Monkeypox
Monkeys are the primary
host of the monkeypox virus. Therefore, this disease is called monkeypox.
Cases transmitted from monkeys to humans were first discovered in 1970 in
Congo, South Africa.
Symptoms of this
disease are similar to those of smallpox, such as fever and a blistering skin
rash, plus swollen lymph nodes in the armpits.
Transmission of
monkeypox among humans occurs through direct contact with lending or wounds in
the skin, body fluids, droplets (splashes of saliva) released when sneezing and
coughing, and touching surfaces contaminated with monkeypox virus.
The dangers of
this disease can be effectively prevented through vaccines. Antivirals for the
treatment of monkeypox are still being studied further.
How common is this disease?
Monkeypox began
to become an endemic disease in Central and West Africa.
It was first
discovered in 1958 when a smallpox outbreak was rife in a collection of apes
deliberately kept in a laboratory belonging to a health institution for
research. The first human case occurred in 1970 in the Democratic republic of
congo.
Since then, the Centers for Disease Control and Prevention
(CDC) noted there have been pretty several cases of
monkeypox infection occurring in humans outside Africa, with details:
- 47 points in the United States in
2003
- 3 patients in the UK in 2003
- 1 topic in Israel in 2018
- 1 case in Singapore (1 case) in 2019
Young adults,
adolescents, young children, and infants are more susceptible to monkeypox infection.
About 10% of reported deaths are primarily children.
Signs and symptoms of monkeypox
People infected
with the monkeypox virus will show their first symptoms 6-16 days after
exposure.
The period when
the virus has not actively reproduced in the body is known as the incubation
period. The incubation period of the monkeypox virus can range from 6-13 days.
However, it can also occur in a longer span, which is 5-21 days.
However, as long
as it does not cause symptoms, a person can still transmit the monkeypox virus
to others.
The initial
symptoms of this disease are the same as chickenpox caused by viral infections, which cause
symptoms similar to flu.
Reporting to WHO, the emergence of monkeypox symptoms is
divided into two periods of infection, namely the invasion period and skin
eruption. Here's the explanation:
Invasion period
The invasion
period occurs within 0-5 days after being infected with the virus for the first
time. When a person is in the invasion period, he will show some symptoms of monkeypox,
such as:
- Fever
- Severe headaches
- Lymphadenopathy (swollen lymph nodes)
- Pain
- Muscle pain
- Severe weakness (asthenia)
Swollen lymph
nodes characterize the distinguishing between monkeypox and other types of
smallpox. Non-variola smallpox infections, such as chickenpox and firepox, do not cause swollen lymph nodes.
In severe
symptoms, an infected person may experience other health problems in the early
days of the infection.
Such is the case
studied in the clinical
manifestations of human monkeypox study. Groups of patients exposed to the virus through the mouth or respiratory
tract show respiratory disorders such as coughing, strep throat, and runny
nose.
Meanwhile,
patients who are bitten directly by infected animals also experience nausea and
vomiting in addition to fever.
Period of skin eruption
This period
occurs at 1-3 days after the fever appears. The main symptom in this phase is
the appearance of a skin rash.
The rash first
appears on the face and then spreads throughout the body. The face and palms of
the hands and feet are the areas most affected by this rash.
The appearance of
a rash can also be found on mucous membranes located in the throat, genital
areas, including eye tissue and cornea.
The rash usually
begins with spots until they turn into vesicles or lending, which are fluid-filled skin blisters. The inflammation
will turn dry within a few days to form a crust (scab) on the skin.
The development
of rashes ranging from spots to scabs on the skin generally occurs within
approximately 10 days. It takes about three weeks for all the scabs on the body's
skin to peel off on their own.
When to go to the doctor?
If you feel you
are in contact with someone or a wild animal infected with monkeypox, consult a doctor immediately. Especially if
you have recently traveled to the area where this outbreak originated.
As mentioned, if
you experience symptoms, you should immediately see a doctor get the proper
treatment. Treatment also helps prevent the onset of complications.
Although
monkeypox is a disease that can heal by itself(self-limited disease), the
symptoms can be disturbing and uncomfortable. Moreover, this disease tends to
heal longer than other smallpox diseases.
Causes of monkeypox
Monkeypox virus
is a virus derived from animals (zoonotic virus).
It is known that
this virus was initially transmitted by the bite of wild animals such as
squirrels. However, the researchers also found that the virus infected a group
of monkeys under study. From there, this disease is called monkeypox.
