How Close Is The Monkeypox to you??
By Clarance Ezinwa PT. [Nigerian Physiotherapist]
With the recent proliferation of pictures and videos on the internet attributed to mpox (previously monkeypox) are you really in danger of this “viral” disease?? As the world recovers from the devastating effects of the Covid 19 pandemic, are we already heading to yet another??
In this article, we’ll delve into what monekeypox also know as "mpox" really is, where it’s from, where it has been and how close you are to being infected. Then we’ll give tips on what puts you most at risk of contracting this disease, and how to avoid it.
Table of Contents
What is mpox??
Brief History Of This Viral Disease
Mpox has been on a tour around the world
How close are you to being infected??
How do you know you have mpox, common symptoms
Sexual intercourse and mpox
Should you panic??
Credits, Chicago department of public health.
What is Mpox
According to the Nation Institute Of Medicine, Mpox is an endemic virus with origins traced to rural central, west and east Africa with a low mortality rate upon infection. It is a zoonotic (transmitted from animals to humans) orthopoxvirus (genus of viruses that causes raised bumpy rash) that causes diseases in humans similar to smallpox- characteristic blistering on the skin- with outbreak of the virus even in western hemisphere attributed to exotic pet trade and international travel.
Mpox is a very infectious disease caused by Monkeypoxvirus (MPXV) which is an enclosed double stranded DNA virus of poxviridae family (any group of viruses responsible for a wide range of pox diseases in humans and other animals including cowpox, variola etc). The eradication of smallpox and lack of vaccination effort of Mpox gave adequate rise to its increasing clinical relevance.
In as much as mpox is zoonotic in transmission, the on going spike in mpox cases are driven primarily by infectious human to normal human interaction with recent research finding viral loads higher in human body fluids such as urine, saliva, sweat, feces as well as swabs taken from oropharynx and anus with WHO ruling sexual intercourse as high risk in infected individuals. It is also considered somewhat airborne with the virus present in respiratory droplets, but it’s not airborne over long distances.
Brief History Of This Viral Disease;
Most serious diseases that plagued mankind usually had its roots linked to contacts with animals either in isolation or exploration in one of the many forests around the world- mpox was no different. Proper protection and handling of especially newly encountered animals(that’s not your pet) is always strictly advised.
In 1957, Mpox was first discovered and isolated in the mostly flat terrains of Denmark in captive monkeys shipped from Singapore (hence the name the Monkeypox), the first human case came many years later and was recorded in 1970 in the center of the world- Democratic Republic Of Congo- in a child suspected to have had smallpox. Smallpox and Monkeypox share similarities especially its the way and manner it presents in a clinical setting.
Currently, two genetically distinct clades of Mpox have been identified
The congo basin (Central African) clades
West african clades
The former being endemic, responsible for the global outbreak having documented cases of human to human transmission while the later does not. It has also been thought that African rodents to be a natural reservoir of these clades. Infections have been found in squirrels, rats, hedgehogs, pigs, prairie dogs, humans etc.
Mpox Has Been On A Tour Around The World;
From its first incidence in Denmark 1957, to its first human infection in Congo 1970, to the WHO being on red alert about the spike of recorded cases of this serious illness around the world, mpox has really come a long way. Here’s a breakdown of some incidences as recorded around the world:
In 2003, fifty-three human cases of Mpox were recorded in the US alone after being infected by their pet prairie dogs. Gambian giant rats imported from Ghana infected were cohabitants of prairie dogs which were sold as household pets in the Midwestern United States.
October 2018, a case occurred in a man who traveled from Nigeria to Israel to see his family. In May 2019, one case occurred in a man who traveled from Nigeria to Singapore.
In May 2021, three family members returning to the UK from Nigeria were infected, symptoms and severity among them showing evidence of human to human interaction. In July 2021, one case occurred in a man who traveled from Nigeria to Texas. In November 2021, one case occurred in a man who traveled from Nigeria to Maryland.
