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“Yes, it is. An ounce of prevention is worth a pound of cure”.
Monkeypox virus has emerged as the next potential threat to humankind post covid. The latest statement quoted by WHO (World Health Organization) Chief Dr Tedros Adhanom Ghebreyesus suggested that WHO is toying with an idea to change the name of the Monkeypox virus. Therefore, it is currently working with partners as well as health niche experts around the globe to change the name of the virus. Over 30 scientists from Africa and around the world have been approached for this purpose. The announcements related to the updated names will be made sooner as nomenclature which is non-discriminatory, neutral, and non-stigmatising is believed to be apt for the global health community.
The scientists have recently proposed a novel way to name the viral outbreak under clades 1, 2 and 3 for the purpose of diagnosis as it comprises viral genomes from Central and Western Africa. They have listed the monkeypox virus under two different strains:
- Congo Basin clade
- West African clade
The origin related to the new global outbreak is still unknown.
‘Live to inspire and get ready to defeat the virus; Monkeypox. Without awareness, the license of freedom is more dangerous’.
What is the Monkeypox virus?
Monkeypox is a viral disease similar to smallpox and chickenpox that spreads through skin-to-skin contact. ‘Smallpox was the worst disease in history. It killed more people than all the wars in history and the monkeypox belongs to the same family’. As far as monkeypox is concerned, it is a zoonotic virus (transmitted from animals to humans). This virus relates to the orthopoxvirus genus belonging to the poxviridae family. It spreads by close contact with their lesions, eating uncooked infected animal food, body fluids, contaminated materials like bleeding, and respiratory droplets. Also, the incubation period generally varies from 6 to 13 days but can also range from 5 to 21 days.
Discovery of Monkeypox virus
“Invention of new diseases gives the hardest battles to the toughest soldiers as health is valued only when sickness arrives”.
The name of the monkeypox virus was derived from the initial discovery of the virus found in monkeys in 1958 in a Danish laboratory. The first human case was discovered in a child in 1970 in the Democratic Republic of the Congo. There are two different clades:
- The West African clade
- The Congo Basin( Central African) clade
Infected people with the [presence of West African clade seem to experience less severe disease in comparison to the Congo Basin Clade.
Several animal species have been believed to be susceptible (responsive) to this virus. However, uncertainty still exists pertaining to the natural history related to Monkeypox and hence further in-depth research is required to decode the exact reservoir(s).
Is the monkeypox virus really a serious concern?
‘As we know the world is now much more complicated than we predicted. Although we have no history to lean on, it doesn’t mean we don’t have standards that can guide us’.
The outbreak of the monkeypox virus came to the light in several regions outside Africa in May 2022 as it is most common in West and Central Africa which raised an alarm. Since 13th May 2022, so many cases from 12 Member States in non-endemic countries have been reported to WHO. The ongoing investigation revealed that reported cases do not have any established travel links to varied endemic areas. Also, 28 suspected cases so far have been confirmed as of 21st May 2022 by the laboratory but again no associated death because of this virus has been identified till date.
The CDC discovered 35 cases related to the monkeypox in the U.S in June 2022 and more than 1000 cases globally. It is self-limited but a few individuals and categories may be more prone to this virus in pregnant women, children, or those with weak immune systems due to critical health issues. Also, WHO states that there is a higher possibility of a mother passing the virus to an unborn baby prior to delivery through the placenta, an organ that connects the baby to the womb.
The director of the centres for disease control and prevention, Inger Damon [Division of high consequence pathogens and pathology] stated that “Healthcare providers should be on high alert for signals to any rash if it relates to the features of Monkeypox. We are suggesting that people immediately consult their physician if they suspect any new rashes on their body that relates to the viruses.”
However, identification of monkeypox virus is quite a challenging task as symptoms resemble chicken pox and it also leads to pus-filled boils like smallpox.
The purpose related to this disease outbreak report is simply to raise more awareness and inform readiness besides ensuring effective control along with technical guidance to facilitate immediate recommended actions to prevent further transmission.
How does the monkeypox virus spread?
‘Disease is an unhealthy response to the human body which multiplies in a matter of days or even hours if not cured on time’.
Monkeypox virus gets transmitted when an individual comes into close contact with the infected animal, person or any material that is contaminated with the moneypox virus either through a scratch or a bite while using the products derived or created from them.
It also gets transmitted via respiratory secretion during prolonged face-to-face contact besides a few activities like cuddling, kissing, or touching body parts infected with the Monkeypox sores. However, at this time it is not known whether vaginal fluids or semen can transmit it or not.
It is doubted that whether African rodents are truly responsible for transporting the virus or no. Thus, it is advised that veterinarians who scrutinize animals with suspected Monkeypox should follow infection control precautions to protect themselves, clients, staff, and other animal patients in the clinic.
In Africa, serologic evidence (a medical science dealing with blood serum) related to monkeypox infection has been detected in an array of a variety of mammals that include rodents, non-human primates, and squirrels.
The virus has been isolated so far only twice in the wild from animals. Once from a rope squirrel that was seen in 1985 in the Democratic Republic of the Congo and once from a mangabey noticed in 2012 in Cote d’ivoire.
The transmission route pertaining from animal to animal may arrive through skin abrasions respiratory droplets, organic matter containing virus particles, inhalation of the aerosolized virus, the eye or via the ingestion of infected animal tissue.
The risk related to laboratory transmission can be mitigated when testing routines related to clinical specimens of either confirmed or suspected monkeypox patients.
- Limiting the number related to staff testing specimen
- Wearing essential personal protective equipment
- Avoiding any such course of action that could produce infectious aerosols
- Using standard applied standard precautions
Importation ban on African Rodents
The CDC banned the importation of all African rodents into the US on June 11, 2003. Even FDA
(Food and Drug Administration) restricted the transport, sale, distribution, or release of prairie dogs with six precise genera of African rodents into the environment in the United States. However, an Interim final rule on November 3 replaced this order. Under this rule, the CDC has the authority to
“Prevent the importation related to the Monkeypox virus.
