Monkeypox: Ramifications And Preventions

WHAT is Monkeypox? It is an infectious disease caused
by the monkeypox virus. The disease was first identified
in laboratory monkeys, hence its name, but in its
natural state it seems to infect rodents more often than monkeys
(primates).
Monkeypox is usually transmitted to humans from rodents,
pets, and primates through contact with the animal’s blood or
through a bite. Human monkeypox can be difficult to distinguish
clinically from smallpox (to which it is closely related) and chickenpox
(to which it is not).
In addition to monkeys, reservoirs for the virus are found in
Gambian pouched rats, and African squirrels. The use of these
animals as food may be an important source of transmission to
humans.
Monkeypox was first identified in 1958 as a pathogen of crabeating
macaque monkeys used as laboratory animals. The crabeating
macaque is often used for neurological experiments.
The virus was found in humans in 1970. Between 1970 and
1986, over 400 cases in humans were reported. The first reported
outbreak of monkeypox in the United States occurred in 2003 in
the Midwestern States of Illinois, Indiana, and Wisconsin, with
one occurrence in New Jersey. The outbreak was traced to a
prairie dog infected by an imported Gambian pouch rat.
In May, 2003, a young child became ill with fever and rash after
being bitten by a prairie dog purchased at a local swap meet
near Milwaukee, Wisconsin. In total, 71 cases of monkeypox
were reported through June 20, 2003. All cases were traced to
Gambian rats imported by a Texas exotic animal distributor from
Accra, Ghana in April, 2003 but no death was recorded. Electron
microscopy and serologic studies were used to confirm that the
disease was human monkeypox.
Patients typically experienced prodromal symptoms of fever,
headaches, muscle aches, chills, and drenching sweats. Roughly
one-third of patients had nonproductive coughs. This prodromal
phase was followed 1 to 10 days later by the development of a
papular rash that typically progressed through stages of vesiculation,
pustulation, umbilication, and crusting. In some patients,
early lesions had become ulcerated. Rash distribution and lesions
occurred on head, trunk, and extremities; many of the patients
had initial and satellite lesions on palms, soles, and extremities. Rashes were generalized in some patients. After onset of the rash,
patients generally manifested rash lesions in different stages. All
patients reported direct or close contact with prairie dogs, later
found to be infected with the monkeypox virus.
The virus can spread both from animal to human and from
human to human. Infection from animal to human can occur
via an animal bite or by direct contact with an infected animal’s
bodily fluids. The virus can spread from human to human by both
respiratory (airborne) contact and contact with infected person’s
bodily fluids. Risk factors for transmission include sharing a bed,
room, or using the same utensils as an infected patient. Increased
transmission risk associated with factors involving introduction
of virus to the oral mucosa. Incubation period is 10–14 days.
October 4, 2017, the virus was reported to have occurred in
Bayelsa State. The index case in Bayelsa originated from Agbura,
the victim had reportedly killed and eaten a monkey. Within an
interval of one week, 10 cases were already recorded including
a medical doctor. The 10 victims were quarantined which 49
persons who had contact with them were kept under observation.
There is no casualty yet as two of the victims have been
certified healed from the virus.
The Chief Executive Officer, National Centre for Disease Control,
Dr. Chikwe Ihekweazu revealed that 31 cases of monkeypox
have been recorded from seven States which includes Bayelasa,
Rivers, Cross River, Ekiti, Akwa Ibom, Lagos, and Ogun. However,
Ogun State government refuted Ihekweazu’s claim of outbreak
of monkeypox in the State.
Ihekweazu noted that the agency was awaiting the laboratory
results and confirmation of the 31 suspected cases and added
that many of the suspected cases being investigated were likely
to be monkeypox. He urged the public to remain calm, avoid
self medication but report any suspected case to the nearest
health facility.
Considering the nearness of Delta State to some of the affected
States, the Commissioner for Health, Dr. Nicholas Azinge
assured Deltans that government was fully prepared to wedge
war against the disease as the State Rapid Response team has
been placed on Red Alert to respond to emergencies wherever
they may occur in the State. He confirmed that the State Ministry of Health was collaborating
with the World Health Organization (WHO) in taking proactive
measures to combat the disease.
He disclosed that the Disease Surveillance Officers in the 25
LGAs were already sensitized and said that disease outbreak
prevention and case management materials have been prepositioned
in the LGAs having common borders with Bayelsa
State to forestall possible importation of the disease.
“In addition, we are going to maintain constant border patrol
of the three LGAs- Patani, Bomadi and Burutu LGAs- that have
common borders with Bayelsa state to forestall possible importation
of the disease”, he assured.
He said that the disease symptoms include: Fever, intense
headache, lymphadenopathy (swelling of the lymph node), back
pain, myalgia (muscle ache); an intense asthenia (lack of energy);
and rashes which begins from the face and spread to other parts
of the body including the palm and sole of the feet, rashes, beginning
on the face and then spreading to other parts of the body
including palms of the hands and sole of the feet.
“If you notice any of these signs and symptoms, please go to
the nearest health centre or hospital immediately or call the
following emergency numbers: 07037120510; 08036680784”,
Azinge advised.
He recommended ways of preventing the disease to include,
reducing the risk of human-to-human transmission; avoiding
close physical contact with monkey pox infected people; isolating
potentially infected animals from other animals and quarantined
immediately. “Any animal that may have come into contact with
infected animals should be quarantined”, he added.
He urged those caring for ill people to protect themselves
by wearing gloves and protective equipment and advised that
Regular hand washing should be carried out after caring for or
visiting sick people.
He said, “Reducing the risk of animal-to-human transmission.
Efforts to prevent transmission in endemic regions should focus
on thoroughly cooking all animal products (blood, meat) before
eating”. “Gloves and other appropriate protective clothing should
be worn while handling sick animals or their infected tissues,
and during slaughtering procedures”
.