Delhi reported its first case of the monkeypox virus,(July 24, 2022). Important to note that the patient does not have any history of travel abroad. It suggests local transmission of disease.

 

Earlier three cases of the disease were found in Kerala —among people who arrived from the United Arab Emirates.

Delhi case

31-year-old patient, a resident of Delhi, is currently admitted and recovering in the isolation ward of Lok Nayak Hospital. He had attended a Stag party in Himachal Pradesh recently.

How was the diagnosis confirmed?

The diagnosis has been done by the National Institute of Virology (NIV), Pune using PCR test

What is monkeypox?

Monkeypox is an illness caused by the monkeypox virus. In simple terms, It is a viral zoonotic infection which can spread from animals to humans. It can also spread from person to person.

Is Monkeypox similar to Coronavirus?

Monkeypox virus is DNA Virus (unlike SarsCov-2 which is RNA Virus). It has different symptoms and causes.  However, like covid, monkeypox can also spread from person to person.

Is it primarily transmitted from Monkeys?

No. It was transmitted primarily from Rodents to Humans in Western African countries mainly Nigeria and Congo.

The disease is called monkeypox because it was first identified in colonies of monkeys kept for research in 1958 in Zaire (now Congo). It was later detected in humans in 1970.

 

Worldwide Spread

Rodents got exported to the US and there the virus jumped to piere dogs and then to humans. Current pandemic is witnessing human-to-human transmission primarily through the sexual route.

 

Mode of transmission:

Close contact and Sexual route is the most important route. Most cases in the world have been seen in Gay Men, MSM community is most at risk.

Other routes like a mouth, Direct skin contact, and fomites can be infective

Airborne droplet infections are being considered.

Skin lesions, vesicular fluid, and scab scrapings are highly infective.

 

 Disease burden:

In nearly 77 Countries more than 16000 cases

Primarily Western Europe

 

Major Symptoms:

Fever

Backache

Profound weakness

Rash

Signs:

Swollen lymph nodes. This is followed or accompanied by the development of a rash which can last for two to three weeks.  *Vascular Rash on Face, Palms, and Soles.

Rash spares trunk.

Symptoms typically last two to three weeks

Incubation period:

6 to 13 days

Period of infectivity

2 days prior to symptoms till all the lesions have healed (count 3 weeks).

Treatment

Symptomatic

Any Effective Anti-viral drug?

Yes Tecovirimat

The drug is available in India. It was developed by the USA  primarily to thwart any potential smallpox virus warfare.

Vaccine:

The smallpox vaccine provides cross immunity against monkeypox in 85% of cases.

People in the age group of the 50s and late 40s having two big smallpox vaccination marks might be protected

Why the disease is surfacing now?

Because the immunity of the population has gone down. Smallpox vaccination was abandoned in the late 70s. It is cross-protected against monkeypox.

How to protect?

• Isolate the patient till all lesions heal
• Give him clothes with long sleeves and long pants
• Triple layer mask

Treatment:

• Antipyretics, Supportive treatment, hydration good diet
• On lesions calamine lotion
• Anti Viral to be reserved for immunocompromised and malnourished likely to have complications.

Protection of HCWs

• Mask PPE kit
• hand washing
• 80%alcohol
• Soap water repeated proper hand washing
• Disinfection using 1% Sodium Hypochlorite
• Proper disposal of clothing and linen.

For more information contact The Smart Doctors.