Issue an order causing an imported animal to be placed in the quarantine.’
Issue an order causing an imported animal to export again
Also, Issue an order causing an imported animal to be demolished
Have authority to take any other action required to prevent the prevalence of the virus.”
How can the monkeypox virus be diagnosed?
‘Symptoms are the body’s mother tongue. Hence never neglect it and cure the disease’.
Few symptoms can help recognize the Monkeypox virus such as:
- Fever
- Headache with chills
- Tiredness with aching muscles
- Sore throat
- Trouble breathing(in serious cases)
- Swollen lymph nodes
Some new rashes start appearing after three days of the fever, which typically appear on the face before they spread to other body parts. Moreover, rashes are more common on hands, arms, feet, and legs that seem to follow a common specific pattern such as flat, round lesions (macules). Gradually, these rashes turn into slightly raised bumps (papules). After that, the bumps get filled with clear fluid (vesicles) and the same further gets converted into the yellowish fluid (pustules) which finally that crust over and fall off.
It generally takes between 1 and 2 weeks post discovering the sickness from the monkeypox virus but it can get extended to as long as 3 weeks. Ironically, the infectious person is believed to be more prone to further spread of the virus for up to 21 days after exposure to the first symptomIn some cases, thousands of lesions grow together. They cause damage to a large portion of the skin at once. Death is however rare but possible. In Africa so many people live with inadequate health facilities and hence children are more at risk for illness and death.
Sometimes it also comes with serious secondary infections such as-
- Sepsis
- Bronchopneumonia
- Encephalitis
- Infection of the cornea with possible vision loss.
What is to be done next?
‘Worrying doesn’t make any difference but working does. Every challenging problem has a solution but sometimes it needs a different perspective to figure out as we are standing up together to find a path to limit the spread of illness’.
The entire journey related to communicable diseases demands not just attention but awareness to wipe out its existence from the entire planet. Therefore it is recommended to consult the doctor immediately after getting exposed to the virus and do the following needful:-
- Check body temperature twice a day.
- If the person infected with the virus has chills and swollen lymph nodes but no fever or rashes should be isolated at home in a separate room for 24 hours and the local health department should be contacted.
- The daily routine can be followed as usual if no symptom is noticed. However, one needs to avoid donation of blood, cells, tissues, breast milk or any organ while experiencing the symptoms.
The laboratory test can diagnose the virus but there is no specific treatment to cure it. After detection of the virus, the doctor will recommend warding off further serious complications with over-the-counter medicines and plenty of fluids besides complete rest.
The doctor can also consider recommending moving to antivirals and vaccinia gamma globulin
(made from the blood of individuals vaccinated against smallpox) as well as the smallpox vaccine to limit the outbreak.
“The vaccination doesn’t mean the battle is over. It shows we are winning the war”.
If smallpox is vaccinated recently ( 3-5 years) then it can protect against Monkeypox as smallpox vaccination is believed to be 85% effective vaccine to prevent the virus.
The U.S. possess the two smallpox vaccine-
- ACAM2000
- JYNNEOS( Imvamune, Imvanex)
These two vaccines have live viruses named ACAM2000 that are injected by pricking the skin. The virus can grow on a tiny lesion after getting this vaccine hence it is vital to ensure not spreading the virus while the lesion heals.
Next JYNNEOS in two shots can be taken 4 weeks apart but there is no risk related to spreading the virus.
It is best to get vaccinated before getting infected but injected afterwards still prevents the disease as CDC (Centers for Disease Control and Prevention) advises vaccinating within 4 days after the diagnosis of the virus. It can be done as long as 14 days and will still remain effective but experts recommend getting the smallpox vaccine if not gotten in the last 3 years.
People with the smallpox vaccine can experience minor reactions such as-
- Mild fever besides tiredness
- Swollen glands
- Itching and redness at the vaccination site.
How can it be prevented?
‘No one will manufacture a lock without a key. Thus, awareness is the key that leads to permanent reduction of the virus to zero from the earth’.
Precautionary steps are required to be followed before declaring it an international health emergency. That means it would impart it the same designation as the Covid-19 pandemic. Also, it is the responsibility of the people to minimize the damage done by this virus.
To liberate the nation from the shackles of the deadly virus we need to work on eradicating the roots related to the virus.
- Avoid contact with animals that could harbour the virus( including animals that are sick as well as dead animals found in the virus-detected areas.
Therefore, avoid 3C’s i.e. closed spaces, crowded places and close contact with others to ensure safety.
- Avoid contact with any material of infected animals.
- Practice good hand hygiene by washing hands either with soap or alcohol-based hand sanitizer with at least 60% alcohol recommended by CDC after coming in contact with sick animals or humans.
- Use personal protective equipment ( PPE) during the treatment of patients.
- Risk Communication should be notified by insights from social listening detecting public opinion and should timely address possible rumours and inaccurate data.
To sum up, the Monkeypox virus demands immediate attention to raise awareness to mitigate the fatalities by undertaking comprehensive case findings. It is the need of the hour to raise awareness about isolation( provided with supportive care), among potentially affected communities, health care providers, and contact tracing( identifying individuals who may have close contact with patients during infectious time. It is also important to elicit their name and contact information within 24 hours as well as inform those most at risk by providing accurate information and protecting frontline workers.
So it is time to revive the fighting spirit to defeat the virus and this is where integrating yoga in day-to-day life can help by increasing immunity. Are you ready to join hands?
Share in the comments what do you think about Monkeypox and how to come up with innovative ways to combat it.
