In 1796, Edward Jenner introduced the modern smallpox vaccine. Edward Jenner is well known around the world for his innovative contribution to immunization and the ultimate eradication of smallpox.
In 1967, the WHO intensified efforts to eliminate the disease. Smallpox is one of the infectious diseases to have been eradicated.
In 1980, the World Health Assembly declared smallpox eradicated (eliminated), and no cases of naturally occurring smallpox have happened thereafter.
Since smallpox was eradicated in 1980, the monkeypox virus (MPXV) has emerged as the most threatening orthopoxvirus in the world.
The World Health Organization (WHO) has declared the latest mpox outbreak in Africa a “public health emergency of international concern”, the category used in the past for Ebola outbreaks, Covid-19 and a 2022 mpox surge in Europe.
A global outbreak of clade II in 2022–2023 marked the first incidence of widespread community transmission outside of Africa. In July 2022, the World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC). The WHO reverted this status in May 2023 as the outbreak came under control, citing a combination of vaccination and public health information as successful control measures.
WHO had earlier declared monkeypox as a PHEIC in July 2022 and subsequently revoked the same in May 2023. Globally, since 2022, WHO has reported 99,176 cases and 208 deaths due to monkeypox from 116 countries.
Mpox caused by human-to-human transmission of monkeypox virus in the Democratic Republic of the Congo with spread to neighboring countries.The monkeypox virus (MPXV) clade I epidemic that has been affecting the Democratic Republic of the Congo (DRC) since November 2023 has recently spread to several other African countries including Burundi, Rwanda, Uganda and Kenya.
Outbreaks of M pox have been reported, in the endemic countries in tropical Africa (Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ghana, Ivory Coast, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan). Outbreaks of mpox are frequent in areas where the disease is endemic – these areas often have poor healthcare infrastructure and outbreaks are rarely documented.
In India, around 30 Mpox cases have been detected since 2022. The most recent case in the country was reported in March 2024. Serum Institute of India recently said it is currently working to develop a vaccine for Monkeypox, with positive outcomes expected in a year's time.
The last reported case of Mpox in India was in March 2024, from Kerala. Since the beginning of the outbreak in 2022, India has recorded a total of 30 confirmed Mpox cases
Mpox, a viral infection causing pus-filled lesions and flu-like symptoms, is generally mild but can be deadly in some cases. The clade 1b variety of mpox has caused global concern due to its seemingly easier transmission through routine close contact.
Also known as monkeypox, the viral disease can spread between people, mainly through close contact, and occasionally from the environment to people via objects and surfaces that have been touched by a person with mpox.
About m pox virus:
Monkeypox virus was discovered in 1958, when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research.
The monkeypox virus (MPV, MPXV, or hMPXV) is a species of double-stranded DNA virus that causes mpox disease in humans and other mammals.
mpox virus morphology and genome
Mpox is caused by Mpox virus, a member of the genus orthopoxvirus in the family Poxviridae, is characterized by its brick-shaped or oval morphology with a diameter of ~200–250 nm. Its genome consists of a linear, double-stranded DNA with a length of ~197 kb and encoding about 180 proteins.
It is a zoonotic virus belonging to the orthopoxvirus genus, making it closely related to the variola, cowpox, and vaccinia viruses.
Phylogenetic analysis demonstrated that the current monkeypox strain is closely related to clade IIb, which caused recent multi country outbreaks.
A zoonosis plural zoonoses or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite, or prion) that can jump from a non-human (usually a vertebrate) to a human and vice versa.
Transmission of mpox:
Monkeypox is an infectious disease caused by a virus transmitted to humans by infected animals, but it can also be transmitted from human to human through close physical contact.
Monkeypox spreads when a person comes in contact with an animal or a person who has the virus. Transmission occurs through: Direct contact with an infected person's bodily fluids, sores, scabs or respiratory droplets. This can also occur through cuddling, kissing or sex.
Smallpox is characterized by a rash or skin lesions generally concentrated on the face, hands and feet.
It can also be transmitted through kissing, hugging, massaging, and cuddling. Less commonly, it can spread through touching materials used by a person with mpox, including soiled clothing, towels, and bedding.
Mpox can spread through close contact of any kind, including through kissing, touching, oral and penetrative vaginal or anal sex with someone who is infectious. People who have sex with multiple or new partners are most at risk.
