Health Science: Don’t Let Monkeypox Play Tricks on You

What is Monkeypox

Monkeypox is a zoonosis caused by infection with the monkeypox virus (MPXV). In September 2022, my country reported its first imported case of monkeypox. Since June 2023, multiple provinces in my country have reported multiple cases of monkeypox, posing a high risk of new local secondary outbreaks and hidden transmission.

Epidemiological characteristics

1. Source of infection

The source of infection includes monkeypox cases and infected rodents, monkeys, apes and other primates. The host of the monkeypox virus is still unclear, and it is currently believed that African rodents (African squirrels, tree squirrels, Gambian kangaroos, dormice, etc.) may be its natural hosts.

2. Transmission channels

Monkeypox virus mainly invades the human body through mucous membranes and broken skin, and is transmitted by direct contact with the diseased skin or mucous membranes of cases. It can also be transmitted by contact with virus-contaminated objects, long-term close-range inhalation of respiratory droplets from cases, contact with respiratory secretions, disease exudates, blood and other body fluids of infected animals, or infection by bites or scratches from infected animals.

3. Susceptible population

The general population is susceptible. People who have been vaccinated with smallpox vaccine have a certain degree of cross protection against monkeypox virus.

4. Epidemic characteristics

Before 2021, monkeypox was endemic in Central and West Africa, mainly through contact with infected animals. The human-to-human transmission chain was short, mainly sporadic cases and clusters among children and young adults, occasionally spreading to other countries and regions through family or travel. Since May 2022, the outbreak in many countries around the world has mainly spread through sexual contact among men who have sex with men (MSM, referring to men who have sex with the same sex). Most cases are young men, and the disease has spread through large gatherings and subsequent MSM in the community, and has spread to many countries and regions around the world.

Incubation period

Incubation period: 5-21 days, usually 6-13 days.

Contagious period

The patient is contagious from the time symptoms appear until the rash crusts fall off naturally and new skin forms. Investigations have suggested that some patients may be contagious 1-4 days before symptoms appear.

Early symptoms

Fever, headache, back pain, myalgia, and lymphadenopathy may occur.

Skin and mucous membrane rashes

It usually appears after the fever subsides, and in some cases it may appear before systemic symptoms. The rash often develops through several stages, including macules, papules, blisters, pustules, crusting, and shedding of the crust. Different forms of rashes may exist at the same time, and may be accompanied by obvious itching and pain. It may affect the oral and pharyngeal mucosa, anus, genitals, conjunctiva, and cornea. After the crust falls off, erythema or pigmentation or even scars may remain, and the scars may last for several years.

Disease course and severity

The course of monkeypox is about 2-4 weeks, and the course of the disease may be longer in patients with weakened immunity. Monkeypox is a self-limiting disease, and the symptoms of most cases will disappear on their own. Severe cases and deaths have also occurred, mainly in children, pregnant women and people with weakened immunity. In the monkeypox outbreaks in many countries around the world since 2022, most cases have mild clinical manifestations, some cases have no systemic symptoms, and the rash is limited to the genitals and anorectal mucosa. The deaths are mainly in people with weakened immunity such as untreated HIV-infected people. Since 2022, the mortality rate of cases in non-endemic areas around the world has been about 0.1%.

Precautions

1. Reduce the risk of monkeypox infection by limiting close contact with people suspected or confirmed to have monkeypox or with animals that may be infected with monkeypox.

2. Regularly clean and disinfect environments that may be contaminated by viruses carried by infectious people.

3. Be aware of monkeypox outbreaks in your area and talk openly with those you have had close contact with (especially sexual contact) about any symptoms you or they may have.

4. If you think you may have monkeypox, seek medical attention and isolate yourself from others until the evaluation and test results are known to protect others.

5. If you may have monkeypox or have been diagnosed with it, you should isolate yourself from other people until all your lesions have scabbed over and fallen off, and a new layer of skin has grown underneath. This will prevent you from spreading the virus to others.

6. Until more is known about the sexual transmission of monkeypox, condoms should be used as a preventive measure during sexual contact within 12 weeks after recovery.

Kind tips

Although monkeypox virus is currently circulating mainly in certain populations

However, there is still a risk of spread to the general population

Monkeypox virus is the common enemy of all mankind

May we overcome prejudice

Enhance protection awareness

Take care of yourself

Be kind to others