Monkey Pox (Monkeypox)

Monkey Pox (Monkeypox) — Monkeypox aka monkeypox is a viral infectious disease caused by a rare virus from animals (zoonotic virus).

Monkeys are the main host of the monkeypox virus. Therefore, this disease is called monkey smallpox. Cases that were transmitted from monkeys to humans were first discovered in 1970 in Congo, South Africa.

Symptoms of this disease are generally similar to those of smallpox (smallpox), such as fever and skin rash that blisters become elastic. However, symptoms are also accompanied by swelling of the lymph nodes in the armpit.

Transmission of monkeypox among humans takes place through direct contact with elastic or sores on the skin, body fluids, droplets released when sneezing and coughing, and touching surfaces contaminated with the monkeypox virus.

The dangers of this disease can be effectively prevented through vaccines. Antiviral for the treatment of monkeypox is still being studied further.

How common is this disease?

Monkeypox began as an endemic disease in Central and West Africa.

It was first discovered in 1958 when a smallpox epidemic attacked a group of monkeys that were deliberately kept in a laboratory belonging to a health institution for research. The first human case occurred in 1970 in the Democratic Republic of the Congo.

Since then, the Centers for Disease Control and Prevention (CDC) has noted that there have been quite a number of cases of monkeypox infection in humans outside Africa, with details:

  • 47 cases in the United States in 2003
  • 3 cases in the UK in 2003
  • 1 case in Israel in 2018
  • 1 case in Singapore (1 case) in 2019
  • 4 cases in the UK in 2022

Young adults, adolescents, and young children and infants are more susceptible to monkeypox infection. Of the approximately 10% of reported deaths, the majority are children.

Monkeypox signs and symptoms

People infected with the monkeypox virus will start showing their first symptoms 6-16 days after exposure.

The period when the virus is not yet actively multiplying in the body is known as the incubation period. The incubation period for the monkeypox virus can range from 6-13 days. However, it can also occur in a longer range, which is 5-21 days.

However, as long as there are no symptoms, a person can still transmit the monkeypox virus to others.

The initial symptoms of this disease are the same as chickenpox caused by a viral infection, which causes flu-like symptoms.

Reporting from the WHO, the appearance of monkeypox symptoms is divided into two periods of infection, namely the invasion period and the skin eruption period. Here’s the explanation:

Invasion period

The invasion period occurs within 0-5 days after being infected with the virus for the first time. When a person is in the invasion period, he will show some symptoms of monkeypox, such as:

  • Fever
  • Huge headache
  • Lymphadenopathy (swollen lymph nodes)
  • Back pain
  • Muscle ache
  • Severe weakness (asthenia)
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Swollen lymph nodes that are the distinguishing feature between monkeypox and other types of smallpox. Non-variola smallpox infections, such as chickenpox and shingles, do not cause swollen lymph nodes.

In cases of severe symptoms, the infected person may experience other health problems early in the infection.

Such is the case studied in the Clinical Manifestations of Human Monkeypox study. The group of patients exposed to the virus through the mouth or respiratory tract showed respiratory problems such as coughing, sore throat, and runny nose.

Meanwhile, patients who were directly bitten by an infected animal also experienced nausea and vomiting in addition to fever.

Skin eruption period

This period occurs 1-3 days after the fever appears. The main symptom in this phase is the appearance of a skin rash.

The rash first appears on the face and then spreads all over the body. The face and palms and feet are the areas most affected by this rash.

The appearance of a rash can also be found on the mucous membranes located in the throat, genital area, including eye tissue and cornea.

The rash that forms usually starts with spots until they turn into vesicles or blisters, which are fluid-filled skin blisters. Within a few days, the rash will turn dry to form a crust (scab) on the skin.

The development of a rash from spots to scabs on the skin generally occurs within about 10 days. It takes about three weeks for all the scabs on the skin to peel off on their own.

When to go to the doctor?

If you think you have come into contact with a person or wild animal infected with monkeypox, consult a doctor immediately. Especially if you have recently traveled to an area where this outbreak originated.

If you experience the symptoms as mentioned above, you should immediately consult a doctor to get the right treatment. Treatment also helps prevent complications from occurring.

Although monkeypox is a self-limited disease, the symptoms can be annoying and uncomfortable. Moreover, this disease tends to heal longer than other smallpox diseases.

Causes of monkey pox

Monkeypox virus is a virus of animal origin (zoonotic virus).

It is known that this virus was originally transmitted by the bite of wild animals such as squirrels. However, the researchers also found that this virus infected a group of monkeys under study. From here, this disease is called monkey smallpox.