Monkeypox virus
comes from the genus Orthopoxvirus in the family Poxviridae. The genus
Orthopoxvirus includes smallpox-causing variola virus, vaccinia virus (used in
smallpox vaccines), and cowpox virus.
Most cases of monkeypox
experienced by humans are caused by transmission from animals. Viruses
originating from animals can enter the human body through open wounds in the
skin, respiratory tract, mucous membranes, and mucosa (saliva).
How to transmit monkeypox
The disease is
known to be transmitted through direct contact with skin lesions, blood, body
fluids, or mucosa (saliva) that contain the virus. However, how do animals pass
it on to humans?
In Africa,
animal-to-human transmission occurs through daily contact with infected Gambian
monkeys, squirrels, and rats.
According to the CDC, the transmission of chickenpox from animals to
humans can also occur through animal bites, direct contact with animal fluids
or skin lesions, or indirect contact with surfaces contaminated with the virus.
Cases of
monkeypox transmission from one person to another are generally very
minimal. News of the monkeypox virus between humans often occurs from droplets from
an infected person's respiratory tract.
Not only through
exposure to droplets released when sneezing or coughing by an infected person,
but the virus transmission from droplets can also occur when making regular
face-to-face contact with an infected person.
The virus can
also move from the body of pregnant women into the fetus through the placenta.
Risk factors
Anyone who has
never been infected with the monkeypox virus has the opportunity to experience
this disease. However, the risk of contracting will be greater if:
- Make direct contact without wearing
protective gear with wild stars.
- Have close contact with monkeys
infected with the virus of this disease.
- Eating meat and other body parts of
wild animals, especially without first cooking to maturity.
- Caring for people who have monkeypox.
- Conduct research on the monkeypox
virus in the laboratory.
Diagnosis
To diagnose this
disease, the doctor will perform a physical examination to identify symptoms.
However, this disease can be misdiagnosed into other smallpox diseases such as
chickenpox or firepox.
Therefore, the
doctor will usually require you to undergo laboratory tests to determine the
existence of viral infections that cause monkeypox.
One of the tests
that doctors recommend is a swab test or polymerase chain reaction (PCR). This test aims to analyze samples from
skin lesions or parts of the skin affected by smallpox.
Treatment for monkeypox
So far, there has
been no specific treatment for monkeypox in Indonesia, considering that this
disease has not been found in Indonesia.
Although there is
no specific treatment, this disease can be treated by controlling the symptoms
through supportive treatment and antivirals.
Supportive
treatment cannot stop a viral infection but aims to increase the body's
resistance strength to fight infection.
During
experiencing symptoms, you are encouraged to increase rest time and meet the
needs of fluids and nutrients by undergoing a strict healthy diet.
You should also
quarantine yourself by staying at home and limiting social contact with people
in the neighborhood.
Until now, there
is no specific drug that can overcome viral infections that cause monkeypox.
However, the type of antiviral used to treat smallpox, namely cidofovir
or tecovirimat, can help the recovery process.
In cases of
severe symptoms, patients are encouraged to undergo hospitalization to get
intensive treatment.
To control the
health impact of this disease, prevention through the smallpox vaccine and
immunoglobulin vaccine becomes the leading solution for handling monkeypox.
Prevention of monkeypox
Prevention is
always better than cure. This is also true in the treatment of monkeypox.
Smallpox vaccine
(Jynneos) is known to be 85% effective at preventing this disease. The vaccine
is a modified modification of the vaccinia vaccine that was previously used to
avoid smallpox.
In 2019, the FDA
officially approved Jynneos as a vaccine that can prevent smallpox
(smallpox)as well as monkeypox(monkeypox).
Administering two
doses of the Jynneos vaccine in 28 days has been shown to strengthen the immune
system compared to one of the previous smallpox vaccines.
However, the
availability of such vaccines in public health care centers is still minimal.
In Indonesia alone, there is no specific vaccine to prevent monkeypox.
Today,
implementing clean and healthy living behaviors such as regular handwashing
with soap, especially after interacting with animals, is still a significant
preventive effort that can help you avoid the risk of infection with this
disease.
Some other things
you can also do to prevent monkeypox, among others:
- Avoid direct contact with rats,
primates, or other wild animals that may be exposed to the virus
(including communication with dead animals in infected areas).
- Avoid contact with any objects, such
as bedding that have been stopped by sick animals.
- Do not eat wild animal meat that is
not cooked correctly.
- Stay away as much as possible from
infected patients.
- For medics, wear masks and gloves
when dealing with sick people.
If there are any
questions or complaints related to this disease, immediately consult a doctor
for the best solution.
