By: Geraldus Sigap
Monkeypox, a viral disease that was once considered rare and confined primarily to remote parts of Central and West Africa, has recently captured global attention due to its unexpected and rapid spread across various countries. As the world continues to grapple with the ongoing challenges of infectious diseases, understanding the threat posed by monkeypox and knowing how to protect oneself is more important than ever. This article delves into the origins, symptoms, transmission, and prevention of monkeypox, offering insights on how to stay safe amid the current outbreak. Monkeypox is caused by the monkeypox virus, a member of the Orthopoxvirus genus, which also includes the variola virus responsible for smallpox. The disease was first discovered in 1958 when outbreaks occurred in colonies of monkeys kept for research, hence the name “monkeypox.” The first human case was recorded in 1970 in the Democratic Republic of Congo (DRC), and since then, the virus has been endemic in parts of Central and West Africa.
Monkeypox is a zoonotic disease, meaning it is transmitted from animals to humans. The primary animal reservoirs are thought to be rodents and other small mammals, with humans contracting the virus through direct contact with the blood, bodily fluids, or skin lesions of infected animals. While the virus can spread from person to person, human-to-human transmission was traditionally considered less common until the recent outbreak.
The symptoms of monkeypox in humans are similar to those of smallpox but are generally milder. After an incubation period of 7 to 14 days, the disease typically begins with non-specific symptoms such as fever, headache, muscle aches, and fatigue. Swollen lymph nodes, a distinctive feature of monkeypox, usually appear early in the infection. Within a few days of the onset of fever, a rash develops, often starting on the face before spreading to other parts of the body.
The rash progresses through several stages, beginning as macules (flat, discolored spots), then papules (raised bumps), vesicles (fluid-filled blisters), and pustules (pus-filled lesions), before finally crusting over and scabbing. The lesions can be painful and itchy, and the rash may last for 2 to 4 weeks before healing completely. In severe cases, the lesions can lead to scarring.
Figure 1. Rash symptoms from Monkeypox
Although monkeypox is generally self-limiting, meaning it resolves on its own without treatment, the disease can be more severe in young children, pregnant women, and individuals with weakened immune systems. Complications can include secondary bacterial infections, respiratory distress, and, in rare cases, death. The recent monkeypox outbreak has raised concerns due to its unusual pattern of transmission. Unlike previous outbreaks, which were largely confined to specific regions in Africa, the current outbreak has seen cases reported in multiple countries across Europe, North America, and Asia. This spread has highlighted the need to understand the various ways the virus can be transmitted. Monkeypox spreads through direct contact with the bodily fluids, respiratory droplets, or skin lesions of an infected person. It can also be contracted by touching contaminated objects, such as bedding or clothing. Close physical contact, including sexual contact, has been identified as a key factor in the spread of the virus during the recent outbreak, particularly among certain social networks.
The virus can also be transmitted from mother to child during pregnancy through the placenta or during childbirth. While airborne transmission (spread through tiny droplets that remain suspended in the air) is not considered a major route for monkeypox, it is still a potential risk in settings with prolonged close contact, such as healthcare facilities.
Preventing the spread of monkeypox requires a combination of public health measures and individual actions. Vaccination, particularly with the smallpox vaccine, which has been shown to be about 85% effective against monkeypox, is one of the most effective ways to prevent the disease. However, widespread vaccination campaigns for monkeypox are not currently in place, so other preventive measures are crucial.
Public health authorities recommend the following steps to reduce the risk of contracting and spreading monkeypox:
- Avoid Close Contact: Limit close physical contact with individuals who are suspected or confirmed to have monkeypox. This includes avoiding touching their skin lesions, bodily fluids, or contaminated objects.
- Practice Good Hygiene: Regularly wash your hands with soap and water or use an alcohol-based hand sanitizer, especially after contact with an infected person or contaminated objects.
- Use Personal Protective Equipment (PPE): Healthcare workers and caregivers should use appropriate PPE, including gloves, masks, and gowns, when caring for patients with monkeypox.
- Isolate Infected Individuals: People with monkeypox should be isolated from others until their lesions have healed completely. This helps prevent the virus from spreading to family members, friends, or coworkers.
- Avoid Contact with Wild Animals: Since monkeypox is a zoonotic disease, avoid contact with wild animals, especially in regions where the virus is known to be endemic. Avoid consuming or handling bushmeat, which may carry the virus.
- Educate and Inform: Public awareness and education about monkeypox are essential. Stay informed about the latest updates on the outbreak and follow the guidance of public health authorities.
The monkeypox vaccination primarily involves the use of the Modified Vaccinia Ankara (MVA) vaccine, which is also effective against smallpox due to the close relationship between the two viruses. This vaccine is approximately 85% effective in preventing monkeypox and is recommended for individuals who have been exposed to the virus or are at high risk, such as healthcare workers. Vaccination is most effective when administered within four days of exposure but can still be beneficial up to 14 days if symptoms have not yet appeared. As of now, monkeypox vaccination in Indonesia is not yet widely available, but the government is closely monitoring the global situation and working with international health organizations to prepare for any potential outbreaks. The Ministry of Health is focused on preventive measures such as surveillance, early detection, and public education to control the spread of the virus.
At Abdi Waluyo Hospital, we are committed to providing comprehensive care for those concerned about monkeypox and other infectious diseases. Our team of healthcare professionals, including specialists in infectious diseases and dermatology, are equipped to diagnose and manage monkeypox cases with the highest standards of care. Our hospital also offers advanced diagnostic services, including state-of-the-art imaging and laboratory testing, to support accurate and timely diagnosis. In addition, our infection control protocols ensure a safe environment for patients and staff, minimizing the risk of disease transmission.
Resources
- Patel A, Bilinska J, Tam JCH, et al. Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series. BMJ 2022;378:e072410.
- Mpox (monkeypox) [Homepage on the Internet]. [cited 2024 Aug 24];Available from: https://www.who.int/news-room/fact-sheets/detail/monkeypox
- Clinical Recognition | Mpox | Poxvirus | CDC [Homepage on the Internet]. 2023 [cited 2024 Aug 24];Available from: https://www.cdc.gov/poxvirus/mpox/clinicians/clinical-recognition.html
