Monkey Pox. BL Explainer: Monkey pox

What is Monkeypox and has it surfaced in India?

Monkeypox is not a new virus, and is part of the small pox family. Caused by the monkeypox virus, it is known to jump species (zoonotic), from animals to humans. This usually happens when people are in close proximity with wild animals (that could be reservoirs for the virus) and handling or consuming wild bush meat, among other things. It can also spread between humans through close contact, but transmission is known to be slower than the SARS-CoV-2, which causes Covid-19. Monkeypox is commonly found in Central and West Africa — known for its tropical rainforests — where animals that may carry the virus typically live, says the World Health Organization (WHO). The disease is identified in other countries when people travel from regions where it is endemic. It has not been reported from India, but surveillance has been stepped-up at ports.

What are its symptoms?

People are advised to watch out for typical symptoms, including fever, intense headache, muscle aches, back pain, low energy, swollen lymph nodes and skin rashes or lesions. The rash usually begins within one to three days of the start of a fever. Lesions can be flat or slightly raised, filled with clear or yellowish fluid, and can then crust, dry up and fall off. The rash tends to be concentrated on the face, palms of the hands and soles of the feet. They can also be found on the mouth, genitals, and eyes, the WHO said. It could last between two to four weeks, and is infectious, say virologists, advising identification and isolation. Care also needs to be taken in handling infected material like bed sheets.

How fast is it spreading? Is it deadly?

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It has been identified in several European countries, starting with the United Kingdom (early May) , where the person’s travel history was traced back to Nigeria. It has since spread to about 12 countries including the United States, Israel, Australia Portugal, Spain, Belgium, Germany, France, Netherlands, Sweden and Canada. While the world is yet to push the panic button, virologists are concerned.

“This is the first time that chains of transmission are reported in Europe without known epidemiological links to West and Central Africa. These are also the first cases worldwide reported among MSM (men who have sex with men)”, says the European Centre for Disease Control and Prevention. The WHO adds, the absence of transmission without a travel history to endemic regions, presented a “highly unusual event”. On MSMs, it clarified, it may not be exclusively in this group, and possibly resulted from people seeking care in primary care and sexual health clinics. The Central African type has a mortality rate of 10 percent. The virus presently circulating is the West African one.

More cases are likely to be reported as surveillance expands, says the WHO, as their expert and technical groups outline response strategies.

Are existing vaccines effective against this disease?

While there is no vaccine against monkey pox, there are approved anti-virals being considered for treatment — tecovirimat (against monkey pox), brincidofovir and a vaccine (IMVANEX) against small pox. These were approved (and vaccine stockpiled) in the United States following concerns of the small pox virus being used as a bio-weapon. Those of us born before 1980 may have have received the small pox vaccine (it left a distinct mark on your forearm). This vaccine was dropped from global immunisation plans, as small pox was eradicated.

What precautions are experts advising?

Information from multiple countries is still trickling in. Experts are studying the human transmission (and possible transmission to animals), to alert if the virus changes its behaviour. Governments have been advised to step up surveillance and alert doctor communities to watch for symptoms. People also need to be watchful if they come in contact with someone who is infected.