MONKEYPOX OUTBREAK

Monkeypox, a zoonotic disease caused by an orthopox virus, causes a smallpox-like illness in humans. We present a comprehensive review to see how monkeypox epidemiology has changed since its discovery in the Democratic Republic of Congo in 1970. Ten African nations and four other countries are experiencing human monkeypox now.

What are the symptoms of monkeypox in humans?

Symptoms of monkeypox disease might emerge anywhere from 5 to 21 days after infection. The majority of people return to normal after two to four weeks. The symptoms in humans include fever, headache, muscular pains, and exhaustion, which might last a day or two. Some may also experience sore and swollen lymph nodes. A rash emerges one to three days after the fever, ranging from red patches to little bumps on the skin. These can develop into blisters, which can fill with a yellowish fluid. At times, the rash looks like chickenpox, syphilis, or herpes. WHO specialists state that it commonly spreads from the face to the limbs, hands, feet, and the rest of the body.

What are the causes of monkeypox?

Monkeypox virus, a DNA virus, is the principal causative agent in humans for monkeypox disease.
The illness is most prevalent in tropical rainforests. The virus transmission occurs from an animal infected by this virus into the human body through the mucous membranes. Once a person becomes infected, they can transmit it to other people; family members and healthcare workers are particularly vulnerable. It is a highly contagious disease. Close contact with an infected person, particularly sexual activity, is the primary mode of viral transmission. The virus can also be passed from person to person through pulmonary (airborne) contact or contact with the body fluids of an infected individual.
Sharing utensils and living space with an infected person are also risk factors for transmission. Experts associate the factors influencing the introduction with an increased chance of transmission. Bites or scratches, bush meat preparation, and communication with bodily fluids such as through contaminated bedding can all result in animal-to-human transmission.

Monkeypox outbreak of 2022 in Europe and America

As of 20th May 2022, case numbers, while modest, appear to be regularly increasing. Between the 6th and the 20th of May, England confirmed 20 cases. Spain has reported 23 possible but unconfirmed cases, while Portugal has confirmed five of its twenty suspected cases. The United States has reported one case.

Changing faces of the monkeypox epidemiology

West Africa has reported human monkeypox infections in the past. But since 1981, the Congo basin in Central Africa has reported most illnesses.
Monkeypox can infect a wide range of mammalian species. However, the virus has only been isolated once from one wild animal, a Funisciurus squirrel in the Democratic Republic of Congo.
Human monkeypox infection surveillance in endemic locations is difficult. Surveillance systems face various issues, including inadequate infrastructure, limited resources, incorrect diagnostic specimens and a lack of specimen collection, and clinical difficulties in detecting monkeypox infection. 
More data from recent monkeypox cases and previous initiatives is becoming available. This information will help reevaluate the characteristics of the disease that help distinguish monkeypox from other rash disorders.

Virus differences: Central and West African monkeypox

One can divide monkeypox viruses into two phylogenetic clades: West Africa and Central Africa. (A clade is an organism group descended through a common ancestor.) Researchers discovered disease severity varied amongst clades during the West African monkeypox outbreak in the US in 2003.
In general, humans and nonhuman primates suffer less from West African monkeypox infections. Genome analyses of West and Central African strains revealed a group of potential genes that could play a role in clade virulence differentiation. These genes possibly participate in viral life cycle changes, host range changes, immune evasion, or virulence factors.
In human cells generated from previously infected monkeypox patients, central African monkeypox blocks T-cell receptor-mediated T-cell activation, preventing inflammatory cytokine production.

Monkeypox Treatment

Monkeypox cases are often minor, and people recover within weeks. However, depending on the type, the death rate varies. 
According to the ECDC, the West African clade, seen in Europe so far, has a case fatality rate of roughly 3.6 percent. (This figure is estimated from studies conducted in African countries). Children, young adults, and immunocompromised people have a greater mortality rate.
There are no particular treatments for monkeypox. Studies demonstrate that smallpox vaccination is up to 85% effective in preventing monkeypox. Other effective medications are the antivirals cidofovir and tecovirimat. The UK government has purchased large quantities of vaccine doses to tackle the monkeypox outbreak of 2022. They have already begun distribution to affected people's close contacts.

Conclusion

The 2022 monkeypox outbreak has illustrated that human monkeypox can spread through zoonotic reservoirs. 
Civil strife and displacement raise concerns about the virus spreading into regions where monkeypox does not exist. In such scenarios, people may move to more heavily forested areas, where they are more likely to come into contact with wildlife and contract a variety of zoonoses.  
The observed increase in human disease incidence requires deeper examination, study, and new research. These aspects would help comprehend better the many elements involved in disease transmission and spread. 
Many concerns about human disease, animal reservoirs, and the virus itself remain unanswered — improvements in our understanding of this essential zoonosis can help better direct prevention initiatives and minimize human disease. 
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