The Monkeypox disease, which is relatively rare but potentially serious, is drawing increased attention due to its symptoms, and mode of transmission, hence the need for public awareness.
As the Nigeria Centre for Disease Control and Prevention (NCDC) prepares to roll out a vaccination campaign targeting high-risk groups, it is essential for Nigerians to understand what mpox is, how it spreads, the symptoms to watch out for, and most importantly, how to prevent it.
Mpox (formerly known as Monkeypox) is a disease caused by infection with a virus, known as Monkeypox virus. This virus is part of the same family as the virus that causes smallpox. People with mpox often get a rash, along with other symptoms. The rash will go through several stages, including scabs, before healing. Mpox is not related to chickenpox.
History
Monkeypox virus was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox” originally, the source of the disease remains unknown. Scientists suspect African rodents and non-human primates (like monkeys) might harbor the virus and infect people.
The first human case of mpox was recorded in 1970, in what is now the Democratic Republic of the Congo. In 2022, mpox spread around the world. Before that, cases of mpox in other places were rare and usually linked to travel or to animals being imported from regions where mpox is endemic.
The World Health Organization renamed the disease in 2022 to follow modern guidelines for naming illnesses. Those guidelines recommend that disease names should avoid offending cultural, social, national, regional, professional, or ethnic groups and minimize unnecessary negative effects on trade, travel; tourism, or animal welfare. The virus that causes it still has its historic name, however.
Virus types
1. Clade I causes more severe illness and death. Some outbreaks have killed up to 10% of the people who get sick, although more recent outbreaks have had lower death rates. Clade I is endemic to Central Africa.
2. Clade II is the type that caused the global outbreak that began in 2022. Infections from clade II mpox are less severe. More than 99.9% of people survive. Clade II is endemic to West Africa.
Symptoms and Signs
Monkeypox is characterized by a range of symptoms that typically begin within 7 to 14 days after exposure to the virus. Initial symptoms often include fever, headache, muscle aches, and backache. This is followed by the appearance of a distinctive rash that usually starts on the face and then spreads to other parts of the body. The rash progresses through several stages, from flat lesions to raised bumps, then to fluid-filled blisters, and finally to crusted scabs. The rash is often accompanied by swollen lymph nodes, which can help distinguish monkeypox from other similar diseases like chickenpox.
Prodromal Phase (Initial Symptoms):
§ Fever: The onset of fever is often the first symptom, ranging from mild to high-grade.
§ Headache: Severe headaches are common during the early stages of infection.
§ Muscle Aches: Myalgia, or muscle pain, is frequently reported.
§ Back Pain: Lower back pain can be a symptom, often accompanying muscle aches.
§ Fatigue: A general feeling of tiredness and weakness may set in.
§ Lymphadenopathy: Swelling of the lymph nodes is a distinctive feature of Mpox, differentiating it from other viral infections like chickenpox or smallpox.
Rash Phase:
§ Rash Onset: After 1 to 3 days of fever, a rash typically appears, starting on the face and then spreading to other parts of the body. The rash progresses through different stages:
§ Macules: Flat, discolored spots on the skin.
§ Papules: Raised, solid bumps.
§ Vesicles: Small, fluid-filled blisters.
§ Pustules: Blisters filled with pus.
§ Scabs: The pustules eventually crust over and form scabs, which later fall off.
§ Distribution: The rash usually affects the face, palms of the hands, soles of the feet, and mucous membranes (mouth, eyes, and genital areas).
Complications:
§ In severe cases, Mpox can lead to complications such as secondary bacterial infections, respiratory distress, sepsis, encephalitis (inflammation of the brain), and, in rare instances, death. The disease is more severe in young children, pregnant women, and individuals with weakened immune systems.
Mode of Transmission:
Monkeypox is primarily transmitted to humans through direct contact with the blood, bodily fluids, or lesions of infected animals, particularly rodents and primates. Human-to-human transmission can occur through respiratory droplets during prolonged face-to-face contact or through contact with contaminated materials such as bedding or clothing. The virus can also be spread through direct contact with the rash or bodily fluids of an infected person.
1. Animal-to-Human Transmission: Humans can contract Mpox through direct contact with the blood, bodily fluids, or lesions of infected animals. This can happen during hunting, skinning, or consuming bush meat. Additionally, handling or consuming undercooked meat from infected animals can lead to infection.
2. Human-to-Human Transmission: Mpox spreads from person to person through close contact with respiratory droplets, bodily fluids, or lesions. This often occurs in households, healthcare settings, or through intimate contact. Prolonged face-to-face contact or touching contaminated surfaces, such as bedding, clothing, or towels, can also facilitate transmission.
3. Contaminated Objects: The virus can survive on surfaces for an extended period, making indirect transmission possible. Shared items like bedding, towels, or utensils can harbor the virus, posing a risk to anyone who comes into contact with them.
4. Mother-to-Child Transmission: Pregnant women can pass the virus to their unborn children through the placenta, leading to congenital Mpox.
Aetiology:
Monkeypox is caused by the monkeypox virus, which belongs to the Orthopoxvirus genus, the same family that includes the variola virus (which causes smallpox) and the vaccinia virus (used in the smallpox vaccine). The virus was first identified in laboratory monkeys in 1958 and was later recognized as a disease affecting humans in 1970 in the Democratic Republic of Congo.
The virus is primarily found in Central and West African countries, where it is considered endemic. However, the recent outbreak has seen cases reported in countries outside this traditional range, sparking international concern and efforts to control the spread.
Public Health Response:
Health authorities are advising the public to practice good hygiene, avoid contact with animals that could be infected, and seek medical attention if symptoms develop. Vaccination efforts are being ramped up in affected regions to control the outbreak, with smallpox vaccines showing some efficacy against monkeypox due to their shared virus family.
The recent outbreak of monkeypox underscores the importance of vigilance and preparedness in managing infectious diseases. By understanding the symptoms, transmission methods, and aetiology of the virus, individuals and health professionals can better protect themselves and their communities from the spread of monkeypox.
Nigeria, in particular, has seen a worrying rise in cases, with 39 confirmed infections across 33 states, including notable numbers in Bayelsa, Cross River, Ogun, Lagos, Ondo, and Ebonyi states.