As of May 2022, one case of human mpox in a man who returned to Massachusetts from Canada was under investigation, as well as clusters of human mpox in the United Kingdom. In the same year, there were several reports coming about record cases in hundreds of males in Spain engaging in male to male sexual intercourse.
Over 120 countries have reported mpox between Jan 2022 – Aug 2024, with over 100 000 laboratory-confirmed cases reported and over 220 deaths among confirmed cases according to the WHO
How Close Are You To Being Infected??
Unless you are
Living in heavily forested rural central, western and eastern Africa including places with already recorded incidence also in your vicinity
Poorly handling of bush meat
Caring for someone with Mpox
A male because males are more inclined to hunt and contact wild animals than other genders.
Having male to male sexual relations or other sexual activities
Have unsanitary habits or live in a deplorable habitat with animals that are thought to be natural habitats of this disease.
If you don’t fall under these categories, then you shouldn’t be on an immediate red alert, but you must still exercise the strictest of healthy habits so as to maintain a very high immune system. Mpox is usually more dire in patients with an already weakened immunity.
Sexual Intercourse and Mpox
As already pointed out earlier on, body fluids including swaps taking directly from the anus of humans have a very high viral load and records from previous years has seen a relationship between mpox and sexual interactions (especially among men to men population)
In 2022, men who have sex with men (MSM) population recorded a higher incidence of Mpox especially across europe with a presentation involving predominantly genital lesions;
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In a cohort of 595 confirmed cases of Mpox in Spain in 2022, 99% of cases were found to be in the MSM population, with the lesions predominantly affecting the genital, perineal, or perianal areas. The study also identified inguinal lymphadenopathy as a predominant feature suggesting that sexual transmission was the main mode of transmission.
Germany reported 1304 confirmed cases as of 6th July 2022, again mainly in the MSM population. Sequencing data from various countries suggests that the 2022 epidemic is caused by the West African clade of the Mpox virus. However, emerging data suggest that the present outbreak may have a newly emerging clade.
With increased viral load in body fluids, sex is usually the easiest route to becoming infected. With the surge in mpox incidences, WHO has warned against having sex especially when you feel unwell and unsure as to the cause of your illness.
How Do You Know You Have Mpox
You go to the hospital and get tested, knock off speculations and address any accompanying health problems.
Blood work isn’t usually the go to investigative procedure as it’s harder to recognize different orthopoxvirus through blood work- standard procedure is through swab from fluids and open skin lesions. The preferred laboratory test for mpox is detection of viral DNA by polymerase chain reaction (PCR).
Incubation period of Mpox is usually 7-14 days. When patients present with fever and lymphadenopathy (swollen lymph nodes in response to an underlying illness or condition) before lesions appear.
Patients are thought to be contagious at this point, symptoms can last 2-4 weeks or even longer in people with an already weakened immune system.
Common symptoms of mpox are:
rash
fever
sore throat
headache
muscle aches
back pain
low energy
swollen lymph nodes.
For some people, the first symptom of mpox is a rash, while others may have fever, muscle aches or sore throat first.
The mpox rash often begins on the face and spreads over the body, extending to the palms of the hands and soles of the feet. It can also start on other parts of the body where contact was made, such as the genitals.
Some people may have one or a few skin lesions and others have hundreds or more. These can appear anywhere on the body including:
palms of hands and soles of feet
face, mouth and throat
groin and genital areas
anus.
Some people also have painful swelling of their rectum (proctitis) or pain and difficulty when peeing (dysuria) or when swallowing.
Should You panic??
Taking the aforementioned precautions listed and understanding the information explained in this blog, you shouldn’t immediately panic. In humans with a non compromised immune system, mpox usually resolves after a few weeks of intensive care. It should be noted that mpox can occur in persons infected with other diseases. It’s also transferable from mother to child in the case of pregnancy mostimes killing the fetus. Appropriate steps should always be taken, and employment of a high sense of awareness is advised.
If you feel skeptical and relatively unsafe about the possibility of ever being infected, you should opt for vaccination. Vaccination against mpox is available at your primary health care provider.
Thanks for your time and attention.
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