Dr Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
Monkeypox is a rare disease caused by infection with the monkeypox virus. The monkeypox virus is in the same family of viruses as the smallpox virus, but is less contagious than smallpox, and its disease causes milder symptoms and is usually not fatal.
In the past, most of the people who contracted monkeypox lived in certain parts of central and western Africa, had travelled there, or had been exposed to infected animals imported from there. During the 2022 outbreak, the disease has been found in people who live in other countries, including Guyana.
HOW IS MONKEYPOX SPREAD?
Monkeypox is spread in different ways:
* Through close, personal, often skin-to-skin contact with someone who has the virus:
* Through direct contact with their rash, scabs, or body fluids
* By breathing in the virus during prolonged, face-to-face contact
* During intimate physical contacts; such as kissing, cuddling, hugging, massaging, or during sex
* From touching items (such as clothes, bedding or towels) that were used by someone who has the virus
* From the pregnant mother to the baby
* From infected animals:
* By being scratched or bitten by the animal
* By preparing or eating meat or using products from the animal.
Someone who has monkeypox can spread it from the time their symptoms start until their rash has fully healed, all scabs have fallen off, and a fresh layer of skin has formed. This usually takes 2 to 4 weeks.
WHO IS MORE LIKELY TO DEVELOP MONKEYPOX?
People who are more likely to develop monkeypox include those who:
* Have been identified by public health officials as a contact of someone with monkeypox
* Had a sexual partner in the past 2 weeks who has been diagnosed with monkeypox
* Had multiple sexual partners in the past 2 weeks in an area with known monkeypox infection
* Have jobs that may expose them to monkeypox, such as health care providers and laboratory workers who do testing to diagnose monkeypox.
SYMPTOMS OF MONKEYPOX
The symptoms of monkeypox usually start within 3 weeks from the time a person has contracted the virus. The symptoms may include:
* Fever
* Headache
* Muscle aches and backache
* Swollen lymph nodes (“swollen glands”)
* Chills
* Exhaustion
* A rash with sores that can look like pimples or blisters. It could be on the face, inside the mouth, and on other parts of the body: like the hands, feet, chest, genitals, or anus. It goes through different stages, including scabs, before healing. This can take 2-4 weeks.
• Persons may have all or only a few symptoms.
• Persons may get a rash first, followed by other symptoms
• Persons may have flu-like symptoms, and then develop a rash 1-4 days later
• Persons may only get a rash.
DIAGNOSIS
To find out if a person has monkeypox, a doctor:
* Will ask about the person’s symptoms and health history.
* Will look at the rash.
* Take a sample of tissue from one of the sores, so it can be tested for monkeypox virus.
* May do blood tests to check for monkeypox virus, or for antibodies to the virus. Antibodies are proteins that a person’s immune system makes to fight foreign substances such as viruses and bacteria.
TREATMENT
There are no treatments specifically for monkeypox, but many people get better on their own. Since monkeypox and smallpox are similar, antiviral medicines that protect against smallpox may also help treat monkeypox.
Antiviral medicines may be recommended for people who are more likely to get severely ill, such as patients who have weakened immune systems.
PREVENTION
There are steps a person can take to help prevent monkeypox:
* Avoid close, skin-to-skin contact with the monkeypox rash. So, while a person is sick with monkeypox:
* Do not touch their rash or scabs.
* Do not kiss, hug, cuddle, or have sex with them.
* Do not share eating utensils or cups with them.
* Do not touch the bedding, towels or clothing of a person who has monkeypox.
* Wash hands often with soap and water, or use an alcohol-based hand sanitizer, especially after contact with sick people.
* Avoid contact with animals that can spread the monkeypox virus, such as rodents and primates. Also, avoid sick or dead animals and any bedding or other materials they have touched.
If a person is sick with monkeypox, it is recommended that they stay at home while sick, if that is possible. If a person has an active rash or other symptoms, it would be best for them to stay in a separate room, away from healthy family members and pets, if they can.
There are two vaccines to protect against monkeypox. One was approved for smallpox and monkeypox (JYNNEOS), and the other was approved for smallpox (ACAM2000):
JYNNEOS is the preferred vaccine to protect against monkeypox. It is a two-dose vaccine.
ACAM2000 may be an alternative to JYNNEOS. ACAM2000 is a single-dose vaccine, but it has the potential to produce more side effects and adverse events than JYNNEOS, and it is not recommended for people with severely weakened immune systems and several other conditions.
The US Centers for Disease Control and Prevention (CDC) recommend vaccination for people who have been exposed to monkeypox, or who are more likely to get monkeypox.
