The Denmark attack: Monkey pox virus

By Hope Abraham Omeiza

Monkey pox is a rare disease that primarily occurs in remote parts of Central and West Africa, near tropical rain forests and is caused by infection with monkey pox virus which belongs to the Orthopox virus genus in the family Poxviridae.
It was first discovered in 1958 in a State Serum Institute in Copenhagen, Denmark when two outbreaks of a pox like disease occurred in colonies of monkeys kept for research, hence the name ‘Monkey pox’. The first human case of monkey pox was recorded in 1970 in the Democratic Republic of Congo (DRC) and this was in a 9 year old boy.
Since then, several cases have been reported majority of which occurred in the rural rain forest regions of Congo Basin and Western Africa, particularly in the DRC where it is considered to be endemic.
A major outbreak occurred in DRC in 1996 – 1997, and subsequently outbreaks have been reported in Midwest USA in 2003 (first reported occurrence outside African continent), Unity Sudan in 2005 and Central African Republic in 2016.
Nigeria is currently battling with a suspected outbreak of monkey pox in Bayelsa State where 11 persons including a medical doctor have been placed on surveillance and quarantined at the Niger Delta University Teaching Hospital, Okolobiri, Yenagoa.
The monkey pox virus is transmitted when a person comes in contact with the virus from an infected animal, infected humans or materials contaminated with the virus.
The virus enters the body through broken skin, respiratory tract of the mucous membranes (eyes, nose or mouth).
Animal-to-human transmission may occur by bite or scratch, bush meat preparation.
In Africa, human infections have been documented through the handling of infected monkeys, Gambian giant rats and squirrels, with rodents being the major reservoir of the virus. Eating inadequately cooked meat of infected animals is a possible risk factor.
Human-to-human transmission results primarily via respiratory droplet particles which usually requires prolonged face to face contact which puts household members of active cases at greater risk of infection.
Transmission can also occur from close contact with skin lesions of an infected person of objects recently contaminated by patient fluids or lesion materials. Monkey pox can also be transmitted via the placenta (Congenital monkey pox).
In humans, the symptoms of monkey pox are similar to but milder than the symptoms of small pox. The incubation period (time from infection to symptoms) for monkey pox is usually 7 – 14 days, but can range from 5 – 21 days.
The illness usually begins with symptoms such as fever, headache, muscle aches, back ache, swollen lymph nodes, chills and exhaustion.
Within 1 – 3 days or longer after fever onset, patient develops a rash, which often begins on the face, then spreading to other parts of the body.
The face (95% of cases) and palms of hands and soles of feet (75% of cases) are most affected. The disease is usually self limited with symptoms lasting 14 – 21 days.
However, more severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and severity of complications.
The case fatality of monkey pox has been less than 10% in documented events, mostly among young children.
Monkey pox can only be diagnosed definitively in the laboratory where the virus can be identified by a number of different tests such as Enzyme Linked Immunosorbent Assay (ELISA), Antigen detection tests, Polymerase Chain Reaction (PCR) and virus isolation by cell culture.
There are no specific treatments or vaccines available for monkey pox infection, however, outbreaks can be controlled.
Monkey pox infected individuals would require supportive care mostly and most times recover fully since the disease is self limiting.
Given the current suspected outbreak of monkey pox in Nigeria, there are measures that can be taken by the general public and health workers to prevent infection with the virus. These include;
– Proper cooking of all meat before consumption
– Avoiding contact with animals that could harbor the virus.
– Avoiding contact with any materials such as bedding that has been in contact with a sick animal.
– Close contact with infected patients should be avoided.
– Practice good hand hygiene after contact with infected animals or humans. For example washing your hands with soap and water or using an alcohol-based hand sanitizer.
– Health workers as well as care givers of infected people should use personal protective equipments and gloves when caring for patients.
The observance of the above mentioned measures as well as the members of the public having a high index of suspicion will go a long way in containing the current suspected outbreak of Monkey pox in Nigeria.

Dr. Omeiza. 08060810748. [email protected]


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