The spread of monkeypox has become a major health threat after the head of the World Health Organization on Saturday declared the highest level of alert in an attempt to contain the disease, analyzing the symptoms of the disease, which has more than 16,000 reported cases, as well as methods for diagnosing, treating and vaccinating against it.
Symptoms
High fever, headache, severe muscle pain, unusual fatigue, swollen lymph nodes, and pain in the jaw, neck, or groin appear early in the disease. In the second stage, rashes appear on the skin and mucous membranes of the whole body.
In the current wave of monkeypox, the areas around the genitals are often affected, as are the areas around the anus and mouth. Damage sometimes precedes the manifestation of the disease in the lymph nodes, fever, fatigue, and pain recall WHO.
In different cases of the disease, the symptoms vary. After a few days or weeks, the rash forms crusts, which eventually fall off, and the lesions disappear. The disease is contagious throughout the illness.
Diagnostics
Monkeypox is a possible diagnosis when exposed to the virus within three weeks of contact with a confirmed or suspected case, when returning from an African country where the virus is endemic, or when having multiple sexual partners.
In the current wave, centered in Europe, the majority of those affected are men who have sex with men, mostly young and predominantly urban, according to the World Health Organization.
Diagnosis can be difficult because in some cases there are no usual symptoms, and the disease resembles some sexually transmitted infections, various health authorities warn.
The medical examiner first rules out other conditions that lead to skin rashes, such as chickenpox, palmar nail disease, herpes zoster, smallpox, bacterial skin infections, scabies, syphilis, herpes, or a skin allergic reaction.
Confirmation of the diagnosis of monkeypox requires testing, most commonly with a PCR test. A skin sample (biopsy or swab from vesicles) and/or a nasopharyngeal sample (in patients with manifestation in the mouth or pharynx) are taken more rarely.
The person must self-isolate while waiting for the test result. In the case of a confirmed positive result, isolation for three weeks is recommended.
It is not yet known whether the virus can be transmitted through semen, and if so, how often. As a precautionary measure, the European Center for Disease Prevention and Control recommends using a condom for twelve weeks after recovery.
Treatment
Monkeypox resolves on its own within two to three, and sometimes four weeks. Often, the only treatment for symptoms such as fever or itching is needed.
In some cases, the lesions are too painful, as many patients testify, which can lead to painkillers and even hospitalization.
Experts advise not to injure the lesions to avoid further spread of the virus throughout the body or leaving scars. It is advisable to cover the lesions to reduce the risks.
In some people, the disease may progress to superinfection of skin lesions, as well as respiratory, digestive, ocular, or neurological problems.
If necessary, treatment with antiviral drugs is prescribed, for example, Tekovirimat, which is mainly used for smallpox.
Severe cases are more common in children, pregnant women, and immunosuppressed people. To date, no deaths have been reported in either Europe or the United States.
Vaccine
The third-generation smallpox vaccine from the Danish company Bavarian Nordic (Imvanex or Geneos, a live vaccine that does not multiply in humans) can be administered to adults, including medical personnel, after exposure to a risk group, and also as a preventive measure.
If the vaccine is given within four days of exposure to the virus, it can have an important protective effect, according to the European Center for Disease Prevention and Control. The European Commission yesterday approved the extension of the use of one of these vaccines also against monkeypox.
In some countries (USA, UK, Canada, and France), preventive vaccination is offered to groups of people more at risk of contracting the virus, including men who have sex with other men. Thousands of people have already been vaccinated in New York.
Vaccination is carried out in two doses with an interval of at least 28 days. For persons vaccinated against smallpox in childhood, one dose is sufficient. In case of low immunity, a third dose is also recommended.