The monkeypox virus belongs to the genus Orthopoxvirus in the family Poxviridae. Viruses belonging to the Orthopoxvirus genus include the variola virus that causes smallpox (smallpox), vaccinia virus (which is used in the smallpox vaccine), and cowpox virus.

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Most cases of monkeypox experienced by humans are caused by transmission from animals. Viruses of animal origin can enter the human body through open wounds in the skin, respiratory tract, mucous membranes, and mucous membranes (saliva).

How to transmit monkeypox

This disease is known to be transmitted through direct contact with skin lesions, blood, body fluids, or mucous (saliva) containing the virus. However, how do animals get to transmit it to humans?

In Africa, animal-to-human transmission is known to occur through daily contact with infected Gambian monkeys, squirrels and mice.

According to the CDC, transmission of chickenpox from animals to humans can also occur through animal bites, direct contact with fluids or animal skin lesions or indirect contact with surfaces contaminated with the virus.

Cases of transmission of monkeypox from one person to another are generally very minimal. Transmission of the monkeypox virus between humans often takes place from droplets from the respiratory tract of an infected person.

Not only through exposure to droplets released when sneezing or coughing by an infected person, transmission of the virus from droplets can also take place during regular face-to-face contact with infected people.

This virus can also move from the body of pregnant women to the fetus through the placenta.

Risk factors

Anyone who has never been infected with the virus that causes monkeypox has the opportunity to experience this disease. However, you are more at risk of contracting the disease when:

  • Make direct contact without wearing protective gear with wild stars.
  • Having close contact with monkeys infected with this disease virus.
  • Consuming meat and other body parts of wild animals, especially without first being cooked thoroughly.
  • Caring for people who have monkeypox.
  • Conducting research on the monkeypox virus in the laboratory.

To diagnose this disease, the doctor will perform a physical examination to identify symptoms. However, this disease can be misdiagnosed as other smallpox diseases such as chickenpox or shingles.

Therefore, usually the doctor will require you to undergo laboratory tests that are used to determine the presence of a viral infection that causes monkeypox.

One of the tests that doctors recommend is a swab test or polymerase chain reaction (PCR). This test aims to analyze samples from skin lesions or parts of the skin affected by smallpox.

Treatment for monkeypox

So far, no specific treatment for monkeypox has been found in Indonesia, considering that cases of this disease have not been found in Indonesia.

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Although there is no specific treatment, this disease can be managed by trying to control the symptoms that arise through supportive care and treatment through antivirals.

Supportive care cannot stop the ongoing viral infection, but aims to increase the body’s immune strength to fight infection.

While experiencing symptoms, you are encouraged to increase your rest time and meet your fluid and nutritional needs by following a strict healthy diet.

You should also self-quarantine by staying at home and limiting social contact with people in the surrounding environment.

Until now there is no specific drug that can overcome the viral infection that causes monkeypox. However, the type of antiviral used to treat smallpox (smallpox), namely cidofovir or tecovirimat can help in the recovery process.

In cases of severe symptoms, the patient is recommended to be hospitalized in a hospital for intensive treatment.

To control the health impact of this disease, prevention through smallpox vaccine and immunoglobulin vaccine is the main solution for handling monkeypox.

Monkeypox prevention

Prevention is always better than cure. This also applies to the handling of monkeypox.

The smallpox vaccine (Jynneos) is known to be 85% effective in preventing this disease. The vaccine is a modified version of the vaccinia vaccine which was previously used to prevent smallpox (smallpox).

In 2019, the FDA officially approved Jynneos as a vaccine that can prevent smallpox (smallpox) as well as monkeypox (monkeypox).

Administration of two doses of Jynneos vaccine in 28 days has been shown to strengthen the immune system response compared to one dose of the previous smallpox vaccine.

However, the availability of the vaccine in public health care centers is still very limited. In Indonesia, there is no specific vaccine available to prevent monkeypox.

Nowadays, implementing clean and healthy living behaviors such as washing your hands with soap regularly, especially after interacting with animals is still the main prevention effort that can help you avoid the risk of infection with this disease.

Some other things you can also do to prevent monkeypox include:

  • Avoid direct contact with rats, primates, or other wild animals that may be exposed to the virus (including contact with animals that die in infected areas).
  • Avoid contact with any objects, such as bedding, that a sick animal has been in.
  • Do not eat wild animal meat that is not properly cooked.
  • Stay away from infected patients as much as possible.
  • For medical workers, use masks and gloves when handling sick people.

If there are questions or complaints related to this disease, immediately consult a doctor for the best solution.

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