Delhi records first Monkeypox case; Everything about the global public health emergency

Monkeypox is gradually spreading across India with Delhi being the latest state to report a case of the viral zoonosis. Overall, it is the fourth case in the country, with all the remaining cases being reported from Kerala.

Ironically, the Delhi-based man, a resident of Paschim Vihar locality in West Delhi, does not have a history of traveling abroad, unlike the remaining three cases from Kerala.

As per the media reports, the 34-year-old man had traveled to Himachal Pradesh with his male friends last month and on his return, he developed a fever. He ignored the symptoms initially thinking it was because of a change in weather.

When the fever did not subside for over a week and skin lesions started to develop at various places on his body, he consulted a doctor who referred him to Lok Nayak Hospital, which is the official center for isolating and managing the suspected and confirmed cases of monkeypox.

One of the contacts of the Delhi-based patient is also showing symptoms and has been asked to isolate himself. His other contacts have also been advised to closely monitor their symptoms and keep them away from crowded places.

As already described, monkeypox is a viral zoonosis, which means that this virus infects humans from animals. The symptoms of monkeypox are very similar to the signs of smallpox but according to research, it is less severe.

Monkeypox virus has two different genetic clades - the Central African and West African. Between the two of these, the Central African clade, also known as Congo Basin, produces more severe symptoms and is comparably more transmissible.

Monkeypox usually does not require any specialized treatment and lasts for up to two to four weeks. Over a period of time, the fatality rate has ranged from zero to 11 percent among general people. Young children are more prone to fatality due to the virus.

Recently, when monkeypox has been declared as a global health emergency, the fatality rate has been observed to be three to six percent.

Fever, rashes and headache have been the most apparent symptoms of monkeypox. These symptoms generally last for 3 weeks. It also presents itself with symptoms like sore throat, swollen lymph nodes and cough.

In one to three days of developing fever, the patient starts to develop skin lesions, which last for up to two to four weeks. These lesions are often painful until the healing phase begins when the patient experiences severe itching.

Monkeypox transmits from one human to another through large respiratory droplets. When a healthy person spends a long time in the presence of an infected person, he/she becomes susceptible to contract the virus. Transmission of this virus is also possible through exchange of body fluids or coming in contact with lesion material.

Touching or coming in contact with the clothes of an infected person may also result in transmission of the virus.

As this virus is transmitted from animals to humans, it can also transmit through a bite or scratch of small mammals like rats and squirrels and non-human primates like apes and monkeys. The transmission is also possible through bushmeat consumption of an infected animal.

WHO Director General Tedros Adhanom Ghebreyesus recently announced that monkeypox is a public health emergency of international concern. During his address to the world, he acknowledged that this virus is predominantly infecting men who have sex with men and have multiple sex partners. He also highlighted that this outbreak can be contained with correct strategies in the right groups.

A research published last Thursday in the New England Journal of Medicine highlighted that out of the 528 confirmed cases, a total of 95 percent cases were result of the transmission through sex and a total of 98 percent of infected people were either gay or bisexual men.

The Centers for Disease Control and Prevention (CDC) has laid out the following measures to prevent monkeypox. Have a look:

• Avoid getting in skin-to-skin contact with people who appear to have rashes resembling monkeypox
• Avoid touching the rash or scabs on anyone's skin
• Do not kiss, cuddle or have intercourse with a person suffering from monkeypox
• Do not eat in the same utensils with a person suffering from monkeypox
• Do not touch the clothes or bed sheets used by a monkeypox patient
• Frequently wash your hands or use an alcohol-based hand sanitizer
• Stay away from animals who can potentially transmit monkeypox (rodents and primates)
• Avoid touching the surfaces where a dead animal has been
• Measures to take after contracting Monkeypox
• CDC recommends, if you have a suspicion that you have contracted monkeypox, you should immediately isolate yourself in a confined place. You should not come in contact with your family, friends or pets at all.

CDC also recommends people to go for vaccination if they have been exposed to monkeypox or are at a higher risk of contracting the virus. Here are the guidelines on who should go for monkeypox vaccination -

• You should consider going for vaccination if you have come in close contact with a person diagnosed with monkeypox
• You should consider going for the vaccination if your sexual partner in the past two weeks has been diagnosed with monkeypox
• You should go for the vaccination if you have had multiple sexual partners in the past two weeks in an area where multiple monkeypox cases have been detected
• People whose jobs may have exposed them to orthopoxviruses, such as:
  • Lab worker who has to run tests for orthopoxviruses
  • Lab workers handling cultures or animals having orthopoxviruses
  • The designated healthcare or public health workers

Unfortunately, the scientists are yet to find out a specific treatment for monkeypox. Hence, the best way to get over the disease is by isolating yourself in a room and cutting down all contact with people and pets.

However, the United States Food and Drug Administration (US FDA) had approved Tpoxx (tecovirimat) in the year 2018 for the treatment of smallpox, which is a close relative of monkeypox.

Hence, the CDC has approved the antiviral drug to be used as an investigational drug against monkeypox. It is worth mentioning that Tpoxx is manufactured by SIGA Technologies, an American Pharmaceutical company.

The first case of monkeypox was recorded in humans way back in 1970 in the Democratic Republic of Congo. Most of the cases have been reported from the rural and rainforest regions of the Congo Basin. Most of the human cases have been recorded in Central and West Africa.

Ever since 1970, 11 African countries have reported monkeypox cases. The virus was first recorded outside Africa in the United States back in 2003, which went on to infect a total of 70 people.

Monkeypox has also been reported in countries like Israel, the United Kingdom and Singapore at different times.

In May 2022, Monkeypox spread into several non-endemic countries. In a total of 75 countries across the world, over 16,000 cases of the virus have been reported so far. The death toll due to the outbreak has reached five globally.