This document provides an overview of monkeypox, including:
1) It describes monkeypox as a rare viral disease caused by infection with the monkeypox virus, with symptoms similar to smallpox but typically milder.
2) Outbreaks of monkeypox have primarily occurred in central and western Africa, though some cases have been reported in other parts of the world through international travel or imported animals.
3) Transmission occurs through direct contact with infected animals like rodents or non-human primates, or close contact between humans.
4) Symptoms include fever, headache, rash, and lesions that may cover the entire body. Most cases resolve within a few weeks
Monkeypox is derived from the genus Orthopoxvirus from the family Poxividae. This
genus has two kinds of viruses: smallpox and monkeypox virus. Monkeypox is a
zoonotic disease (spread from animal to human or vice versa) and was initially
diagnosed with pox-like symptoms on colonies of monkeys kept for research in 1958,
hence the name monkeypox. At the time of the elimination of smallpox in 1970,
monkeypox in humans was first identified in the Democratic Republic of Congo and
later in Central and Western African countries.1,2 In 2019, a newer vaccinia vaccine
was approved to prevent the disease. Furthermore, investigations are still carried out
on the same.
Animal-to-human (zoonotic) transmission can occur from direct contact with
infected animals' blood, bodily fluids, or cutaneous or mucosal lesions. In Africa,
evidence of monkeypox virus infection has been found in many animals, including
rope squirrels, tree squirrels, Gambian pouched rats, dormice, different species of
monkeys, and others. It was also found that eating improperly/half-cooked meat is
also a cause. The disease spread outside Africa by infected travellers and imported
infected animals. In 2018-2019, cases of monkeypox were confirmed in travellers
from Nigeria, Singapore, the United Kingdom, and Israel. Human-to-human
transmission can result from close contact with respiratory secretions and lesions of
the skin.3
Risk groups include people with severe illnesses who require hospitalization or an
immune-compromised person (HIV, leukaemia, etc); patients with comorbidities, a
pediatric population less than eight years old, and pregnant or breastfeeding women.2
The incubation period is generally 6-13 days, but it can range from 5-21 days. The
disease progression has two phases: The invasive phase (0-5 days), characterized by
headache, fever, back pain, myalgia, fatigue and lymphadenopathy. The rash
appearing phase (1-3 days) begins after the onset of the first phase and is
characterized by the appearance of rashes on the face and then spreads up to the
trunk and limbs of the body. Rashes evolve from macules (flat base lesions) to papules
(firm lesions), then vesicles (clear fluid- filled lesions), and finally postulates
(yellowish fluid-filled lesions) and crusts. It affects the face (in 95% of cases), palms
of the hands, and soles of the feet (in 75% of cases). Also affected were oral mucous
membranes (in 70% of cases), genitalia (30%), conjunctivae (20%), as well as cornea.
Complications of monkeypox include pneumonitis, encephalitis, sight-threatening
keratitis, and secondary bacterial infections.3,4
🔥HOT TOPIC🔥
Sharing my PowerPoint slides on 🐵 MONKEYPOX🐵
(a potential/sure shot question for MD exam)
This can be used for a 2 hour session of PG seminar since all the aspects of the disease are covered.
It includes a compilation of;
1. Infectious history (in detail)
2. Epidemiology (Global, local)
3. Case definitions
4. Clinical features
5. Differential diagnosis (including comparison with common DDs)
6. Complications
7. Investigations
8. Management
9. Vaccines
10. Other specific preventive measures
Share among Community Medicine residents for maximum reach and benefits...😊
Monkeypox is derived from the genus Orthopoxvirus from the family Poxividae. This
genus has two kinds of viruses: smallpox and monkeypox virus. Monkeypox is a
zoonotic disease (spread from animal to human or vice versa) and was initially
diagnosed with pox-like symptoms on colonies of monkeys kept for research in 1958,
hence the name monkeypox. At the time of the elimination of smallpox in 1970,
monkeypox in humans was first identified in the Democratic Republic of Congo and
later in Central and Western African countries.1,2 In 2019, a newer vaccinia vaccine
was approved to prevent the disease. Furthermore, investigations are still carried out
on the same.
