The Indian Practitioner

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Monkeypox : Transmission, Clinical Features, Diagnosis, Treatment, and Prevention


Affiliations
1 General Medicine, TNMC & Nair Hospital, Mumbai, India
2 Seth GS Medical College and KEM Hospital, Mumbai, India
     

   Subscribe/Renew Journal


Monkeypox is a zoonotic disease that is caused by the Monkeypox virus (MPX). MPX is similar to the virus that causes smallpox. It was endemic to central and west regions of Africa but has recently been reported in different parts of the globe. The primary reservoirs of MPX are wild animals particularly primates (Mangabey monkeys), Gambian pouched rats, and squirrels. Most cases of Monkeypox are due to the transmission of the virus from animals to humans. In addition, there have also been instances of human-to-human spread through respiratory droplets, fomites, and sexual contact. Monkeypox has a varied presentation ranging from mild symptoms to severe disabling complications. Real time PCR is used to diagnose orthopoxvirus. Retrospective diagnosis is done using serological tests. Symptomatic management and prevention of secondary infection are the mainstay aim of treatment. Antiviral drugs like cidofovir, brincidofovir, and tecovirimat seem to work against MPX even though there is no specific treatment against the virus. Health education of masses, prophylactic vaccination, quarantining the exposed, appropriate personal protective equipment for health care workers, etc. is some of the preventive measures to curb the disease. The newer-generation smallpox vaccine, JYNNEOS and the older-generation ACAM20, can also be used for prevention of Monkeypox.

Keywords

Monkeypox Virus, Smallpox, Orthopoxvirus, Skin Lesions, Antiviral Medications, Ring Vaccination.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Petersen E, Kantele A, Koopmans M, Asogun D, Yinka-Ogunleye A, Ihekweazu C, Zumla A. Human Monkeypox: epidemiologic and clinical characteristics, diagnosis, and prevention. Infectious Disease Clinics. 2019;33(4):1027-43. Available from- Human Monkeypox - Infectious Disease Clinics (theclinics.com)

  • John T, Sapha, Sharon T, Juergen R, Andrea A, Luke H, Romain P, Achyuta N, Iain R, Maximillian H, Vanessa A, Christoph B.Monkeypox Virus Infection in Humans across 16 Countries — April–June 2022. The New England Journal of Medicine. 2022. Available from- Monkeypox Virus Infection in Humans across 16 Countries — April–June 2022 | NEJM

  • Alakunle, E.F., Okeke, M.I. Monkeypox virus: a neglected zoonotic pathogen spreads globally. Nat Rev Microbiol. 2022;20:507–508. Available from-Monkeypox virus: a neglected zoonotic pathogen spreads globally | Nature Reviews Microbiology.

  • Okyay RA, Bayrak E, Kaya E, Şahin AR, Koçyiğit BF, Taşdoğan AM, Avcı A, Sümbül HE. Another Epidemic in the Shadow of Covid 19 Pandemic: A Review of Monkeypox. Eurasian J. Med. Oncol. 2022;7:10. Available from-Another Epidemic in the Shadow of Covid 19 Pandemic A Review of Monkeypox-2022.pdf (ejmo.org)

  • Qizan G, Changle W, Xia C, Sandra C. Monkeypox virus: a re-emergent threat to humans. VirologicaSinica. 2022;S1995-820X(22)00120. Available from- Monkeypox virus: a re-emergent threat to humans - PubMed (nih.gov)

  • Brown K, Leggat PA. Human Monkeypox: current state of knowledge and implications for the future. Tropical medicine and infectious disease. 2016;1(1):8. Available from-TropicalMed |Free Full-Text | Human Monkeypox: Current State of Knowledge and Implications for the Future|HTML (mdpi.com)

  • C.K. Ellis, D.S. Carroll, R.R. Lash, A.T. Peterson, I.K. Damon, J. Malekani and P. Formenty. Ecology and geography of human Monkeypox case occurrences across Africa. J. Wildl. Dis. 2021;48:335-347. Available from- Ecology And Geography Of Human Monkeypox Case Occurrences Across Africa | Journal of Wildlife Diseases (allenpress.com)

