Monkey pox is a viral disease with symptoms in humans similar, but milder, to those seen in smallpox patients. Human monkeypox is endemic in villages of Central and West Africa. The occurrence of cases is often found close to tropical rainforests where there is frequent contact with infected animals.
Monkeypox is a viral zoonosis, i.e. a disease transmitted from animals to humans. It can be transmitted through contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. Human infections have been documented through the handling of infected monkeys, Gambian giant rats and squirrels, with rodents being the most likely reservoir of the virus.
Symptoms last from 14 to 21 days and include: fever, intense headache, lymphadenopathy (swelling of the lymph node), back pain, myalgia (muscle ache), and an intense asthenia (lack of energy). Skin rashes appear often beginning on the face and then spread elsewhere on the body. These lesions evolve from maculopapules (lesions with a flat bases) to vesicles (small fluid-filled blisters), pustules, followed by crusts.
The clinical diagnosis must consider other rash illnesses, such as smallpox (even though it is eradicated), chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies. Optimal diagnostic specimens are from lesions – vesicular swabs of lesion exudate or crusts stored in a dry, sterile tube (no viral transport media) and kept cold.
There are no specific treatments or vaccines available for monkeypox virus infection, but outbreaks can be controlled. Vaccination against smallpox has been proven to be 85% effective in preventing monkeypox in the past but the vaccine is no longer available to the general public after it was discontinued following global smallpox eradication. Nevertheless, prior smallpox vaccination will likely result in a milder disease.
Prevention and Control
Prevention consists in avoiding any contact with rodents and primates as well as limiting direct exposure to blood and inadequately cooked meat. Close physical contact with infected people or contaminated materials should be avoided. Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues and when taking care of ill people.
Healthcare workers and those treating or exposed to patients with monkeypox or their samples should consider being immunized against smallpox through their national health authorities.