Animal-to-human (zoonotic) transmission can occur from direct contact with
infected animals' blood, bodily fluids, or cutaneous or mucosal lesions. In Africa,
evidence of monkeypox virus infection has been found in many animals, including
rope squirrels, tree squirrels, Gambian pouched rats, dormice, different species of
monkeys, and others. It was also found that eating improperly/half-cooked meat is
also a cause. The disease spread outside Africa by infected travellers and imported
infected animals. In 2018-2019, cases of monkeypox were confirmed in travellers
from Nigeria, Singapore, the United Kingdom, and Israel. Human-to-human
transmission can result from close contact with respiratory secretions and lesions of
the skin.3
Risk groups include people with severe illnesses who require hospitalization or an
immune-compromised person (HIV, leukaemia, etc); patients with comorbidities, a
pediatric population less than eight years old, and pregnant or breastfeeding women.2
The incubation period is generally 6-13 days, but it can range from 5-21 days. The
disease progression has two phases: The invasive phase (0-5 days), characterized by
headache, fever, back pain, myalgia, fatigue and lymphadenopathy. The rash
appearing phase (1-3 days) begins after the onset of the first phase and is
characterized by the appearance of rashes on the face and then spreads up to the
trunk and limbs of the body. Rashes evolve from macules (flat base lesions) to papules
(firm lesions), then vesicles (clear fluid- filled lesions), and finally postulates
(yellowish fluid-filled lesions) and crusts. It affects the face (in 95% of cases), palms
of the hands, and soles of the feet (in 75% of cases). Also affected were oral mucous
membranes (in 70% of cases), genitalia (30%), conjunctivae (20%), as well as cornea.
Complications of monkeypox include pneumonitis, encephalitis, sight-threatening
keratitis, and secondary bacterial infections.3,4
🔥HOT TOPIC🔥
Sharing my PowerPoint slides on 🐵 MONKEYPOX🐵
(a potential/sure shot question for MD exam)
This can be used for a 2 hour session of PG seminar since all the aspects of the disease are covered.
It includes a compilation of;
1. Infectious history (in detail)
2. Epidemiology (Global, local)
3. Case definitions
4. Clinical features
5. Differential diagnosis (including comparison with common DDs)
6. Complications
7. Investigations
8. Management
9. Vaccines
10. Other specific preventive measures
Share among Community Medicine residents for maximum reach and benefits...😊
Ectoparasites on genitalia in this Era - a study at tertiary care center in T...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A lecture by Dr. Naya Hassan about Monkeybox; which is a viral zoonotic infection that results in a rash similar to smallpox and started to spread around the world since May 2022.
An overview on Monkeypox, Current Paradigms and Advances in its Vaccination, ...Dr Varruchi Sharma
Monkeypox virus is an orthopoxvirus sharing the common genus with variola and vaccinia virus. Most of the monkeypox (MPX) cases had been reported from the central and west African region (the main endemic areas) prior to 2022 but there was a sudden outbreak in May, 2022 disseminating the infections to thousands of people even in non-endemic countries, posing a global public health emergency. MPX was considered a rae and neglected disease, however the 2022 MPX outbreaks in multiple countries attracted attention of worldwide researchers to pace up for carrying out researches on various aspects of MPXV including attempts to design and develop diagnostics, vaccines, drugs and therapeutics counteract MPX. Apart from being a zoonotic disease, the current outbreaks highlighted rapid human-to-human transmission of MPXV, besides the reverse zoonosis has also been documented with recent first report of human-to-dog transmission, urging a call for the importance of one health approach. Atypical and unusual disease manifestations as well asymptomatic MPXV infections have also been observed during 2022 MPX outbreak. the affected patients typically develop a rash resulting in a mild disease followed by recovery with some supportive care and use of antivirals such as tecovirimat, cidofovir and brincidofovir in severe disease cases. Modified vaccinia Ankara (MVA) vaccine with an excellent safety profile has been recommended to patients with higher risk exposure and immunocompromised individuals. Moreover, another vaccine the replication-competent vaccine (ACAM2000) could be a suitable alternative to MVA’s non-availability to some selective immunocompetent individuals. Current review highlights the salient aspects of management and treatment of monkeypox along with underlying promises in terms of therapeutics and a variety of challenges posed due to current global public health emergency situation to counteract MPX.
Furuncularmyiasis in a Child Caused by Flesh Fly (Wohlfahrtia magnifica) and ...inventionjournals
We report the case of a two-year-old boy with hyper eosinophilia who presented with a swelling on his left scapular that had persisted for more than three weeks. A second-stage larva of Wohlfahrtia magnifica was found with associated bacterial organisms such as Proteus vulgaris, Staphylococcus aureus and Staphylococcus epidermidis, leading to the diagnosis of cutaneous myiasis. Following removal of the larva and secondary bacterial therapy, the clinical and hematological manifestations returned to normal. Diagnosis of myiasis and associated secondary infections should always be kept in mind in the event of clinical signs of furuncular lesions, pain, fever, exudation which may be accompanied by eosinophilia.
Decoding the Monkeypox Virus : From Discovery to PreventionSindhBiotech
This lecture is presented by our volunteer Sajid Ali Shah, he is from Islamabad, Pakistan, and he is covering the topic Decoding the Monkeypox Virus : From Discovery to Prevention.
