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Author:G C Khilnani Chairman, PSRI Institute of Pulmonary, Critical care and Sleep Medicine. Formerly, Professor and Head, Dept of Pulmonary Med AIIMS, N Delhi
- 32 000 confirmed cases of monkeypox has been reported across 82 nonendemic countries
India
healthysoch
New Delhi, August 20, 2022:
32,000 cases in 82 countries, is an alarming bell for global spread of Monkeypox infection. Most of us have not seen outbreaks of small pox infection which killed so many and disfigured others. The monkey virus is of the same family, therefore, causes deep concern.
Covid pandemic has created immense awareness of global public health and importance of case detection and prevention of transmission. As availability of vaccination is going to take quite some time and no drug is approved for treatment, all effort should be on prevention of transmission. Fortunately, unlike Covid, airborne transmission seems to be not important mode with Monkeypox infection.
Several cases ( 9 cases till few days back) have been reported from Kerala and Delhi. Most of these patients did not have travel history. This could be ` tip of the iceberg’ as testing facilities are limited. The silver lining is low rate of transmission by respiratory secretions and fomites. Unlike Covid virus (RNA) which is notorious for mutations (variants), this virus is DNA virus and does not have that nuisance Therefore, case finding and isolation can do the trick of containing this potential menace.
Monkeypox was declared a Public Health Emergency of International Concern (PHEIC) by WHO • Monkeypox is transmitted primarily through direct skin to-skin infectious lesions. Transmission through respiratory secretions and fomites (bed linen, utensils etc) is less important • The mean incubation period is 7.6 days
The initial symptoms are those of a flu-like illness with fever, malaise, headache, and fatigue often with swelling of lymph nodes. Rashes appears on hands face and other parts of body. Complications of monkeypox may include pneumonia, encephalitis, and eye infections • Death is rare and so far 4 people have died • The diagnosis is by orthopoxvirus PCR test .
The treatment is supportive and symptomatic. No antivirals are currently approved for monkeypox. Tecovirimat, an antiviral drug approved for the treatment of smallpox is being tested for its clinical efficacy. Two vaccines, JYNNEOS and ACAM2000 (only approved for small pox) are available. FDA issued an Emergency Use Authorization (EUA) for the JYNNEOS vaccine for use in high risk individuals 18 years and above. This vaccine is also effective when uses as post exposure prophylaxis.
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