Monkey pox and why is it concerning?

Abhilasha Singh

Monkeypox or Mpox is a viral illness caused by the monkeypox virus, a species of the genus Orthopoxvirus. The two genetic clades of the virus are clades I and II.

The monkeypox virus was discovered in Denmark in 1958 in monkeys kept for research and the first reported human case of mpox was a nine-month-old boy in the Democratic Republic of the Congo (DRC, 1970). Mpox can spread from person to person or occasionally from animals to people. Following the eradication of smallpox in 1980 and the end of smallpox vaccination worldwide, mpox steadily emerged in central, east, and west Africa. A global outbreak occurred in 2022–2023.

Signs and symptoms 

Mpox can be transmitted to humans through physical contact with someone infectious, with contaminated materials, or with infected animals. Some of the early signs seen in the infected people are,
-rash
-fever
-sore throat
-headache
-muscle aches
-back pain
-low energy
-swollen lymph nodes. 

For some people, the first symptom of pox is a rash, while others may have different symptoms first. 

The rash begins as a flat sore which develops into a blister filled with liquid and may be itchy or painful. As the rash heals, the lesions dry up, crust over, and fall off. 

Some people may have one or a few skin lesions and others have hundreds or more. These can appear  anywhere on the body such as:
-palms of hands and soles of feet
-face, mouth, and throat
-groin and genital areas

Transmission 

Person-to-person transmission of pox can occur through direct contact with infectious skin or other lesions such as in the mouth or on the genitals; this includes contact that is
-face-to-face (talking or breathing)
-skin-to-skin (touching or vaginal/anal sex)
-mouth-to-mouth (kissing)
-mouth-to-skin contact (oral sex or kissing the skin)
-respiratory droplets or short-range aerosols from prolonged close contact

Since anyone can get mpox. It spreads from contact with the infected, such as,
-persons, through touch, kissing, or sex
-animals, when hunting, skinning, or cooking them
-materials, such as contaminated sheets, clothes, or needles 
-pregnant persons, who may pass the virus on to their unborn baby. 

Prevention

Getting a Mpox vaccine can help prevent infection. The vaccine should be given within 4 days of contact with someone who has pox (or within up to 14 days if there are no symptoms). 

It is recommended for people at high risk to get vaccinated to prevent infection with Mpox, especially during an outbreak. This includes:

-health workers at risk of exposure
-men who have sex with men
-people with multiple sex partners
-sex workers.

Some of the Dos and Don't regarding Mpox are,

Dos:-

-stay home and in your room if possible
-wash hands often with soap and water or hand sanitizer, especially before or after touching sores
-wear a mask and cover lesions when around other people until your rash heals
-keep skin dry and uncovered (unless in a room with someone else)
-avoid touching items in shared spaces and disinfect shared spaces frequently 
-use saltwater rinses for sores in the mouth
-take sitz baths or warm baths with baking soda or Epsom salts for body sores
-take over-the-counter medications for pain like paracetamol (acetaminophen) or ibuprofen.

Don't:-

pop blisters or scratch sores, which can slow healing, spread the rash to other parts of the body, and cause sores to become infected; or
shave areas with sores until scabs have healed and you have new skin underneath (this can spread the rash to other parts of the body).

Challenges and complications in the society 

Challenges due to anxiety:- social anxiety due to loneliness, quarantine, and fear of being contagious to others. Patients felt helpless and considered themselves a burden on their caregivers. There are also financial constraints, especially in developing countries, where 40%–50% of the population is below the poverty line, daily wage earners, and the sole earners of their families. The authors emphasized that awareness of the mental health status of these patients must be raised.

Challenges due to social stigma:-The mental health of patients is affected because they are stigmatized by the people around them. People suffer social boycotts and experience loneliness, which depresses them. This was also seen in the COVID-19 pandemic, where the bodies of the patients were not given to their relatives, creating anxiety; people started hiding their symptoms and stopped reporting them to hospitals.

Challenges of mental health of pregnant women:- The mental health status of pregnant women who were infected with MPXV or had any of their close relatives suffering from MPX. The fear and anxiety of these women were far greater than those of others because they were not only concerned with themselves but also with their newborns.

The mental health of adolescents and children:- MPX illness is not only affecting the mental health of the adult population but also children and adolescents. These may carry long-term implications not only on their own health and life but also on society.

Not only through the physical aspect but also through the psychological aspect MPXV infection-related studies on psychiatric disorders, including mental stress, show that 25%–50% of patients with MPX experience anxiety and depression, mainly due to isolation, boredom, and loneliness during the active course of the disease. This study speculates that many psychological elements are not measurable and cannot be studied scientifically. Other terrifying factors, such as infected people around them and in the family, non-competency of health professionals treating them, and finally, shame and blame for the physical symptoms, especially related to the skin, further aggravate and add to the mental insults not only in adults but also in children and adolescents.