Monkey Pox: An Important Zoonotic Disease

Monkey Pox: An Important Zoonotic Disease

MAYA MEHARA¹ , TAPENDRA KUMAR² ,  CHANDNI JAWA³

1. V.Sc scholar, Department of veterinary Public health, College of veterinary and animal sciences, Bikaner Rajasthan
2. D scholar, Department of veterinary gynecology and obstetrics, College of veterinary and animal sciences (RAJUVAS) Bikaner Rajasthan
3. Teaching Associate, Department of veterinary Public health, College of veterinary and animal sciences, Bikaner Rajasthan

Introduction

After the deadly COVID-19 virus outbreak, the monkey pox virus, another virulent pathogen, is currently experiencing a rise in cases around the world. The monkey pox virus causes the viral ailment known as monkey pox. The monkeypox virus, an orthopoxvirus, is the cause of monkeypox, which is a zoonotic illness that can transfer from animals to humans. Small animals (such as African dormice, giant-pouched rats, and rope and sun squirrels) are thought to keep the virus alive in the habitats of West and Central Africa, while the animal reservoir remains unclear.

Monkeypox cases were found in many non-endemic nations in May 2022. A total of 12 non-endemic nations, including Australia, Belgium, Canada, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, the UK, and the US, have reported 92 confirmed cases and 28 suspected cases of monkeypox infection as of May 21, 2022, according to the World Health Organization (WHO).

Modes of transmission:

Monkeypox virus was once restricted to specific regions of Africa, but the environment of the disease has expanded, suggesting that human monkeypox infections may continue to intensify. The specifics of viral circulation in animal populations and the exact species that harbor this virus are not entirely known, although research and evidence point to rodents as a likely reservoir.Monkeypox virus spreads through close contact with infected animals and humans, or contaminated materials. The virus may enter through broken skin, respiratory tract, and mucous membranes such as the eyes, nose, or mouth.

			Human to human transmission is possible through contact with respiratory secretions, bodily fluids, and skin lesions of an infected person. Again, contact with recently contaminated objects can also cause transmission. Apart from close contact, monkeypox can also transmit from mother to fetus through the placenta. While close physical contact has been identified as a transmission route, data remains insufficient to determine whether monkeypox spreads directly through sexual intercourse.
	Animal to human transmission of monkeypox may be through contact with blood, bodily fluids, and lesion material of an infected animal, including wounds such as bites and scratches. Consuming inadequately cooked meat and other products from infected animals is also considered a potential route for contamination.

Signs and Symptoms:

The incubation period (interval from infection to onset of symptoms) of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.

The infection can be divided into two periods:

• Invasion symptoms include fever, severe headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle aches), and severe asthenia (lasts 0–5 days) (lack of energy). Compared to other diseases that may initially seem similar, monkeypox has a specific characteristic called lymphadenopathy (chickenpox, measles, smallpox)

• The skin eruption often starts one to three days after the onset of a fever. Instead of the trunk, the rash is more frequently found on the face and limbs. In 95% of instances, it also affects the palms of the hands and soles of the feet in addition to the face (in 75 percent of cases). Along with the cornea, oral mucous membranes, genitalia, and conjunctivae are all additionally impacted (in 70% of cases). The progression of the rash goes from macules (flat, firm lesions) to papules (slightly raised, firm lesions), vesicles (clear fluid-filled lesions), pustules (yellowish fluid-filled lesions), and crusts that dry up and break off. Lesions can range in number from a few to several thousand. Lesions may combine in extreme circumstances.
• In the general population, the case fatality ratio of monkeypox has traditionally fluctuated from 0 to 11%; it has been higher in young children. The case fatality rate has recently been between 3 and 6 percent.

Diagnosis:

The clinical differential diagnosis that must be considered includes other rash illnesses, such as chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies. Lymphadenopathy during the prodromal stage of illness can be a clinical feature to distinguish monkeypox from chickenpox or smallpox.

If monkeypox is suspected, health workers should collect an appropriate sample and have it transported safely to a laboratory with appropriate capability. Confirmation of monkeypox depends on the type and quality of the specimen and the type of laboratory test. Thus, specimens should be packaged and shipped in accordance with national and international requirements. Polymerase chain reaction (PCR) is the preferred laboratory test given its accuracy and sensitivity. For this, optimal diagnostic samples for monkeypox are from skin lesions – the roof or fluid from vesicles and pustules, and dry crusts. Where feasible, biopsy is an option. Lesion samples must be stored in a dry, sterile tube (no viral transport media) and kept cold. PCR blood tests are usually inconclusive because of the short duration of viremia relative to the timing of specimen collection after symptoms begin and should not be routinely collected from patients.

Prevention and Control:

Raising awareness of risk factors and educating people about the measures they can take to reduce exposure to the virus is the main prevention strategy for monkeypox. Through restrictions on animal trade, some countries have put in place regulations restricting the importation of rodents and non-human primates. Captive animals that are potentially infected with monkey pox should be isolated from other animals and placed into immediate quarantine. Any animals that might have come into contact with an infected animal should be quarantined, handled with standard precautions and observed for monkey pox symptoms for 30 days.

Veterinarians should consider all mammals susceptible to monkeypox and be aware of how the disease transmits from animal to animal. Veterinarians who decide to treat animals with suspected monkeypox should use infection control precautions to protect themselves, staff, clients, as well as other animal patients in the clinic.

Treatment:

Clinical care must be properly optimized in order to treat monkeypox symptoms effectively, handle complications, and avoid long-term effects. Fluids and food should be provided to patients in order to maintain a healthy nutritional condition. As necessary, secondary bacterial infections should be treated. Based on information from both animal and human research, the European Medicines Agency (EMA) granted tecovirimat and cidofovir an antiviral drug originally created to treat smallpox, a licence to treat monkeypox in 2022. It is still not readily accessible. If tecovirimat is utilised for patient treatment, it is ideal to monitor it in a clinical research setting with prospective data gathering.

References:

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