Is Mpox another pandemic?

Many countries, including India, are on high alert to fight and address a massive, untoward imperative. The concerned authorities are making every effort to ensure they are adequately prepared to halt the spread of mpox in the event of an out-of-control situation.

Although the World Health Organisation (WHO) confirmed that mpox is yet to reach the stage of an appalling proportion as coronavirus, the supervisory body did declare the virus as a public health emergency of international concern (PHEIC) on August 14, 2024, under the International Health Regulations (2005) (IHR).

For the uninitiated, the Democratic Republic of the Congo (DRC) is where mpox first emerged in Africa in 2022. The ongoing eruption is spurred by Clade 1, a more severe variant of the contagion that gets people to contract the disease via skin-to-skin or sexual contact.

For the uninitiated, the Democratic Republic of the Congo (DRC) is where mpox first emerged in Africa in 2022. Clade 1, a more severe variant of the contagion that spreads through skin-to-skin or sexual contact, is the driving force behind the ongoing eruption. As of August 2024, a new strain of the mpox virus, clade 1b, is gripping Africa and spreading to other continents like Asia and Europe. Incidentally, a new strain of the mpox virus, clade 1b, is gripping Africa and extending its tentacles to other continents, such as Asia and Europe.

Dope on Mpox

“Mpox is a contagious disease caused by a virus from the variola group, which technically alludes to smallpox,” defines Dr Dinesh Kumar Tyagi, director of internal medicine at Fortis Hospital, Greater Noida. Incidentally, the monkeypox virus, a significant discovery in the field of infectious diseases, was first identified in 1958 during two outbreaks of a pox-like malady in research monkey colonies.

Medical microbiologist Prof. Ashok Rattan informs that, “Mpox is a zoonotic disease that spreads between animals and humans. It can induce rashes and flu-like symptoms. The virus spreads through close contact with an infected individual. It is endemic and regularly found in parts of Central and West Africa. The virus-causing mpox is detected in small rodents, primates like monkeys and other mammals in these regions.”

Signs & Symptoms

The symptoms include fever, cough, muscle ache, back pain, total body ache, headache, and the appearance of vesicular lesions, which start from the face and further spread across the body. Mpox symptoms typically appear within a week post-exposure to the infection, but it can take a day or as long as 21 days to be discernible. They typically last for a fortnight to four weeks, but they may persist longer in people with weak immune systems. After exposure, the common signs of the mpox virus comprise rashes, swollen or enlarged lymph nodes, chills, fatigue, and flu-like symptoms, among others.

“The rash appears as flat, red bumps and can be painful. Later, these lumps can turn into pus-filled blisters and eventually crust over and fall off. This entire process takes two to four weeks to resolve. Sores can also appear in the mouth, face, hands, feet, penis, vagina or anus,” says Prof. Rattan adding, “Some individuals may have only a few skin lesions, while others may have hundreds or more eruptions. These can surface anywhere on the body, including the palms, soles of feet, throat, trunk, groin, genital areas, etc.”

It is important to detect the early indications of mpox. Dr Mala Kaneria, consultant of infectious diseases at Mumbai’s Jaslok Hospital & Research Centre, shares that “The rash may precede the onset of fever and is as same as the smallpox rashes (now eradicated) running through various stages in the form of vesicles, papules and pustules. People contract mpox through close contacts with infected individuals, including skin to skin, mouth to skin contact or even via talking and breathing, which release respiratory droplets. It can also be transmitted sexually, especially men to men or even during pregnancy from mother to child.”

Vaccine

Among the primary preventive measures that authorities should take and implement to keep mpox at bay or restrict it from further relapse is vaccination. There must be active immunisation programmes to dispense the shots to those affected and awareness drives to focus on contact tracing.

According to Prof. Rattan, “vaccine doses will protect individuals from contracting mpox.”

The two main vaccines considered for monkeypox are JYNNEOS and ACAM2000. It is approved by the FDA to safeguard individuals of 18 years and above who are denoted to be at high risk for mpox infection.”

“Given the limited supply of vaccines, accessibility of the same will initially be prioritised to curb a strong outbreak and this may include those who are in close physical contact with people already being infected with mpox as well as persons whose occupations might put them at an increased risk, including laboratory staff and healthcare workers,” highlights the medical expert.

Points to note

Symptoms usually last for two to four weeks or even longer in immunosuppressed individuals. While most people fully recover, some fall seriously sick.

Home Care

Most immunocompetent patients with mpox viral disease experience a mild infection and can recover from the comforts of their homes without any medical intervention. Domestic attention involves:

Covering skin lesions with clothing to reduce contact and transmission risks.

Avoid sharing personal items like clothes, towels and utensils.

Using disposable gloves for direct contact with lesions if caring for someone with mpox.

Maintaining good hygiene, such as frequent hand washing and wearing a well-fitting facemask around others.

Pain relief medications and stool softeners or sitz baths may be needed for specific symptoms like pain from proctitis.

It’s important to seek medical advice if symptoms worsen or if there are complications.

Dos & Don’ts

There is no approved antiviral treatment for mpox. The aim is to manage the rashes, and the associated pain and prevent the same.

The patient should quarantine himself immediately and stay in a separate and well-ventilated room

Should always wear a triple-layer mask as large respiratory droplets are a major route to transmit the infection

Direct contact with the patient’s clothes, bedding or items used by them should be avoided

Maintain good hand hygiene and wash hands frequently, especially after touching the sores

The skin should be kept dry and uncovered unless someone else is present in the room (when it should be covered)

Avoid scratching the sores or breaking the vesicles as this can spread the infection and cause secondary bacterial infection

Avoid shaving till the sores heal completely

Paracetamol can be taken for pain relief

Saltwater rinses can be used for mouth sores

Practise safe sex. Using condoms may reduce the risk of getting mpox but will not prevent it from spreading through skin-to-skin or mouth-to-skin contact

Getting an mpox vaccine can help prevent contracting the infection (pre-exposure prophylaxis). It is recommended for people at high risk of getting mpox, especially during an outbreak.