limited to close familial contact.
In 2022, an outbreak outside endemic countries affected many nations, primarily spreading through sexual contact. The virus was first identified in 1958 in monkeys brought from Africa as laboratory animals, with the first human case recorded in 1970 in a child in Africa.
The zoonotic nature of monkeypox means it is a disease that can be transmitted from animals to humans. In Africa, it has started spreading from wild animals such as monkeys, squirrels, and rats to humans. Transmission can occur through animal bites, scratches, the consumption of infected animal meat, or skinning wild animals.
Hence, it is crucial to frequently wash hands, prioritize personal hygiene, be cautious with shared items, and avoid contact with infected individuals.
What are the Variants of Monkeypox Virus (MPOX)?
Monkeypox virus, also known as MPOX, has two distinct genotypes. The World Health Organization (WHO) has named them Clade I (Central African lineage) and Clade II (Congo Basin/West African lineage) based on their identification in August 2022.
The Clade II strain is further divided into Clade IIa and Clade IIb. Historically, the Central African strain has caused more severe diseases compared to the West African strain and has been reported to be relatively more contagious. The monkeypox virus that began spreading globally in 2022 has been classified as Clade IIb, with cases reported from the Democratic Republic of the Congo and surrounding areas falling under the Clade II group after September 2023.
As of June 2024, due to the clinical differences observed in the spread and recent case increases, the WHO has deemed it appropriate to designate the strain as Clade Ib. This strain is believed to be potentially more contagious and could lead to more severe clinical outcomes, prompting the WHO to declare an emergency.
How Does Monkeypox Virus (MPOX) Spread?
Monkeypox virus spreads through lesions, respiratory droplets, body fluids, and shared contaminated items from an infected animal or person.
The primary mode of transmission from animals to humans occurs through direct contact with the blood, body fluids, skin, or mucosal lesions of infected animals, bites, scratches, or consumption of raw or undercooked infected animal meat.
Human-to-human transmission occurs through skin-to-skin contact, such as sexual intercourse, kissing, prolonged close conversation at face-to-face distances, and the use of contaminated clothing, sheets, or towels. Small wild animals like squirrels, rats, and mice are commonly associated with the spread of MPOX.
The transmission routes for monkeypox virus are generally as follows:
- Skin contact (touching, kissing, sexual intercourse)
- Saliva, scratches, bites from animals, or consumption of infected animal meat
- Contact with contaminated items like bedding and towels
- Prolonged close contact alongside the spread of respiratory droplets
- Mother-to-child transmission during pregnancy, childbirth, and subsequent close contact
What are the Symptoms of Monkeypox Virus (MPOX)?
Common symptoms include fever, itchy skin rashes, swollen lymph nodes, and fatigue, which can escalate to severe cases depending on the disease’s severity. Symptoms typically manifest within three weeks after infection with the virus, with the entire process lasting between two to four weeks. The drying and falling off of rashes after exposure to the virus generally indicates recovery.
The symptoms that can occur in individuals infected with the monkeypox virus include:
- Fever
- Swollen lymph nodes
- Muscle and back pain
- Headache
- Chills
- Fatigue
- Rashes resembling fluid-filled blisters or pustules
- Respiratory issues like sore throat, nasal congestion, or cough
- Difficulty swallowing
- Pneumonia
- Vomiting
- Diarrhea
- Urinary tract infection
- Sepsis (blood poisoning)
- Encephalitis
- Myocarditis
- Proctitis (inflammation of the rectum)
What are the Stages of Monkeypox Disease?
Monkeypox disease manifests itself in three stages: the incubation period, the prodromal period, and the rash stage.
The incubation period lasts 1-2 weeks without symptoms, during which a person does not pose a risk of contagion.
During the prodromal period, early symptoms may begin to appear, including fever, fatigue, sore throat, headache, cough, and swollen lymph nodes. Swelling of lymph nodes in the neck, armpit, and groin is a particularly characteristic symptom that facilitates diagnosis.
The final stage, where rashes appear, is especially the most contagious period of the disease. The risk of transmission is high until the rashes dry up and a new layer of skin forms. Initial lesions commonly appear in the mouth and on the tongue. Flat lesions on the body become raised within 1-2 days. Following this, the lesions develop into fluid-filled blisters over the next 1-2 days. In the second week, the rashes begin to crust over, and the scabs fall off within a week.
How is Monkeypox Virus (MPOX) Diagnosed?