For video: https://youtu.be/-RT2UvTerBc
human settlements/communities increased the possibility of a disease infecting many people at a time in a geographical area i.e known as an epidemic. And with time as communities mingled with each other either for trade, war, etc. they spread the diseases to new location fueling the pandemic.
Ectoparasites on genitalia in this Era - a study at tertiary care center in T...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A lecture by Dr. Naya Hassan about Monkeybox; which is a viral zoonotic infection that results in a rash similar to smallpox and started to spread around the world since May 2022.
An overview on Monkeypox, Current Paradigms and Advances in its Vaccination, ...Dr Varruchi Sharma
Monkeypox virus is an orthopoxvirus sharing the common genus with variola and vaccinia virus. Most of the monkeypox (MPX) cases had been reported from the central and west African region (the main endemic areas) prior to 2022 but there was a sudden outbreak in May, 2022 disseminating the infections to thousands of people even in non-endemic countries, posing a global public health emergency. MPX was considered a rae and neglected disease, however the 2022 MPX outbreaks in multiple countries attracted attention of worldwide researchers to pace up for carrying out researches on various aspects of MPXV including attempts to design and develop diagnostics, vaccines, drugs and therapeutics counteract MPX. Apart from being a zoonotic disease, the current outbreaks highlighted rapid human-to-human transmission of MPXV, besides the reverse zoonosis has also been documented with recent first report of human-to-dog transmission, urging a call for the importance of one health approach. Atypical and unusual disease manifestations as well asymptomatic MPXV infections have also been observed during 2022 MPX outbreak. the affected patients typically develop a rash resulting in a mild disease followed by recovery with some supportive care and use of antivirals such as tecovirimat, cidofovir and brincidofovir in severe disease cases. Modified vaccinia Ankara (MVA) vaccine with an excellent safety profile has been recommended to patients with higher risk exposure and immunocompromised individuals. Moreover, another vaccine the replication-competent vaccine (ACAM2000) could be a suitable alternative to MVA’s non-availability to some selective immunocompetent individuals. Current review highlights the salient aspects of management and treatment of monkeypox along with underlying promises in terms of therapeutics and a variety of challenges posed due to current global public health emergency situation to counteract MPX.
Furuncularmyiasis in a Child Caused by Flesh Fly (Wohlfahrtia magnifica) and ...inventionjournals
We report the case of a two-year-old boy with hyper eosinophilia who presented with a swelling on his left scapular that had persisted for more than three weeks. A second-stage larva of Wohlfahrtia magnifica was found with associated bacterial organisms such as Proteus vulgaris, Staphylococcus aureus and Staphylococcus epidermidis, leading to the diagnosis of cutaneous myiasis. Following removal of the larva and secondary bacterial therapy, the clinical and hematological manifestations returned to normal. Diagnosis of myiasis and associated secondary infections should always be kept in mind in the event of clinical signs of furuncular lesions, pain, fever, exudation which may be accompanied by eosinophilia.
Decoding the Monkeypox Virus : From Discovery to PreventionSindhBiotech
This lecture is presented by our volunteer Sajid Ali Shah, he is from Islamabad, Pakistan, and he is covering the topic Decoding the Monkeypox Virus : From Discovery to Prevention.
For video: https://youtu.be/-RT2UvTerBc
human settlements/communities increased the possibility of a disease infecting many people at a time in a geographical area i.e known as an epidemic. And with time as communities mingled with each other either for trade, war, etc. they spread the diseases to new location fueling the pandemic.
Similar to Aniket Bide practice school presentation (20)
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Francesca Gottschalk - How can education support child empowerment.pptx
Aniket Bide practice school presentation
1. Dr.Babasaheb Ambedkar Technological University
डॉ. बाबासाहेब आंबेडकर तंत्रशास्त्र विद्यापीठ
Lonere-402103 Tal- Mangaon, Dist- Raigad (M.S.) India.
MAHAVIR INSTITUTE OF PHARMACY
DTE CODE-5281
D.Pharmacy B.pharmacy
Approved by AICTC, PCI New Delhi, DTE, Govt. of Maharashtra
Affiliated to MSBTE, Mumbai, DBATU, Lonere
6. Introduction
Monkeypox is a rare disease caused by infection with the monkeypox virus.
MPX is a zoonosis caused by the MPX virus (MPXV), which is one of the Orthopoxvirus species.
Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox.
Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal.
