Monkeypox has recently been reported in many countries. What kind of disease is it? The following article will provide answers to some frequently asked questions about monkeypox.
1. What is Monkeypox?
Monkeypox is a viral zoonotic disease that is transmitted from animals to humans. Monkeypox virus is a class of double-stranded DNA viruses with an envelope, belonging to the genus Orthopoxvirus of the family Poxviridae, and smallpox virus and cowpox virus also belong to the genus Orthopoxvirus. Monkeypox occurs mainly in central and western Africa, usually near tropical rainforests, but increasingly in urban areas.
Monkeypox viruses have two genetic evolutionary branches – the Central African (Congo Basin) evolutionary branch and the West African evolutionary branch, and the monkeypox virus in this outbreak originated from the West African branch.
2. What are the hosts of the monkeypox virus?
A variety of animal species have been identified as susceptible to monkeypox virus. These include rodents such as rope squirrels, tree squirrels, Gambian kangaroos, sleeping mice, non-human primates, and other species.
The natural history of monkeypox virus remains uncertain, and further research is needed to determine the exact hosts and how the virus maintains circulation in nature.
3. What are the monkeypox symptoms?
Patients with monkeypox have symptoms very similar to those of smallpox patients, but they are milder and the incubation period is usually 6-16 days or may be 5-21 days. Initial symptoms include fever, rash, headache, muscle aches and fatigue, and can lead to swollen lymph nodes (smallpox virus does not have swollen lymph nodes) and a range of complications.
In the later stages of the infection, fever, headache, back pain, myalgia, and severe weakness may also occur. The rash usually begins within 1-3 days after the onset of fever and usually appears on the face and extremities. It affects the face, palms and soles of the feet, oral mucosa, genitals, conjunctiva, and cornea. The rash evolves from a flat plaque to a slightly raised papule that becomes a blister, pustule, and finally dries and crusts off.
4. What are the modes of transmission of monkeypox virus?
Monkeypox virus may be transmitted by contact or respiratory droplets and can enter the body through broken skin, respiratory tracts, and mucous membranes.
5. How can I prevent the monkeypox virus?
In general, we should wear masks, prevent prolonged face-to-face contact with people in closed environments, keep injured skin away from exposed air surfaces, and avoid contact with materials and bedding that could be contaminated with the virus. Avoid eating undercooked meat and other animal products from infected animals.
6. What is the lethality rate of the monkeypox virus?
In general, younger age groups are more likely to develop monkeypox. Also, because smallpox vaccination was discontinued worldwide after the eradication of smallpox, people under 40 to 50 years of age (depending on the country/region) may be more susceptible to monkeypox. Monkeypox is usually self-limiting, with severe symptoms often seen in children, pregnant women, and people with suppressed immune function. The severity of symptoms is highly dependent on the degree of virus exposure and the patient’s own underlying disease.
Monkeypox mortality rates range from 0% to 11% in the general population and are higher in young children. The monkeypox virus in this outbreak originated from the West African branch, which had a 3.6% morbidity and mortality rate, compared with 10.6% for the Central African (Congo Basin) evolutionary branch.
7. Where did the current outbreak originate?
Monkeypox was first identified in monkeys in a Danish laboratory in 1958, and the first human case was identified in a child in the Democratic Republic of Congo in 1970.
The current outbreak was first identified in the United Kingdom on May 6, 2022, and more than 100 people have been diagnosed. According to WHO, 92 laboratory-confirmed cases and 28 suspected cases of monkeypox under investigation have been reported to WHO in 12 non-monkeypox-endemic Member States since May 13, 2022, through May 22, 2022, with no deaths at this time. Epidemiological investigations are ongoing, but it is highly illogical that the cases reported so far do not have an established brigandage to endemic areas. Based on the information currently available, cases have been identified primarily among men who have sex with men seeking treatment at primary care and sexual health clinics.
8. Is there a monkeypox virus test kit?
Since orthopoxvirus is serologically cross-reactive, both antigen and antibody tests are not specific enough to confirm the diagnosis, and people who have received cowpox vaccine are prone to false-positive results. Nucleic acid detection kits are the optimal way, and some biological companies already produce and sell monkeypox virus detection kits.
9. Is there a monkeypox vaccine or an effective drug?
Several observational studies have shown that the effectiveness of smallpox vaccination in preventing monkeypox is approximately 85%. Therefore, prior smallpox vaccination may be less severe.
There are currently two approved vaccines against smallpox and monkeypox in the United States: ACAM200, a smallpox vaccine developed by Emergent Product Development Gaithersburg, and JYNNEOSTM, a smallpox + monkeypox vaccine developed by Bavarian Nordic, which is the only vaccine approved by the FDA The other is Bavarian Nordic’s JYNNEOSTM, the only vaccine approved by the US FDA for the prevention of monkeypox.
There are no specific drugs available for monkeypox, but smallpox vaccine, antiviral drugs, and cowpox immunoglobulin can be used as a means of controlling outbreaks of monkeypox virus.
10. Will the current epidemic spread globally like Covid-19?
In terms of infectiousness and lethality, the basic infectious number of monkeypox virus, R0 < 1, indicates that it is weakly infectious and the source of the disease will gradually disappear, making it difficult to cause a large-scale epidemic.
However, there is no definite travel relationship between the reported cases and the endemic areas, indicating that a large number of cases remain undetected. WHO is currently conducting an epidemiological investigation of the current monkeypox outbreak, and it is expected that with the expansion of surveillance, more cases of monkeypox will be detected and further spread is possible.