On May 9, 2023, health officials disclosed concerning news of three confirmed Monkeypox cases (mpox) in Pakistan, with Islamabad emerging as the most affected area. And its time to create an awareness in it!

Monkeypox is a rare but potentially serious viral disease that belongs to the Orthopoxvirus family, closely related to the infamous smallpox. The story of Monkeypox begins in 1958 when the virus was first discovered in monkeys. Hence, the name “Monkeypox” was coined. However, it was only in 1970 that the first human case was reported in the Democratic Republic of the Congo. 

Since then, outbreaks have occurred intermittently in Central and West African countries. The disease, while not a household name like its relative smallpox, has nonetheless left an indelible mark on the medical history books. Here are the details that all you need to know about Monkeypox, transmission, vaccinations and prevention!

First You Need To Understanding Monkeypox

• A Viral Disease Classification:

Monkeypox, like its relative smallpox, is classified as a viral disease. The causative agent of this disease is the Monkeypox virus, scientifically known as Orthopoxvirus. This virus, which can be transmitted from animals to humans and between humans, has sparked concerns in recent years due to its potential for outbreaks and human-to-human transmission.

• Primary Symptoms and Distinctions:

Monkeypox shares several symptoms with other poxvirus infections, such as smallpox and chickenpox. The primary symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion. 

It’s important to note that Monkeypox is generally less severe than smallpox. While both diseases share similar symptoms, smallpox had a much higher mortality rate and more severe clinical presentation.

• Regions Where Monkeypox is Common:

Monkeypox is primarily found in Central and West Africa. Countries in these regions, such as the Democratic Republic of the Congo, Nigeria, and Cameroon, have reported Monkeypox cases over the years.  Now it has also entered the boundaries of Pakistan, which urgently requires heightened awareness and precautionary measures to address the emerging Monkeypox cases. Here are the details about this disease from its transmission to its recovery that you should must know!

The Causes and Transmission of Monkeypox

Monkeypox is caused by the Monkeypox virus, a member of the Orthopoxvirus family. This virus is zoonotic, meaning it can be transmitted from animals to humans. It is closely related to the smallpox virus, albeit less severe. Moreover, Monkeypox can be transmitted through various means:

• Animal-to-Human – The virus is often transmitted to humans through direct contact with infected animals, such as rodents, prairie dogs, or monkeys. Handling, slaughtering, or consuming these animals’ touched food can lead to transmission.
• Human-to-Human – Human-to-human transmission is possible through respiratory droplets, contact with bodily fluids or contaminated objects, and close physical contact. This form of transmission is more concerning as it can lead to larger outbreaks.

The exact reservoir hosts for the Monkeypox virus are not definitively identified. However, various animals, particularly rodents like squirrels, have been suspected as potential carriers of the virus. Understanding the reservoir hosts is vital for preventing future outbreaks and controlling the disease’s spread.

The Major Symptoms and Monkeypox Diagnosis

Monkeypox typically progresses through the following stages:

• Incubation Period – The disease starts with an incubation period of about 5 to 21 days after exposure, during which no symptoms are present.
• Fever and Early Symptoms – The first symptoms include fever, headache, muscle aches, chills, and exhaustion.
• Rash Development – A distinctive feature of Monkeypox is the appearance of a rash, which often begins on the face and spreads to other parts of the body. This rash evolves into pustules, which can be painful.
• Pustule Formation – Over time, the pustules fill with thick fluid and later form scabs. They eventually fall off, leaving a pit at the site.

Healthcare professionals diagnose Monkeypox through clinical examination and laboratory tests. A detailed history of animal contact and clinical symptoms is essential. Laboratory tests, including PCR (Polymerase Chain Reaction), can confirm the presence of the Monkeypox virus in a patient’s samples.

The Prevention and Vaccination For Monkeypox

Preventing Monkeypox requires a two-pronged approach. First, maintaining rigorous personal hygiene, including frequent handwashing, is essential to minimize the risk of transmission. Second, it’s imperative to steer clear of direct contact with animals that could potentially carry the virus, especially if these animals exhibit signs of illness. These precautionary measures are pivotal in curbing the spread of the disease.

As of now, there is no specific vaccine for Monkeypox available for the general population. However, research and development efforts are ongoing to create a vaccine that can provide protection against the virus. Monitoring the progress of these vaccines and their availability is essential for future prevention strategies.

Available Treatment and Recovery Procedure 

There is no specific antiviral treatment for Monkeypox. Supportive care, including pain management and maintenance of hydration, is crucial. In severe cases, antiviral medications like cidofovir may be considered.

The prognosis for Monkeypox varies, with some cases being mild and self-limiting, while others can be more severe. Recovery often depends on the individual’s overall health and the timeliness of medical intervention. With appropriate care, many patients do recover from the disease, but scarring can occur at the site of the pustules.

Recent Outbreaks and Updates in Pakistan

As of the recent data available until May 29, 2022, Pakistan had not registered any cases of Monkeypox. However, the global resurgence of Monkeypox has raised concerns, especially considering its unusual transmission patterns and the potential for outbreaks in non-endemic countries. On May 9, 2023, health officials delivered alarming news with the confirmation of three cases of Monkeypox (mpox) in Pakistan. Of particular concern was the fact that Islamabad stood out as the most affected area among them. 

At that time, the provincial health department had issued a high alert and implemented airport restrictions as precautionary measures. Yet, one significant challenge was the lack of diagnostic facilities and testing kits to detect the virus, a critical aspect in managing and preventing outbreaks effectively. It is imperative for the Pakistani government to urgently procure the necessary testing kits, primers, and reagents to prepare for the possible emergence of the Monkeypox virus within the country. 

Ghurki Trust & Teaching Hospital is also ready to create awareness against this viral disease. Because, together, by raising awareness and implementing effective measures, we can combat this outbreak in Pakistan and limit its further spread.