There have been more than 21,000 cases in nearly 80 countries since May and 75 suspected deaths in Africa – mainly Nigeria and Congo – where a deadlier form of monkeypox is spreading than in the West. Spain and Brazil have also reported deaths linked to monkeypox. Last week, the World Health Organization declared it a global health emergency. The rare medical phenomenon caused by the monkeypox virus comes from the same family of viruses, namely the Variola virus that is also responsible for causing smallpox. Recently, a new study, published by the British Medical Journal (BMJ), attracted a lot of attention for its surprising findings. Research has revealed that the new variant of monkeypox has shown never-before-seen symptoms, such as rectal pain and swelling of the penis (edema) in patients, which are different from those seen in the previous outbreak, according to the study. To help with the checklist, Dr Subrata Das, Senior Consultant – Internal Medicine and Diabetology at Sakra World Hospital, shared some of the more common symptoms of monkeypox mentioned earlier – severe headache, fever, skin rashes or lesions/ skin blisters, macules (small non-raised skin patches) to papules (raised firm patches), exhaustion, chills and lymph node swelling in the armpit, neck and groin, muscle aches, back pain. Monkey pox can also present with malaise, lymphadenopathy, vesicles, pustules, and crusting. It can also affect the face and cause palms and mucous membranes, which is similar to smallpox but with larger lesions. iStock Once the disease strikes, the rash healing process takes place in stages. Dr Bindumathi PL, Senior Consultant, Internal Medicine at Aster Hospital, said the recent outbreak in the UK was mainly seen in people who were immunocompromised due to HIV infections. These patients presented with atypical features such as only skin lesions with abscess and tonsillar abscess. No deaths were reported, but pain and suffering in the genital and perineal areas due to skin lesions was more. “Patients can visit various specialties such as an infectious disease specialist, a surgeon, a venereal disease clinic and ENT doctors to get the appropriate disease management they need,” he advises. The study included 197 men with confirmed cases of monkeypox at an infectious disease center in London between May and July 2022. Of the total, 196 identified as gay, bisexual or other men who have sex with men. Overall, 20 (10 percent) of the participants were admitted to the hospital for management of new symptoms. The researchers recommend that clinicians consider monkeypox infection in patients who present with these symptoms. All patients had lesions on their skin or mucous membranes, most commonly in the genital or perianal region. Most (86 percent) of patients reported systemic disease (affecting the whole body). The most common systemic symptoms were fever (62%), swollen lymph nodes (58%), and muscle aches and pains (32%). Graphic from Times Of India And in contrast to existing case reports suggesting that systemic symptoms precede skin lesions, 38 percent of patients developed systemic symptoms after the onset of mucocutaneous lesions, while 14 percent developed lesions without systemic features. A total of 71 patients reported rectal pain, 33 sore throat, and 31 penile swelling, while 27 had oral lesions, 22 had a solitary lesion, and 9 had enlarged tonsils. The researchers also noted that the isolated lesions and swollen tonsils were not previously known to be typical features of monkeypox infection and could be mistaken for other conditions. Just over a third (36 percent) of participants also had HIV infection, and 32 percent of those screened for sexually transmitted infections had a sexually transmitted infection. However, no deaths were reported and no patients required intensive care. Monkey pox can be transmitted through three routes – sexually, skin-to-skin contact and droplet infection. Agencies Dr Subrata Das (L) of Sakra World Hospital and Dr Bindumathi PL of Aster CMI Hospital People with a recent history of travel to any of the infected countries or contact with travelers from those countries when they develop fever, myalgia, sore throat or skin lesions should be isolated and evaluated with appropriate medical care, Dr. Bindumathi said. “The threat lies in its potential to turn into a pandemic due to increased travel to various countries. Hence, awareness about the disease becomes critical,” he added. Dr Das said patients suffering from monkeypox should be isolated for three weeks, as a new person who comes into contact with the infected person can develop symptoms in five to 21 days. “Two to three weeks of quarantine is necessary,” he stressed. Immunocompromised individuals such as patients with HIV, other immunodeficiency syndromes and neonates should be cautious as they are prone to developing infection. Once the disease strikes, the rash healing process takes place in stages. “This (rash/legions) would last for about two to four weeks before it subsides,” added Dr Das. Caregivers of the infected person should practice good hygiene. “The person caring for the patient should wash their hands regularly and should be protected by PPE and follow the necessary precautions just like Covid-19,” said Dr Das. Meanwhile, caregivers should also be careful when touching or handling the utensils, bedding, towels, or clothing of the person infected with monkeypox. The disposal of waste and the disinfection of the patient’s belongings must be done with care. Since the monkeypox and smallpox viruses are genetically identical, Dr. Das suggested that the smallpox antiviral drug could be used to prevent and treat people infected with monkeypox. Monkeypox can have serious and fatal effects with a case fatality rate of about 0.5% to 10%. Therefore, it is important to consult your health care provider in case of any symptoms of monkeypox.
