What is MonkeyPox ?

Overview

MonkeyPox is a viral zoonotic disease which occurs primarily in tropical rainforest areas of Central Africa and West Africa, was found in 1970s. It is typically presents with fever, rush, and swollen lymph nodes and may lead to a range of medical complications. It is usually self-limited disease with the symptoms lasting from 2 to 4 weeks. Case fatality rate may vary from 1-10%. It can be transmitted from Animal to Human as well as Human to Human. The virus can enter the body through broken skin, respiratory tract or the mucous membranes (eyes, nose, or mouth).

Animal to Human Transmission

It may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding.

Human to Human Transmission

It can occur primarily through large respiratory droplets generally requiring a prolonged close contact. It can also be transmitted through direct contact with body fluids or lesion material and indirect contact with lesion material, such as through contaminated clothing or linens of an infected person

Clinical Presentation

The clinical picture typically presents with fever, rush, and swollen lymph nodes and may lead to a range of medical complications. It resembles that of Smallpox, a related Orthopox virus infection which was declared eradicated worldwide in 1980. MonkeyPox is less contagious than Smallpox and causes less severe illness.

• Incubation Period: 7-14 days but can range from 5-21 days, person is usually NOT contagious during this period.
• Infected person may transmit the disease from 1-2 days before appearance of the rush and remain contagious till all the scabs fall off.
• Case fatality rate may vary from 1-10%.

Current Scenario

As on 20 May 2022, the cases of MonkeyPox have been reported from United Kingdom, USA, Europe, Australia and Canada. NO any death has reported till now.

Indian Context

MonkeyPox has not been reported in India, as on 20 May 2022, but with new cases being detected from various countries chances occurring in India cannot be ruled out. The cases that have been reported worldwide are both due to local transmission and also due to travel to African countries. As a proactive approach National Centre for Disease Control (NCDC) and Ministry of Health & Family Welfare (MoHFW) has identified several public health actions to be initiated in event of suspected cases being reported from India.

Public Health Recommendations

1. Health facilities to keep heightened suspicion in people who; Present with an otherwise unexplained rush, Who have travelled, in last 21 days, to a country that has recently had confirmed or suspected cases of MonkeyPox or Report contact with a person or people with confirmed or suspected MonkeyPox
2. All suspected cases to be isolated at designated healthcare facilities until all lesions have resolved and a fresh layer of skin has formed or until the treating physician decides to end isolation.
3. All such patients to be reported to the District Surveillance Officer of Integrated Disease Surveillance Programme (IDSP).
4. All infection control practices to be followed while treating such patient.
5. Laboratory samples consisting of fluid from vesicles, blood, sputum etc to be sent to National Institute of Virology (NIV), Pune for MonkeyPox testing in case of suspicion.
6. In case of positive case is detected, contact tracing has to be initiated immediately to identify the contacts of the patients in the last 21 days.

SOURCE: Interim advisory from National Centre for Disease Control (NCDC), India.