  • Andrea M. McCollum, Inger K. Damon. Human Monkeypox. Clinical Infectious Diseases. 2014;58(2):260–267. Available from-Human Monkeypox | Clinical Infectious Diseases | Oxford Academic (oup.com)

  • Di Giulio DB, Eckburg PB. Human Monkeypox: an emerging zoonosis. The Lancet infectious diseases. 2004;4(1):15-25.Human Monkeypox: an emerging zoonosis - The Lancet Infectious Diseases

  • Ježek Z, Szczeniowski M, Paluku KM, Mutombo M. Human Monkeypox: clinical features of 282 patients. Journal of infectious diseases. 1987;156(2):293-8. Available from- Human Monkeypox: Clinical Features of 282 Patients | The Journal of Infectious Diseases | Oxford Academic (oup.com)

  • Learned LA, Reynolds MG, Wassa DW, Li Y, Olson VA, Karem K, Stempora LL, Braden ZH, Kline R, Likos A, Libama F. Extended interhuman transmission of Monkeypox in a hospital community in the Republic of the Congo, 2003. The American journal of tropical medicine and hygiene. 2005;73(2):428-34. Available from-Extended_Interhuman_Transmission_Of_Monk20211028-10917-go1cb6-with-cover-page-v2.pdf (d1wqtxts1xzle7.cloudfront.net)

  • Surveillance, case investigation and contact tracing for Monkeypox: interim guidance, 22 May 2022]. Geneva: World Health Organization; 2022 (https://apps.who.int/iris/handle/10665/354486/).

  • World Health Organization (WHO). Laboratory testing for the Monkeypox virus: Interim guidance. Geneva: WHO; 2022. Available from: https://www.who.int/publications/i/item/WHO-MPX-laboratory-2022.1

  • A. Nalca, A.W. Rimoin, S. Bavari, C.A. Whitehouse. Reemergence of Monkeypox: prevalence, diagnostics, and countermeasures. Clin Infect Dis. 2005; 4 (12):1765-1771. Available from-https://academic.oup.com/cid/article/41/12/1765/2033760#111799177

  • Ranganath N, Tosh PK, O’Horo J, Sampathkumar P, Binnicker MJ, Shah AS. Monkeypox 2022: Gearing Up for Another Potential Public Health Crisis. InMayo Clinic Proceedings 2022. Available from https://pubmed.ncbi.nlm.nih.gov/35985857/

  • Li Y, Zhao H, Wilkins K, Hughes C, Damon IK. Real-time PCR assays for the specific detection of Monkeypox virus West African and Congo Basin strain DNA. J Virol Methods. 2010;169(1):223-7. Available from- Real-time PCR assays for the specific detection of Monkeypox virus West African and Congo Basin strain DNA - PubMed (nih.gov)

  • Y. Li, V.A. Olson, T. Laue, M.T. Laker, I.K. Damon.Detection of Monkeypox virus with real-time PCR assays. J. Clin. Virol. 2006;36:194-203. Available from-Real-time PCR assays for the specific detection of Monkeypox virus West African and Congo Basin strain DNA - PubMed (nih.gov)

  • V.A. Olson, T. Laue, M.T. Laker, I.V. Babkin, C. Drosten, S.N. Shchelkunov, M. Niedrig, I.K. Damon, H. Meyer a. Real-time PCR system for detection of orthopoxviruses and simultaneous identification of smallpox virus. J. Clin. Microbiol. 2004;42:1940-1946. Available from Real-time PCR system for detection of orthopoxviruses and simultaneous identification of smallpox virus - PubMed (nih.gov)

  • Karem KL, ReynoldsM, BradenZ, et al. Characterization of acute-phase humoral immunity to Monkeypox: use of immunoglobulin M enzyme-linked immunosorbent assay for detection of Monkeypox infection during the 2003 North American outbreak. ClinDiagn Lab Immunol. 2005;12. Available from- characterization of acute-phase humoral immunity to Monkeypox: use of immunoglobulin M enzyme-linked immunosorbent assay for detection of Monkeypox infection during the 2003 North American outbreak - PubMed (nih.gov)

