Time to create awareness about disease, preventive measures

Islamabad:Confirmation of cases of monkeypox (mpox) from at least two countries outside of Africa including Pakistan and Sweden last week has raised concerns around the globe particularly the appearance of cases outside of Africa days after the World Health Organization has declared the virus a public health emergency.

Studies reveal that a relatively new strain of the virus has been hitting the population hard since 2022 in African countries and tens of thousands of patients this year have been reported from Democratic Republic of Congo where people are facing the biggest outbreak of the disease ever recorded. The cases of mpox have so far been reported from at least 13 countries in Africa where the disease has claimed a number lives as well. Health experts here in the twin cities of Islamabad and Rawalpindi are of the view that the situation in Pakistan is still well under control however they believe that it is time to create awareness among public about various aspects of the disease including preventive and control measures.

Mpox is primarily a zoonotic disease, transmitted from animals to humans but human-to-human transmission can also occur, particularly through close contact (talking, breathing, touching) with infected individuals. This can occur through respiratory droplets or contact with skin lesions or secretions of an infected person. 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.

Studies reveal that mpox belongs to Orthopoxvirus genus from a family of Poxviridae, the same genus includes variola, cowpox and vaccinia viruses. Variola virus is responsible for smallpox infection, vaccinia virus is used in the preparation of smallpox vaccine thus, showing a close association of monkeypox with smallpox. The virus that enters the human body through skin or the airways causes flu like symptoms and then lesions on the skin.

The duration of occurrence of symptoms ranges from five to 28 days in general. The clinical symptoms are considered to be less severe than smallpox. They include fever, headache, muscle aches, backache, swollen lymph nodes, chills, exhaustion and rash. The rash can appear on the face, genitals, palms, soles of the feet and elsewhere on the body. The specific lesion can range from a flat, raised or pus-filled one, mimicking herpes, syphilis or chickenpox.

In most of the cases, a rash 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. Experts say that swollen lymph nodes are a hallmark symptom of monkeypox. In some cases, individuals can be infected with mpox without displaying any symptoms.

Experts say that the clinical features of mpox can overlap with those of other viral diseases, and laboratory testing is needed to confirm its diagnosis. Individuals who suspect that they may have monkeypox should seek medical attention promptly.

It is important that rodents and monkeys are associated with the spread of the infection. Mpox virus was first identified in 1958 amongst the colonies of monkeys kept for research purposes and at the time of transfer from Singapore to Denmark. In 1970 the cases were initially found in Democratic Republic of Congo, Central and West Africa, Europe and then involved many regions of the world. The cases were mostly identified in travellers or amongst the imported animals.

Mpox is usually self-limiting but may be severe in some individuals, such as children, pregnant women or persons with weak immune system due to other health conditions.