Monkeypox: Frequently asked questions

By Sushmita Baniya •  Updated: 06/07/22 •  6 min read

The causative agent of monkeypox is the monkeypox virus. It primarily occurs in the central and western parts of Africa, but recently, in 2022, there have been reports of outbreaks in other countries too. Outbreaks have emerged out of Africa in 15 countries (24th May 2022), with more than 100 confirmed cases. Research is being done on its outbreaks as this disease appeared in people without travel history to endemic parts of Africa. Here we have discussed the frequently asked questions relating to this disease.  

History, Difference, and Fatality

Why is the virus called monkeypox?

The virus was first discovered in the laboratory monkey, so it is called monkeypox.

When did it first appear?

It first appeared in 1958.

When was the first human case of monkeypox reported?

The first human case of this disease was reported in the Democratic Republic of the Congo (DRC) in 1970. According to the CDC, most infections are seen in the DRC. Then it was reported in other African countries like Cameroon, Central African Republic, Côte d’Ivoire, Gabon, Liberia, Nigeria, the Republic of the Congo, and Sierra Leone. 

Can Monkeypox cause a pandemic?

Health authorities suggest that it will not cause a pandemic because people without symptoms are not infectious. Isolation of infectious ones can prevent the spreading of the disease. Also, it does not transmit readily like the Covid19. The control of cases is easily possible.

Is monkeypox as dangerous as smallpox?

The causative agent of both the diseases belongs to the same family; Poxviridae. Smallpox causes severe infection and killed millions of people but monkeypox is milder. Eradication of smallpox occurred in 1980.

What is the difference between monkeypox and smallpox?

Lymphadenopathy (swelling of lymph nodes) is one of the symptoms of monkeypox, but it is absent in smallpox. It is a significant difference between them.

What is the reservoir of the monkeypox virus?

Rodents are the animal reservoir in Africa (Congo, Nigeria). Monkeys may harbor the virus and cause infection to human beings too. 

What are the different strains of the monkeypox virus?

1. African strain with the 1-2 % case fatality rate
2. Central African (Congo) strain with a 10% case fatality rate.

What is the genetic material of the monkeypox virus?

DNA is the genetic material in the monkeypox virus.

difference between smallpox and monkeypox
Source: CDC

Mode of Transmission  

What are the modes of transmission of monkeypox?

  • Animal to human
  • From reservoirs (African rodents)
  • Human to human
  • Broken skin
  • Respiratory tract
  • Mucous membrane (eye, nose, mouth)
  • Direct contact with the body fluids and the lesion material
  • Indirect contact with the lesion with the contaminated beddings

How does the transmission occur from human to human?

Monkeypox can transfer from human to human through the large respiratory droplets. These large droplets cannot travel more than a few feet. When they have prolonged face-to-face contact, it can transmit in such cases. Transmission occurs when the person is in contact with the lesion material and body fluids directly or indirectly. 

How does the transmission occur from animal to human?

The transmission occurs when the infected animal bites or scratches a healthy human. Similarly, bush meat preparation or direct or indirect contact with an infected animal’s lesion material also directly transmits the disease. Indirect transmission can occur by contaminated bedding.

What is monkeypox’s incubation period (time from the infection to the appearance of symptoms)?

The incubation period of monkeypox is 7 to 14 days, but it can range from 5 to 21 days. 

Symptoms

Lesions of monkeypox
Monkeypox ( Source: CDC)

What are the symptoms of monkeypox?

The primary symptoms are; headache, muscle ache, backache, swollen lymph nodes, chills, malaise, and exhaustion with or without sore throat and cough.

Swollen lymph nodes (lymphadenopathy) are the distinguishing feature of the disease. Swelling of lymph nodes occurs in the neck (submandibular and cervical), armpits (axillary), and groin (inguinal). It can appear either on one side or on both sides of the body.

The secondary symptoms are rashes which first appear on the face and then on other body parts. Skin lesions are painful or itchy. The sequence of appearance of skin lesions is macule, papule, vesicle, pustule, scab, and finally, it falls off.

progression of lesions
Skin lesions of monkeypox Source: https://www.gov.uk/

How long will the monkeypox disease last?

The illness of monkeypox disease lasts for 2-4 weeks. It is usually a self-limiting disease.

Prevention 

What is the preventive measure for this disease?

We need to practice safe hand hygiene, as we learned before during the COVID-19 pandemic. Wash your hands regularly with soap and water or an alcohol-based sanitizer. Also, avoid contact with the infected animal or the animals that harbor the virus. We should use personal protective equipment (PPE) while caring for the patients and the sick animals. We need to avoid contact with the bedding of the suspected animals. A person infected with the monkeypox virus needs to be isolated and cared for using the necessary precautions.

Vaccine 

Is a vaccine for monkeypox available?

A vaccine for monkeypox is available. The Jynneos vaccine double dosed given 28 days apart. Jynneos, also known as Imvamune or Imvanex, is a live attenuated vaccine used for both smallpox and monkeypox. Whereas ACAM 2000 vaccine is a single-dose vaccine. It consists of a live vaccinia virus. It has been licensed for smallpox in people at least 18 years old.

Treatment 

What is the available treatment for this disease?

Although there are no proven exact protocols for treating the disease, the traditional smallpox vaccine also protects against monkeypox to some extent. Prior reports have found that the smallpox vaccine is 85 % effective in controlling the monkeypox. Likewise, the higher risk groups are given contact post-exposure prophylaxis with vaccination. For the outbreak control smallpox vaccine, cidofovir, ST-246, and vaccinia immune globulin (VIG) can be used.

References

Sushmita Baniya

Hello, I am Sushmita Baniya from Nepal. I am a postgraduate student of M.Sc Medical Microbiology. I am interested in Genetics and Molecular Biology.

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