Monkeypox

• Context (WHO): The WHO Director-General declared the Monkeypox outbreak a public health emergency of international concern (PHEIC).

• Monkeypox is a rare viral infection caused by the monkeypox virus.
• Mpox is a zoonotic infection (infections that spread from animals).
• First discovered in 1958, Monkeypox occurs primarily in tropical rainforest areas of central and west Africa and is occasionally exported to other regions.
• Common symptoms: Fever, muscle ache, rash and swollen lymph nodes, pus filled skin lesions. It may lead to a range of medical complications, causing even death (3-6% cases).
  • Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks.
  • It is less contagious than smallpox and causes less severe illness.
• Higher risk group: Pregnant ladies, children and low immunity persons.

Transmission

• From animal to humans: Eating products made of infected animals, direct contact with body fluids.
• Person to person: Direct contact with rashes or body fluids, infectious skin or lesions, kissing, touching, oral and penetrative vaginal or anal sex.

Variants of Mpox

1. Clade I/Congo Basin clade

• Clade I is largely sporadic and potentially zoonotic with a fatality rate of less than 4%.
• Clade I leads to more severe disease and death than Clade II.

2. Clade Ib

• It was first reported in the Democratic Republic of the Congo in 2023 and has been spreading through sex and other types of close contact.
• Children under 15 years is the most affected, constituting 80% of all the deaths with the largest case fatality rate in children aged less than one year.
• It caused unprecedented human-to-human transmission in a short period.

3. Clade II/West African clade

• Clade II was behind the global mpox outbreak in 2022 and is primarily found in West Africa, particularly in Nigeria and surrounding regions.

Treatment

• There is no specific treatment or vaccine available for this infection and is treated with supportive care.
• Three smallpox vaccines (MVA-BN, LC16 and OrthopoxVac) have been approved for prevention.
• Infected persons or animals should be quarantined for 30 days.
• Fatality rate: Varies from 0.1 to 10%.