As the world recovers from the devastating COVID-19 pandemic along comes monkeypox, a new disease that threatens to derail the recovery process. A rare disease similar in symptoms to smallpox, but less severe and less contagious, monkeypox has so far been identified in over a dozen countries, outside of the areas where it normally prevails.

Monkeypox is a viral zoonosis — a virus disease transmitted from animals to humans — usually associated with countries in the tropical rainforest areas of Central and West Africa. The World Health Organization says scientists have identified several animals as susceptible to the monkeypox virus, including rope squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates, and other species.

Transmission of monkeypox virus occurs mainly when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. As such, the spread of monkeypox is relatively easier to prevent than COVID-19 or measles, which are spread through small very fine droplets and tiny aerosol particles that contain the virus.

The virus enters the body through broken skin, respiratory tract, or the mucous membranes (eyes, nose, or mouth). Animal-to-human transmission may occur by bite or scratch, wild meat preparation and consumption, direct contact with body fluids or lesion material. While the virus itself is not a sexually transmitted infection, the most recent surge in cases appears to have been spread among men who have sex with other men.

Early symptoms include fever, chills, enlarged lymph nodes, muscle and body aches, and exhaustion, with the most obvious symptom being painful blisters all over the body. Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a rash, or ‘pox’ often beginning on the face then spreading to other parts of the body.

Monkeypox is diagnosed by detection of unique sequences of viral DNA in skin lesions either by real-time polymerase chain reaction (PCR) and/or sequencing. The incubation period of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days. In most cases, the symptoms of monkeypox disappear on their own within a few weeks, however, the rash and pustules can last for several weeks.

In some individuals, disease can lead to medical complications and even death. Mortality has been estimated to be 1 to 10 percent, depending on the strain. Severe disease and mortality are higher among children, young adults, and immunocompromised individuals. Though there is no specific treatment for monkeypox, health authorities say there is no cause for panic, as vaccines and treatments against smallpox have been found to be effective against monkeypox infection.

Because monkeypox virus is closely related to the virus that causes smallpox, antiviral drugs and immunoglobulins used against smallpox are effective in this disease. Clinical studies from Africa suggest that the smallpox vaccine is 85 percent effective against monkeypox. Jynneos (Imvamune or Imvanex), an attenuated live virus vaccine which has been approved by the US Food and Drug Administration (FDA) for the prevention of smallpox and monkeypox, is being administered in some places as two subcutaneous injections four weeks apart.

Disease prevention strategies used in response to COVID-19 could also help against monkeypox, including social distancing, wearing masks, increasing ventilation, and staying home if we are sick. Hand hygiene is also really key since this is a DNA virus which is better suited to survive on surfaces.

Other precautions that can be taken to prevent infection with monkeypox are avoiding contact with any materials, such as bedding that has been in contact with an infected person.Avoiding travel to areas known to have monkeypox and to endemic places where the disease is known to prevail.

Dr. Jibin John Thomas
Registrar , Internal Medicine
International Clinic


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