The monkeypox epidemic has alarmed several people around the world.
There have been more than 2,100 cases in almost 80 countries since May and 75 suspected deaths in Africa – mostly in Nigeria and Congo – where a more deadly form of monkeypox is spreading than in the West. Spain and Brazil have also reported monkeypox-related deaths.
Last week, the World Health Organization declared it a global emergency. The rare medical phenomenon caused by the monkeypox virus comes from the same family of viruses, namely the Variola virus, which is also responsible for causing smallpox.
Recently, a new study published by the British Medical Journal (BMJ) attracted a lot of attention with its surprising findings. The research revealed that the new variant of monkeypox showed previously unseen symptoms such as rectal pain and penile swelling (edema) in patients that were different from those seen in the previous outbreak, according to the study.
To help with the checklist, Dr. Subrata Das, senior consultant in internal medicine and diabetology at Sakra World Hospital, shared some of the most common symptoms of monkeypox that have been reported in the past — acute headache, fever, skin skin rashes or lesions/blisters, macules (small non-raised skin patches) to papules (raised hard spots), fatigue, chills and swollen lymph glands in the armpits, neck and groin, muscle pain, back pain.
Monkeypox can also present with malaise, lymphadenopathy, vesicles, pustules, and scabbing. It can also affect the face and cause palms and mucous membranes, which is similar to smallpox but with larger lesions.
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Once infected with the disease, the treatment procedure for the rash proceeds in stages.
Dr Bindumathi PL, senior consultant in internal medicine at Aster Hospital, said the recent outbreak in the UK was predominantly seen in people who were immunocompromised due to HIV infections. These patients present with atypical features such as skin-only lesions with abscess and tonsillar abscess. No deaths have been reported, but pain and suffering in the genital and perigenital areas due to skin lesions is more.
“Patients can visit different specialties such as infectious disease, surgeon, venereal disease clinic and ENT doctors to get the appropriate disease treatment they need,” she advised.
The study included 197 men with confirmed cases of monkeypox at an infectious disease center in London between May and July 2022. Of the total, 196 identified as gay, bisexual or other men who have sex with men.
Overall, 20 (10%) of the participants were admitted to hospital for treatment of new-onset symptoms. The researchers recommend that clinicians consider monkeypox infection in patients with these symptoms.
All patients had lesions on the skin or mucous membranes, most often on the genitals or in the perianal area. Most (86 percent) of patients reported systemic disease (affecting the whole body). The most common systemic symptoms were fever (62%), swollen lymph nodes (58%) and muscle aches (32%).
Graphic from The Times Of India
And in contrast to existing case reports suggesting that systemic symptoms precede skin lesions, 38 percent of patients developed systemic symptoms after the appearance of mucosal lesions, while 14 percent presented with lesions without systemic features. A total of 71 patients reported rectal pain, 33 sore throat, and 31 penile swelling, while 27 had oral lesions, 22 had a single lesion, and 9 had swollen tonsils.
The researchers also noted that single lesions and swollen tonsils were not previously known to be typical features of monkeypox infection and could be confused with other conditions.
Just over a third (36 percent) of participants also had an HIV infection, and 32 percent of those tested for STIs had a sexually transmitted infection. However, no deaths were reported and no patients required intensive care.
Monkeypox can be transmitted in three ways – sexually, through skin-to-skin contact and through droplet infection.
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Dr Subrata Das (left) of Sakra World Hospital and Dr Bindumati PL of Aster CMI Hospital
People with a recent history of travel to any of the infected countries or contact with travelers from those countries who develop fever, myalgia, sore throat or skin lesions should be isolated and evaluated with appropriate medical care, Dr. Bindumati said. “The threat lies in its potential to become a pandemic due to increased travel to different countries. Hence, awareness of the disease becomes crucial,” she added.
Dr Das said patients suffering from monkeypox should be isolated for three weeks as a new person who comes in contact with the infected individual can develop symptoms after five to 21 days. “Two-three weeks of quarantine is necessary,” he emphasized.
Immunocompromised individuals, such as patients with HIV, other immunodeficiency syndromes and neonates, should be cautious as they are prone to developing infection.
Once infected with the disease, the treatment procedure for the rash proceeds in stages. “It (rash/legions) will last for about two to four weeks before it subsides,” added Dr. Das.
People caring for an infected person should maintain good hygiene. “The person caring for the patient should wash their hands regularly and should be protected with PPE and follow the necessary precautions as with Covid-19,” shared Dr. Das.
Meanwhile, caregivers should also be careful while touching or handling the utensils, bedding, towels, or clothing of a person affected by monkeypox. Disposal of waste and disinfection of the patient’s belongings should be done carefully.
Since the monkeypox and smallpox viruses are genetically the same, Dr. Das hypothesized that the smallpox antiviral drug could be used to prevent and treat individuals affected by monkeypox. Monkeypox can have a serious and fatal impact with about a 0.5 percent to 10 percent mortality rate.
Therefore, it is important to consult the health care provider in case of symptoms of monkeypox.
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