How Does Monkeypox Spread?

Monkeypox is a zoonotic disease which means its transmission occurs from animals to humans. It is caused by a virus that belongs to the Orthopoxvirus group. Cases of this disease have been recorded in the tropical rainforests of Central and Western Africa for decades.

However, in 2022, many non-endemic countries reported this disease. With 20,638 confirmed cases in 68 countries by the end of July 2022, the World Health Organisation (WHO) declared it a public health emergency. To know how monkeypox spread across so many countries, as well as the risk of infection and precautionary measures, go through the following sections.

Monkeypox transmission takes place via direct contact. The transmission can happen from animal to human or from human to human though the latter is less common. Direct contact with bodily fluids, blood, and cutaneous or mucosal lesions of infected animals can transmit this virus.

Certain species of animals such as Gambian pouched rats, tree squirrels, dormice and some monkeys are vulnerable to this disease. However, there hasn't been any discovery yet of any particular natural reservoir of this virus.

In the case of human-to-human transmission, monkeypox transmission can happen due to direct contact with the skin lesions or respiratory secretions of an infected human. If someone comes in contact with any object that has previously come in contact with the virus, it can also lead to further transmission.

Other factors that can spread the monkeypox disease include consuming half-cooked meat and other animal products that have a chance of carrying the virus.

When someone contracts this disease, initially, there are flu-like symptoms. Fever, muscle aches and chills might set in for the initial few days. You might also find swollen lymph nodes popping out on your face, neck and other body parts.

After a few days of fever, you might see fluid-filled bumps on your skin. These can show up in your palms and the soles of your feet as well. Generally, the infection lasts for about 2-4 weeks. Before you notice the symptoms, there is an incubation period of about 6 to 13 days.

The following are some of the early symptoms of monkeypox affliction:

• Swollen lymph nodes
• Fever
• Intense headache
• Chills
• Muscle pain
• Fatigue

This period of early symptoms typically lasts for 0 to 5 days, after which rashes appear on the patient's skin. These start as flat and red bumps that cause immense pain and turn into pus-filled blisters. After a few weeks, these form crusts that fall over, with the whole process taking several weeks.

The following people are at risk of contracting the monkeypox disease:

• Anyone who comes in close contact (sexual contact) with an infected individual is at risk.
• People who work closely with animals are at higher risk of getting the disease.
• Anyone working in the healthcare industry, taking care of infected patients, can also easily be infected with this virus.
• People residing in or close to a forest area are at a higher risk of getting the disease.
• Infants, young children, newborn babies and people suffering from immunodeficiency are also at risk.

The first and foremost step to prevent this virus would be to educate the mass about the measures that they can incorporate to stay safe.

The following are the measures that you can take to reduce the spread of monkeypox:

• Avoid coming in close contact with people who might be carrying the infection or are showing symptoms.
• Stay away from animals and avoid consuming animals with a greater risk of infection.
• Keep your surroundings clean and disinfect regularly.
• Have an open conversation with people you meet or come in close contact with on a daily basis about any symptoms that they are experiencing.
• Maintain a distance while interacting with any other person.
• In case you start showing symptoms, inform the people you have been close with and seek medical help.

Several types of research are currently taking place to understand the convenience and accuracy of the vaccination process to prevent and control the transmission of monkeypox.

There is no specific treatment to cure monkeypox yet. However, there are a few antivirals that have been recommended by Strategic National Stockpile (SNS) to treat monkeypox.

The following are a few countermeasures-

Tecovirimat (TPOXX,ST-246)

This antiviral medication was approved by the United States Food and Drug Administration (FDA) to treat smallpox in adults and children. There is currently no data available regarding its effectiveness in treating monkeypox.

However, there have been studies on multiple animal species to prove that it is effective for treating infections caused by Orthopoxviruses. Only minor side effects were recorded during the clinical trial. This medicine is available in the form of a pill and an injection.

Cidofovir (Vistide)

Another antiviral medication that is approved by the FDA is Cidofovir. It is used for patients who have been diagnosed with cytomegalovirus (CVM) retinitis and Acquired Immunodeficiency Syndrome (AIDS).

There is no data available that proves the efficacy of Cidofovir on patients suffering from monkeypox. However, there have been instances where this medication has shown to work effectively on other Orthopoxviruses in-vitro and in several animal species.

Vaccinia Immune Globulin Intravenous (VIGIV)

Authorised by FDA, VIGIV is used for the treatment purpose of complications arising due to vaccinia vaccination. This includes issues like progressive vaccinia, eczema vaccinatum, several generalised vaccinia and other vaccinia infections that may happen to any individual with skin conditions. The CDC (Central of Disease Control) allows the usage of VIGIV for treating  Orthopoxviruses in case of an outbreak.

However, there is no available data that can show the effectiveness of VIGIV on patients who are infected with monkeypox. What sort of benefit it might provide to someone who is severely infected with the monkeypox virus is still unknown.

Brincidofovir (CMX001 or Tembexa)

Approved by FDA on June 4th, 2021, Brindofovir treats the occurrence of smallpox in adults and paediatric patients, including neonates. No data is yet available stating its effectiveness for treating patients with monkeypox. However, it has proved to be effective for treating Orthopoxviruses in-vitro and for animal studies.

Generally, the symptoms of monkeypox subside on their own after a few weeks without needing any treatment. However, in some patients, the symptoms might be aggressive. In this case, they must follow the advice given by the medical professional stringently.

Here are a few important tips that people suffering from this disease can follow to reduce their discomfort-

• Hydrate yourself, rest enough, get an ample amount of sleep, eat nutritious food and indulge in activities that provide you with a sense of comfort.
• If you are in isolation, stay in touch with your loved ones through technology.
• Exercise when you feel up to the task.
• Ask for help if you face any mental health-related discomfort.
• In case you are suffering from monkeypox, refrain from scratching/itching your skin. Instead, take care of the rashes and constantly clean your hands before and after touching the lesions.
• You need to ensure that the rashes are dry and as clean as possible. To clean these areas, you can use antiseptics and sterilised water. For the lesions, you can use salt water. Epsom salt baths can help to soothe the rashes on your body.
• You can keep these rashes uncovered until you are around people; in that case, you need to cover them up to prevent transmission.

The above sections have explained how monkeypox spreads from person to person or animal to person. You can use this information to stay safe and prevent your close ones from falling ill in case you have contracted this disease. If you develop symptoms, it is advisable to consult a doctor and get treatment for it.