Introduction
What is Mpox?
Monkey pox or Mpox is an infectious disease caused by a virus which is transmitted to humans by infected animals and can also be transmitted from an infected human to a uninfected individual through close physical contact. It causes flu-like symptoms (fever and chills) and a rash.
Currently, there is no proven treatment for Mpox, but in most of the cases, Mpox heals spontaneously within 2 or 3 weeks.
The virus that causes Mpox is a member of Orthopoxvirus genus, just like the virus that causes smallpox.
Any person can contract Mpox. In Africa, most cases are among children who are under 15 years old.
Key Facts & Statistics
Key facts and statistics that surround Mpox
- Monkey pox virs is a zoonotic orthopoxvirus that causes a serious smallpox-like illness in human beings
- The Democratic Republic of Congo (DRC) and some countries in Africa have been facing Mpox outbreaks for more than 10 years.
- Several studies have shown that vaccination against “classic” smallpox is more than 80% effective in Mpox prevention. However, vaccination against smallpox has not been carried out since the disease was globally eradicated in 1980.
Causes & Methods of Transmission
What are the causes of Mpox ?
The causative agent is a virus that belongs to genus Orthopoxvirus.
Methods of Transmission
- Person-to-person transmission due to close contact.
- Animal-to-person transmission due to scratches, bites or broken skin or through direct contact with the animal’s body fluids.
- Exposure to recently contaminated materials such as clothing and bedding (that were used by an infected person or animal).
Signs & Symptoms
What are the signs and symptoms of Mpox?
- Swollen lymph nodes.
- Rash.
- Fever.
- Headache.
- Muscle aches.
- Fatigue.
- Chills.
Types
What are the most common types of Mpox virus?
- These types are classified according to the location of origin:
- Clade I: Originated from Central Africa.
- Clade II: Originated from West Africa.
- The 2022-2023 world outbreak was known to be caused by Clade IIb, which is a subtype of Clade II (the less severe West African clade).
Diagnostic Procedures & Tests
How is Mpox diagnosed?
- Mpox is a rare disease. Healthcare providers may suspect other rash illnesses, such as measles or chickenpox. It is the presence of swollenlymph nodes that usually distinguishes Mpox from other poxes.
- Diagnosis can be based on patient history of travel. For example, if they recently travelled to an area with an Mpox outbreak.
- Physical examination of the patient for signs and symptoms.
- Tests:
- Polymerase chain reaction (PCR) test detection of the virus from scab or vesicular fluid.
- Blood testing to check for Mpox virus or antibodies formed against the virus.
Treatment and Management
Does Mpox have a cure?
- Mpox is usually a self-limited disease (Mpox heals spontaneously within 2 or 3 weeks).
- After diagnosis, the condition is monitored closely and attempts at relieving symptoms and preventing dehydration are made. Apart from these, antibiotics are administered to treat secondary bacterial infections in case they develop.
How is Mpox treated?
Drug treatment options are:
- Tecovirimat.
- Cidofovir.
- Brincidofovir.
Tecovirimat
It is approved for the treatment of severe Mpox. It inhibits the orthopoxvirus VP37 envelope wrapping protein, preventing the virus from leaving an infected cell.
Cidofovir and brincidofovir
- These are other anti-viral agents that have been shown to be effective against orthopoxviruses in vitro. There is ongoing research to establish their efficacy against Mpox.
- Brincidofovir is a prodrug of cidofovir and may have a n improved safety profile over cidofovir. Cidofovir is administererd together with probenecid to reduce risk of nephrotoxicity. Both cidofovir and brincidofovir inhibit viral replication by selectively inhiiting viral DNA polymerases.
- It should be noted that brincidofovir carries a black-box warning of an increased risk of death with extended use.
Complications
What are the complications of Mpox?
- Pneumonia
- Encephalitis
- Death. Mpox can be fatal.
Prevention
How do we prevent Mpox?
- Vaccination against mpox.
- Improved surveillance and epidemiological analysis are some of the measures which are required to better assess the public health burden and develop strategic plans for the reduction of the risk of wider spread of infection.
Other ways include:
- Washing hands frequently with soap and clean water.
- Using personal protective equipment (PPE) when taking care of patients infected with Mpox virus.
- Disinfecting frequently touched surfaces.
- Avoid contact with infected people or animals.
- Avoid touching materials that may be contaminated with the virus such as bedding used by infected people.