Advisory for prevention of monkeypox

Islamabad:The Office of the District Health Office Islamabad has issued an advisory for prevention of monkeypox, a viral disease that can cause a wide range of symptoms, ranging from mild to severe.

The advisory explains that monkeypox is characterized by a severe rash and transmitted from animals to humans, and occasionally from human-to-human. In the light of recent reports of monkeypox cases in Islamabad, the Health Department Islamabad urged the general public to adopt emergency preventive measures to control progression of the disease.

According to District Health Officer Islamabad Dr. Muhammad Zaeem Zia, monkeypox is primarily a zoonotic disease, transmitted from animals to humans. The disease is endemic in certain parts of Central and West Africa, where it is typically transmitted to humans through the bites, scratches, consumption of infected bushmeat or through contact with infected animals. The natural reservoir of the virus is not known but various small mammals such as squirrels and monkeys are susceptible.

The advisory states that human-to-human transmission of monkeypox can also occur, particularly through close contact (talking, breathing, touching) with infected individuals. This can occur through respiratory droplets or contact with skin lesions. The virus can also be transmitted through contact with contaminated clothing or bedding. The risk of transmission can be reduced through basic infection control measures, such as isolation of infected individuals, use of personal protective equipment, and proper hand hygiene.

According to the advisory issued, a suspected monkeypox case may be “an acute illness with fever over 38 degree centigrade, intense headache, lymphadenopathy (swelling of lymph nodes), back pain, myalgia (muscular pains), and intense fatigue followed one to three days later by a progressively developing rash on the face and spreading to the body, palms of hands and soles of feet.”

On clinical features, the advisory explains the most common symptoms include fever, sore throat, headache, muscle aches, back pain, low energy, swollen lymph nodes, and a rash that starts as a flat sore and develops into a blister filled with liquid, which may be itchy or painful. The rash can appear anywhere on the body and can range from a few to hundreds of lesions.

The rash evolves over a period of 2-4 weeks, with lesions progressing from macules to papules, vesicles, and pustules before crusting over and falling off. Swollen lymph nodes are a hallmark symptom of monkeypox. In some cases, individuals can be infected with mpox without displaying any symptoms.

According to Dr. Zaeem, the clinical features of monkeypox can overlap with those of other viral diseases, and that laboratory testing is needed to confirm the diagnosis. Individuals who suspect that they may have monkeypox should seek medical attention promptly, states the advisory.

Anyone can potentially become infected with monkeypox if they are exposed to the virus. However, certain groups of people may be at increased risk of infection or severe disease. People living or working in areas where monkeypox is endemic, hunters and bushmeat (meat from wild animals) consumers, healthcare workers and household members of active cases, immunocompromised individuals (weakened immune systems, such as those with HIV/AIDS or those undergoing chemotherapy) and travellers to areas where monkeypox is endemic are at greater risk of contracting the infection.

The advisory further states the incubation period of monkeypox is usually 6-13 days but can range from 5 to 21 days. Treatment for monkeypox is mainly supportive. The illness is usually mild and most of those infected will recover within a few weeks without treatment. Treatment is focused on relieving symptoms and preventing complications. Some of the supportive measures that may be used to treat patients with monkeypox include pain relief medications like paracetamol (acetaminophen) or ibuprofen to relieve fever, headache, and muscle pain. Patients with monkeypox may become dehydrated due to fever, sweating, and reduced fluid intake. Rehydration with fluids (orally or intravenously) may be necessary. Lesions should be

kept clean and covered to prevent secondary bacterial infection. Antibiotics may be necessary if a secondary bacterial infection occurs. Patients with severe respiratory symptoms may require supplemental oxygen or mechanical ventilation, states the advisory.

It is important for patients with suspected or confirmed monkeypox to be isolated to prevent transmission of the virus to others. Healthcare workers caring for patients or handling specimens should wash hands (before/after patient care, touching surroundings), use personal protective equipment, including gloves, gowns, masks, and eye protection, when caring for patients with monkeypox and ensure proper waste disposal and environmental decontamination to reduce the risk of transmission.

The advisory states that immunity against monkeypox is primarily acquired through previous infection with the virus or vaccination with the smallpox vaccine, which provides some cross-protection against monkeypox. People who have been previously infected with monkeypox are generally believed to have lifelong immunity.

Monkeypox is self-limiting but can lead to severe illness or death. Complications can arise for children, pregnant women, and those with weakened immune systems. Some of the potential complications of monkeypox include secondary bacterial infections, eye infections, neurological complications and pneumonia, which can be life-threatening. Surveillance and early detection of monkeypox cases can help prevent the spread of the virus and facilitate prompt treatment of infected individuals.