Mpox: No need to worry—just a note of caution!

Some days ago the World Health Organization (WHO) declared mpox a Public Health Emergency of International Concern (PHEIC) due to its widespread presence and increasing cases across many parts of Africa and other countries. According to a WHO update, since 2022, there have been 99,176 reported cases and 208 deaths from mpox across 116 countries.

As I am writing now, India has not reported any new cases of Mpox since March 2024. Authorities believe that the risk of a widespread outbreak with ongoing transmission remains low.

What is Mpox? Previously known as monkeypox, mpox is a rare viral disease that causes rashes and flu-like symptoms. It is a zoonotic disease that can spread between animals and humans.  It belongs to the Orthopoxvirus genus, the same group that includes the virus responsible for smallpox. Mpox is transmitted through close contact with an infected person or animal. In November 2022, the World Health Organization (WHO) renamed monkeypox to mpox to reduce stigma.

There are two strains of the mpox virus: Clade I, which originated in Central Africa, and Clade II, from West Africa. Historically, mpox was mostly confined to Africa, but now it has also been reported in other countries as well.

Who is at risk? Mpox can affect anyone. In Africa, it primarily affects children under 15, while outside Africa, it is more common among men who have sex with men (MSM).

Some people are more likely to get severely ill from mpox;

• Are pregnant
• Are children under 1
• Have a weakened immune system, such as from medication or medical conditions, or untreated or advanced HIV disease
• Have a history of eczema
• Have multiple or new sexual partners
• Persons who have travelled to regions where monkeypox is more common, like certain parts of Central and West Africa.

Signs and Symptoms? Symptoms usually start within 21 days of exposure to the virus and most infections last two to four weeks and resolve on their own. However, some cases can become severe and complications can include severe scars on the face, arm and legs, blindness, other superimposed bacterial infections, and in rare cases, death.

Rash: The rash can look like pimples or blisters and can appear on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals or anus. The rash can go through different stages before healing completely, including scabs. The lesions are often described as painful until the healing phase when they become itchy.

Other symptoms: Fever, headache, muscle aches and backache, swollen lymph nodes, chills, exhaustion, and respiratory symptoms like sore throat, nasal congestion, or cough.

Not everyone develops all symptoms. Some may have just a rash, while others experience flu-like symptoms first or no rash at all. Mpox can still spread even if symptoms are mild.

Mpox Transmission: Mpox spreads through contact with an infected person’s sores, scabs, or respiratory droplets, often in close, intimate settings like cuddling, kissing, or sexual activity. Transmission from animals to humans occurs through bites, scratches, or direct contact with an infected animal’s blood, fluids, or sores. Contaminated materials like clothing or bedding can also transmit the virus.

Diagnosis: Due to its rarity, mpox may initially be mistaken for other rash illnesses, but swollen lymph nodes help distinguish it. Diagnosis involves taking a tissue sample from a sore for PCR testing. Blood samples may also be used to check for the virus or antibodies.

Treatment: Mpox typically resolves on its own within two to four weeks. There is no proven treatment for mpox, but you can try the following things to help you feel better:

Pain relievers and fever reducers

Oatmeal baths

Resting

Drinking plenty of fluids

Isolating yourself and avoiding contact with others until all of your lesions have scabbed. Although there are no specific antiviral treatments for mpox, drugs like cidofovir or tecovirimat may be prescribed in severe cases.

Prevention:

• Avoid contact with infected animals or people.
• Wash hands frequently.
• Avoid Homosexuality
• Wear a mask in crowded indoor spaces.
• Disinfect frequently touched surfaces.
• Use personal protective equipment when caring for infected individuals.
• Vaccines

When to Seek Medical Care:

• Breathing difficulties
• Chest pain
• Stiff neck
• Confusion
• Loss of consciousness
• Seizures
• Complications:
• Secondary bacterial infections of the skin.

• Respiratory issues, especially in severe cases.
• Eye infections, leading to vision problems.
• In rare cases, monkeypox can be fatal, particularly in people with weakened immune systems.

By: Dr Zubair Saleem