Due to the symptom similarities with diseases like chickenpox, measles, bacterial skin infections, scabies, herpes, and syphilis, testing is required to confirm the presence of monkeypox virus. A PCR (polymerase chain reaction) test on a skin lesion sample can diagnose monkeypox virus. If no skin lesions are present, anal or rectal swabs can also be taken for testing.
Additionally, a blood test may be requested to determine whether your immune system is producing antibodies.
How Can One Protect Against Monkeypox Virus (MPOX)?
Surveillance, meaning systematic observations of the virus and rapid identification of new cases, is critical for controlling outbreaks. During outbreaks, close contact with infected individuals poses the most significant risk for monkeypox virus infection.
The close-contact and skin-contact transmission of monkeypox makes crowded environments risky. Caution should be exercised in public transportation, concerts, and gyms to avoid direct contact with others. Swimming in the sea and pools is common during this time. However, there is currently no definitive evidence indicating that the monkeypox virus can spread through water. Caution should be taken when using shared items like loungers and umbrellas in these areas.
Although monkeypox virus is rarely seen, the following precautions should be taken to minimize the risk of contracting it while traveling:
- Get vaccinated (vaccines developed for smallpox also provide protection against monkeypox).
- Avoid contact with individuals exhibiting symptoms of the virus, especially skin contact.
- Do not use personal items of known infected individuals, such as bedding, towels, or clothing.
- If you have been in contact with an infected person, wash your hands frequently with soap and water or use alcohol-based hand sanitizer.
- Avoid animals that could carry the virus.
How is Monkeypox Virus (MPOX) Treated?
There is no specific treatment for monkeypox virus; however, antiviral medications developed for smallpox can be used to treat monkeypox due to the similarities between the two diseases. The goal of treatment for someone infected with the monkeypox virus is to manage and alleviate symptoms such as pain and lesions caused by the disease.
Is There a Vaccine for Monkeypox?
According to the World Health Organization, MVA-BN or LC16 vaccines are recommended, and ACAM2000 vaccine may be used if the others are not available. These vaccines provide protection against the disease, but it remains crucial to maintain precautions even after vaccination.
Does Smallpox Vaccine Protect Against Monkeypox?
Vaccines used against smallpox provide a certain level of protection against monkeypox. Observational studies have indicated that the smallpox vaccine was approximately 85% effective in preventing monkeypox during the period when smallpox vaccination was routinely administered. Thus, individuals previously vaccinated against smallpox may experience milder cases or be protected from monkeypox.
A scar on the upper arm can indicate prior smallpox vaccination. Individuals unsure of their vaccination history can check for this scar on their arms. Additionally, antiviral agents developed for the treatment of smallpox can also be used for monkeypox treatment.
Frequently Asked Questions About Monkeypox Virus (MPOX)
What is the history of monkeypox disease (MPOX virus)?
Monkeypox virus, originally named for its association with monkeys, was reclassified as MPOX since it cannot be directly associated with monkeys. The virus was first observed in lesions on monkeys brought to Copenhagen from the Democratic Republic of the Congo in 1958. Although symptoms were first noted in monkeys, they are not the natural hosts of the virus. Currently, cases are rising, particularly in the Democratic Republic of the Congo and Central and West Africa.
What are the initial symptoms of monkeypox (MPOX)?
The typical symptom of monkeypox is rashes appearing as fluid-filled red blisters. Initial symptoms include fever, swollen lymph nodes, headache, back pain, muscle aches, and fatigue. The rashes tend to be itchy and typically begin on the face, spreading to the body.
Is monkeypox virus (MPOX) deadly?
The fatality rate of monkeypox is generally low but can reach around 10% in some patients, particularly in those with weakened immune systems. Most individuals recover within 2-4 weeks, but children and those with compromised immune systems can experience more severe symptoms.
Is monkeypox related to COVID-19?
Monkeypox is caused by a virus distinct from the virus that causes COVID-19. MPOX is categorized as an orthopoxvirus, while COVID-19 is caused by the SARS-CoV-2 virus. They share similarities in their transmission modes, primarily through close contact with infected individuals.
Conclusion
In conclusion, monkeypox virus (MPOX) is an infectious disease characterized by a variety of symptoms including skin rashes, fever, and swollen lymph nodes. Understanding its transmission routes, symptoms, and preventive measures is crucial for minimizing the risk of infection, especially during outbreaks. Regular handwashing, avoiding contact with infected individuals, and vaccination can significantly reduce the risk of transmission. While there is no specific treatment for MPOX, antiviral medications may alleviate symptoms. Staying informed about the disease and following health guidelines is essential for protection against monkeypox.