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Europe, US on alert over detection of Monkeypox cases: What is the virus, symptoms and its transmission across the globe

While the monkeypox virus does not spread easily among people, the cases in which transmission has occurred, has been generally through contact with the body fluids, blood, sores, and items that have been contaminated with fluids or sores of patients.

The US Centers for Disease Control (CDC) and Prevention along with the Massachusetts health officials recently confirmed the first human case of Monkeypox in the US. Few cases of the virus have also been reported in the United Kingdom, Portugal and Spain. Since its advent in the 20th century, the Monkeypox virus has emerged only in Africa and parts of the west due to migration, the recent rise in cases has raised a nascent alarm worldwide.

What is Monkeypox?

Monkeypox is a rare disease that is caused by infection with the monkeypox virus. It belongs to the same family of Orthopoxvirus viruses that also includes smallpox and cowpox viruses. In 1958, two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research in the Democratic republic of Congo. The Monkeypox virus was first discovered among these monkeys and thus derives its name from the same.

However, it was only in 1970 that the first human case of monkeypox was recorded in the Democratic Republic of the Congo (DRC). Since then, monkeypox has developed its transmittance among people in central and western African countries. The virus has seen a constant presence in Cameroon, the Central African Republic, Cote d’Ivoire, and the Democratic Republic of the Congo – which has reported the largest infections so far, apart from Gabon, Liberia, Nigeria, the Republic of the Congo, and Sierra Leone.

The main reason for the transmission of the disease outside Africa, according to the CDC, is international travel or the import of animals. This has led to the presence of Monkeypox cases in the US,  Israel, Singapore, and the United Kingdom. As of now, the original source of monkeypox virus culture is unknown. The researchers believe that African rodents and non-human primates like monkeys, squirrels and rats harbour the virus and infect humans as well.

What are the symptoms?

The primary symptom of Monkeypox is that the virus that causes visible bumpy rash or pox all over the body. Apart from the pox, Monkeypox can result into fever and severe body ache. Other symptoms include fever, headache, muscle rashes, swollen lymph nodes, chills and exhaustion.

Rashes in form of pox or blisters develop all over the body distinctively, that look like chickenpox or syphilis. The Rash often begins on the face and then spreads to other parts of the body including the genitals. The rash develops all over the body and goes through different stages. It finally develops into a sab and eventually falls off. Those infected with the virus show symptoms within five days and the infection generally lasts for 21 days. 

Infographic by Rafa Estrada: Singapore Ministry of Health

Fatality rate

The Monkeyvirus has two major strains, namely the fatal Congo strain with up to 10% mortality and the West African strain, which has a fatality rate of 1% in the total cases. The cases detected in the UK are of the West African strain. Australia is currently investigating its first case. Case fatality rates are found to be higher among children. WHO says that in certain recent incidents, case fatality rate has been found to be 3% to 6%.

The spread

The Monkeypox virus is contagious in a sense that it spreads through close contact. The preliminary causes from which the spread among humans was evident were spillovers from animal hosts and in between humans. While the monkeypox virus does not spread easily among people, the cases in which transmission has occurred, has been generally through contact with the body fluids, blood, monkeypox sores, and items that have been contaminated with fluids or sores of patients.

The Spread of Monkeypox. Source: Medicine Future

Scientists have observed that the virus can also spread through respiratory droplets following a prolonged physical contact. Thus, Monkeypox can enter the body through broken skin, respiratory tract, or through sensory organs like nose, eyes and mouth.

According to the UK Health Security Agency (UKHSA), people without symptoms of Monkeypox are not considered infectious. However, the agency had advised that on a precautionary basis, those who have been in close proximity of the infected patients should to ensure that if they become unwell with the primary symptoms, they should contact the doctor immediately.

The current situation

Today, Health officials in Massachusetts have detected a monkeypox infection in a man who has been hospitalized, but maintains a good condition. Reportedly, the infected man recently returned from Canada while his close contacts are already being traced. Amidst the growing outbreak of monkeypox worldwide, 14 confirmed cases have emerged from Europe so far across the UK, Spain and Portugal. Meanwhile, 24 others are also being probed for infection.

With the first confirmed case of Monkeypox in US, the health department has alerted the nation and is further investigating 6 other cases for the said infection. According to Dr Jennifer McQuiston, a senior official at USA’s CDC, a number of cases have been detected among gay and bisexual men considering the high probability of regular skin contact among the community.

“I think our concern is that given that you do have four cases among men who have sex with men, that we probably need to be thinking about messaging to our STI clinics, about what to be on the lookout for, what to be alert for,” McQuiston said. The CDC is individually monitoring more than 200 individuals for the virus in 27 states and other countries. While the US thinks its travel links with the UK has developed hidden transmission links, In Britain, only one case has travel links back to Nigeria which was the first case reported in the country.

As on May 16, the total tally of Monkeypox cases in the UK was seven. In Europe, Portugal itself has spotted five cases of the virus and is probing 15 cases. Infections in Portugal are found mostly among young men. The Health department in Spain is probing eight people of who all are either gay or bisexual men. Mateo Prochazka, an STI expert and head of UKHSA team has claimed the pattern of spread is highly suggestive of spread in sexual networks.

The Cure

Jynneos, a vaccine registered in the US has been licensed to prevent monkeypox infections in the country. Doctors have suggested that given the virus’ similarity to smallpox, the jabs and drugs against it are also effective.

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