  • G.D. Huhn, A.M. Bauer, K. Yorita, et al.Clinical characteristics of human Monkeypox, and risk factors for severe disease. Clin Infect Dis. 2005;41(12):742-1751. Available from-Clinical characteristics of human Monkeypox, and risk factors for severe disease - PubMed (nih.gov)

  • D.W. Grosenbach, K. Honeychurch, E.A. Rose, et al.Oral tecovirimat for the treatment of smallpox. N Engl J Med. 2018;379 (1): 44-53. Available from-Grosenbach: Oral tecovirimat for the treatment of smallpox - Google Scholar.

  • C.L. Hutson, A.V. Kondas, M.R. Mauldin, et al. Pharmacokinetics and efficacy of a potential smallpox therapeutic, brincidofovir, in a lethal Monkeypox virus animal model.m Sphere. 2021;6(1):e00927-e01020.Available from-Pharmacokinetics and Efficacy of a Potential Smallpox Therapeutic, Brincidofovir, in a Lethal Monkeypox Virus Animal Model | mSphere (asm.org)

  • H. Adler, S. Gould, P. Hine, et al. Clinical features and management of human Monkeypox: a retrospective observational study in the UK. Lancet Infect Dis.2022;22(7):e177. Available from-Clinical features and management of human Monkeypox: a retrospective observational study in the UK - The Lancet Infectious Diseases

  • Centers for Disease Control and Prevention. Clinical Recognition. 19 May 2022. Available from- www.cdc.gov/pox-virus/Monkeypox/clinicians/clinical-recognition.html.

  • Adalja A, Inglesby T. A novel international Monkeypox out-break. Annals of Internal Medicine. 2022;175(8):1175-1176. Available from- A Novel International Monkeypox Outbreak - PubMed (nih.gov)

  • B.W. Petersen, T.J. Harms, M.G. Reynolds, L.H. Harrison. Use of vaccinia virus smallpox vaccine in laboratory and health care personnel at risk for occupational exposure to Orthopoxviruses—recommendations of the Advisory Committee on Immunization Practices (ACIP). 2015; 65:257-262. Available from- Use of Vaccinia Virus Smallpox Vaccine in Laboratory and Health Care Personnel at Risk for Occupational Exposure to Orthopoxviruses — Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2015 on JSTOR.


Abstract Views: 205

PDF Views: 0




  • Monkeypox : Transmission, Clinical Features, Diagnosis, Treatment, and Prevention

Abstract Views: 205  |  PDF Views: 0

Authors

Charmi Bhanushali
General Medicine, TNMC & Nair Hospital, Mumbai, India
Vidhi Bhanushali
Seth GS Medical College and KEM Hospital, Mumbai, India

Abstract


Monkeypox is a zoonotic disease that is caused by the Monkeypox virus (MPX). MPX is similar to the virus that causes smallpox. It was endemic to central and west regions of Africa but has recently been reported in different parts of the globe. The primary reservoirs of MPX are wild animals particularly primates (Mangabey monkeys), Gambian pouched rats, and squirrels. Most cases of Monkeypox are due to the transmission of the virus from animals to humans. In addition, there have also been instances of human-to-human spread through respiratory droplets, fomites, and sexual contact. Monkeypox has a varied presentation ranging from mild symptoms to severe disabling complications. Real time PCR is used to diagnose orthopoxvirus. Retrospective diagnosis is done using serological tests. Symptomatic management and prevention of secondary infection are the mainstay aim of treatment. Antiviral drugs like cidofovir, brincidofovir, and tecovirimat seem to work against MPX even though there is no specific treatment against the virus. Health education of masses, prophylactic vaccination, quarantining the exposed, appropriate personal protective equipment for health care workers, etc. is some of the preventive measures to curb the disease. The newer-generation smallpox vaccine, JYNNEOS and the older-generation ACAM20, can also be used for prevention of Monkeypox.

Keywords


Monkeypox Virus, Smallpox, Orthopoxvirus, Skin Lesions, Antiviral Medications, Ring Vaccination.

References