Using condoms during sex will help reduce the risk getting mpox but will not prevent spread from skin-to-skin or mouth-to-skin contact.
For most people, monkeypox gets better on its own without treatment and symptoms can be managed at home. However, a person with monkeypox can spread monkeypox from the time symptoms first appear to the time the rash is fully healed.
People at risk for monkey pox:
In some people, the illness can be severe or lead to complications and even death. Newborn babies, children, women who are pregnant and people with underlying immune deficiencies such as from advanced HIV disease may be at higher risk of more serious mpox disease and death.
Symptoms of m pox:
Mpox causes signs and symptoms which usually begin within a week but can start 3–21 days after exposure. Symptoms typically last 2–4 weeks but may last longer in someone with a weakened immune system.
Symptoms of a viral infection depend on where you're infected, but some common ones include: Flu-like symptoms: fever, head and body aches, fatigue. Upper respiratory symptoms: sore throat, cough, sneezing. Digestive symptoms: nausea, vomiting, diarrhea.
The evolution of lesions progresses through four stages—macular, papular, vesicular, to pustular—before scabbing over and desquamation.
The rash will go through several stages, including scabs, before healing. The rash can initially look like pimples or blisters and may be painful or itchy..
Mpox or monkeypox is an infectious viral disease that can occur in humans and other animals.
Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild, and most of infected individuals recover within a few weeks without treatment.The time from exposure to the onset of symptoms ranges from five to twenty-one days, and symptoms typically last from two to four weeks. However, cases may be severe, especially in children, pregnant women, or people with suppressed immune systems.
The incubation period is 3-21 days. During this time, a person does not have symptoms and may feel fine. The illness typically lasts 2-4 weeks.
Mpox is a zoonotic disease, which means it can spread between animals and people. The exact source of mpox in nature is not known, but it is believed that small mammals, such as rope and sun squirrels, giant-pouched rats, and African dormice may carry the virus in parts of West and Central Africa.
Laboratory Diagnosis of mpox :
The immune response following infection with monkeypox virus can be checked through antibody tests ( serological tests).
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Testing for mpox:
individuals and communities
In some cases, blood tests may also be used to detect antibodies, but PCR remains the gold standard for acute diagnosis.Gene sequencing helps in identifying virus .
Your healthcare provider will take a swab from a skin lesion and send it to a lab for polymerase chain reaction (PCR) testing which can detect the virus
Treatment of mpox:
Currently there is no treatment approved specifically for monkeypox virus (MPXV) infections. For most patients with mpox who have intact immune systems and don't have a skin disease, supportive care and pain control will help them recover without medical treatment.
The smallpox vaccine is approximately 85% effective in helping to prevent a monkeypox infection.
There is no specific treatment approved for monkeypox. However, an antiviral called Tecovirimat (TPOXX), approved to treat smallpox, can also be used for people who are at high risk for severe illness or have severe symptoms from monkeypox.
Medicines like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can relieve pain and help you feel better. Your healthcare provider may prescribe stronger pain relievers as well. For rash in the mouth, rinse with salt water at least four times a day.
Preventive measures:
The primary prevention strategies for monkeypox:
•Avoid contact with objects and materials that a person with mpox has used.
•Do not share eating utensils or cups with a person with mpox.
•Do not handle or touch the bedding, towels, or clothing of a person with mpox.
Secondary prevention strategies of mpox:
•Postexposure vaccination with the smallpox vaccination may be recommended in specific groups of people to prevent or attenuate infection.
•Children, pregnant women, and immunocompromised people should be prioritised for vaccination in case of limited vaccine supply.
*The infection control measures for monkeypox:
A patient with suspected or confirmed MPXV infection should be placed in a single-person room; special air handling is not required. The door should be kept closed . The patient should have a dedicated bathroom.
Mpox Prevention Steps.
•Get vaccinated! The JYNNEOS vaccine is recommended for prevention of mpox. Getting both doses provides the best protection.
The Indian government has directed airports, ports, and border authorities to stay vigilant in response to the global rise in Mpox cases. According to reports, central hospitals such as Safdarjung, Ram Manohar Lohia, and Lady Hardinge will have facilities for isolating suspected mpox cases.
Prevention is better than cure.
This is general information.
In case of fully blown m pox seek treatment of your health care provider.
Namaste 🙏🏻
Information compiled by:
Dr. Bhairavsinh Raol
