Monkeypox is a rare human disease, but it is not new. According to the World Health Organization (WHO), Monkeypox has been around for several years, but it used to be endemic only in heavily forested areas in Central and West Africa.

What is new is that several cases of Monkeypox have recently been reported outside Africa, particularly in the European region and other parts of the world that don’t usually have or have never reported Monkeypox cases in the past.

With the outbreak spreading fast internationally, people are getting alarmed. But what exactly is Monkeypox? Is it really a cause for alarm? Read on to know the answers to several common questions about this disease.

What is Monkeypox?

Monkeypox is a viral disease caused by infection with the Monkeypox virus, a virus that belongs to the same family as smallpox.

Despite the name, monkeys are not the primary source of the virus. It is only called Monkeypox because two outbreaks of a pox-like disease (now known as Monkeypox) were first discovered in colonies of monkeys kept for research in 1958. The first human case of Monkeypox was recorded in 1970 in the Democratic Republic of the Congo (DRC).

There are two strains of Monkeypox virus: the Central African strain (also known as Congo Strain) which tends to cause severe infections, and the West African strain, which is less severe.

According to the US Center for Disease Control and Prevention (CDC), the Monkeypox strain that has been causing the recent outbreak in countries outside of Africa is the less severe, West African strain.

How do you catch Monkeypox?

Monkeypox is a viral zoonotic disease which means that it primarily spreads from animals to humans.

Animal-to-human transmission occurs through broken skin when infected animals bite or scratch you. You can also get the virus from eating uncooked contaminated meat of infected animals or having direct contact with their blood, bodily fluids, or mucosal lesions.

Up to this day, the natural reservoir –normal location or carrier where the virus lives and multiplies– of Monkeypox virus remains unknown. But various animal species in Africa, which include squirrels and pouched rats have been identified to harbor the virus and infect humans.

Human-to-human transmission, although traditionally less common, is also possible. It can occur in three ways:

  • direct contact with body fluids or rash lesions of the infected person
  • direct contact with objects contaminated with the virus (things that have touched body fluids or sores of the infected person, like bedding or clothing).
  • Inhalation of the respiratory droplets of an infected person (during prolonged face-to-face contact)

Unlike COVID-19 where virus particles can hang in the air for an extended period, Monkeypox is transmitted through large droplets (such as those exhaled by someone during sneezing) that don’t linger in the air or travel far. As a result, it will require prolonged, intimate contact before you get infected.

What are the signs and symptoms of Monkeypox?

The signs and symptoms of Monkeypox are quite similar to smallpox but often less severe. During the invasion period (first 5 days), flu-like symptoms may appear such as:

  • Fever
  • Intense headache
  • Swollen lymph nodes
  • Back pain
  • Muscle aches
  • Intense asthenia (Lack of energy)

In about 1-3 days after the appearance of fever, a rash will start to develop. This rash starts to appear on the face and then spreads to other parts of the body, typically in the hands, feet, arms, and legs.

The rash caused by Monkeypox changes in appearance throughout the course of infection. It starts as small, flat bumps and then turns into tiny blisters (bumps filled with clear fluid) similar to chickenpox. After several days, these then change into larger, pus-filled blisters that will crust and fall off before recovery.

According to the Department of Health, a person is considered contagious as soon as the first symptoms start to develop and until all the scabs have fallen off.

How long do symptoms last?

Monkeypox has a long incubation period (interval from infection to onset of symptoms). It typically takes 6 to 13 days (but may range from 5 to 21 days) for the symptoms to occur after getting exposed to the virus. During this period, someone with Monkeypox is not yet contagious.

After experiencing the first signs and symptoms, most people recover in 2-4 weeks.

While Monkeypox infection is generally mild in most people, it can cause severe outcomes among vulnerable people such as those with weakened immune systems or who are pregnant.

How is Monkeypox treated?

There is currently no proven or safe treatment for Monkeypox. If you get infected, the treatment generally involves symptom management. But Monkeypox is a self-limited disease which means that, even without treatment, most infected people will recover within 2-4 weeks.

Those who develop secondary infections and local pain may be treated with antibiotics and analgesia.

Are there vaccines to prevent Monkeypox?

There are vaccines available against Monkeypox, but mass vaccination is currently not required and recommended by WHO.

According to the new interim guidance of WHO on vaccine use against Monkeypox, vaccines are only recommended at this time for health workers at-risk for exposure, laboratory personnel working with orthopoxviruses, clinical laboratory personnel performing diagnostic testing for Monkeypox, and outbreak response team members.

The vaccines are also given to contacts of cases after exposure (within 4 days of first exposure) to prevent the onset of the disease.

How to prevent Monkeypox?

Although there is still no confirmed case of Monkeypox in the country, it is important that we keep informed of the ways to protect ourselves, especially when outbreaks like this are spreading fast internationally. Here are the things you can do to protect yourself against Monkeypox:

  • Avoid skin-to-skin or face-to-face contact with anyone who has symptoms
  • Avoid contact with animals that might have the virus, especially dead animals in areas where Monkeypox is common
  • Avoid contact with materials, such as beddings, that have touched a person with Monkeypox or a sick animal
  • Separate infected persons or animals from others at risk for infection
  • Always wash your hands with water and soap or alcohol-based hand rub especially if you must be close to an infected animal or person
  • Use protective gear like masks, safety goggles or glasses, and gloves if you can’t avoid contact (i.e., caring for an infected patient)

What’s the bottom line?

Based on the available information on Monkeypox, there is no reason at this point to panic and be alarmed. But everyone is encouraged to be alert and keep informed especially since the situation is still expected to evolve.

Experts are still in the early stages of understanding this atypical outbreak, so our understanding of how it is spreading and how to properly contain its spread may still change.

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