7. Monkeypox is not related to chickenpox. Monkeypox is a viral zoonosis (a virus transmitted to humans
from animals) with symptoms similar to those seen in the past in smallpox patients, although it is
clinically less severe. With the eradication of smallpox in 1980 and subsequent cessation of smallpox
vaccination, monkeypox has emerged as the most important orthopoxvirus for public health. Monkeypox
primarily occurs in central and west Africa, often in proximity to tropical rainforests, and has been
increasingly appearing in urban areas. Animal hosts include a range of rodents and non-human primates
8. The pathogen:
Monkeypox virus is an enveloped double-stranded DNA virus that belongs to
the Orthopoxvirus genus of the Poxviridae family. There are two distinct genetic clades of the
monkeypox virus: the central African (Congo Basin) clade and the west African clade. The Congo
Basin clade has historically caused more severe disease and was thought to be more transmissible.
The geographical division between the two clades has so far been in Cameroon, the only country
where both virus clades have been found.
Natural host of monkeypox virus:
Various animal species have been identified as susceptible to monkeypox virus. This includes rope
squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates and other species.
Uncertainty remains on the natural history of monkeypox virus and further studies are needed to
identify the exact reservoir(s) and how virus circulation is maintained in nature.
9. Outbreaks
Human monkeypox was first identified in humans in 1970 in the Democratic Republic of the Congo in
a 9-month-old boy in a region where smallpox had been eliminated in 1968. Since then, most cases
have been reported from rural, rainforest regions of the Congo Basin, particularly in the Democratic
Republic of the Congo and human cases have increasingly been reported from across central and west
Africa.
10. Since 1970, human cases of monkeypox have been reported in 11 African countries: Benin, Cameroon, the
Central African Republic, the Democratic Republic of the Congo, Gabon, Cote d’Ivoire, Liberia, Nigeria, the
Republic of the Congo, Sierra Leone and South Sudan. The true burden of monkeypox is not known. For
example, in 1996–97, an outbreak was reported in the Democratic Republic of the Congo with a lower case
fatality ratio and a higher attack rate than usual.
11. Continue..
A concurrent outbreak of chickenpox (caused by the varicella virus, which is not an orthopoxvirus) and
monkeypox was found, which could explain real or apparent changes in transmission dynamics in this case.
Since 2017, Nigeria has experienced a large outbreak, with over 500 suspected cases and over 200
confirmed cases and a case fatality ratio of approximately 3%. Cases continue to be reported until today.
Monkeypox is a disease of global public health importance as it not only affects countries in west and
central Africa, but the rest of the world. In 2003, the first monkeypox outbreak outside of Africa was in the
United States of America and was linked to contact with infected pet prairie dogs.
12. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country
from Ghana. This outbreak led to over 70 cases of monkeypox in the U.S. Monkeypox has also been reported in
travelers from Nigeria to Israel in September 2018, to the United Kingdom in September 2018, December 2019,
May 2021 and May 2022, to Singapore in May 2019, and to the United States of America in July and November
2021. In May 2022, multiple cases of monkeypox were identified in several non-endemic countries. Studies are
currently underway to further understand the epidemiology, sources of infection, and transmission patterns.
Continue..
13. Transmission
Animal-to-human (zoonotic) transmission can occur from direct contact with the blood, bodily fluids, or
cutaneous or mucosal lesions of infected animals. In Africa, evidence of monkeypox virus infection has
been found in many animals including rope squirrels, tree squirrels, Gambian pouched rats, dormice,
different species of monkeys and others. The natural reservoir of monkeypox has not yet been identified,
though rodents are the most likely. Eating inadequately cooked meat and other animal products of infected
animals is a possible risk factor. People living in or near forested areas may have indirect or low-level
exposure to infected animals.
Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an
infected person or recently contaminated objects.
14. Transmission via droplet respiratory particles usually requires prolonged face-to-face contact, which puts health
workers, household members and other close contacts of active cases at greater risk. However, the longest
documented chain of transmission in a community has risen in recent years from 6 to 9 successive person-to-
person infections. This may reflect declining immunity in all communities due to cessation of smallpox
vaccination. Transmission can also occur via the placenta from mother to fetus (which can lead to congenital
monkeypox) or during close contact during and after birth. While close physical contact is a well-known risk
factor for transmission, it is unclear at this time if monkeypox can be transmitted specifically through sexual
transmission routes. Studies are needed to better understand this risk.
Continue..
15. Signs and symptoms:
The incubation period (interval from infection to onset of symptoms) of
monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.
The infection can be divided into two periods:
The invasion period (lasts between 0–5 days) characterized by fever, intense
headache, lymphadenopathy (swelling of the lymph nodes), back pain,
myalgia (muscle aches) and intense asthenia (lack of energy).
Lymphadenopathy is a distinctive feature of monkeypox compared to other
diseases that may initially appear similar (chickenpox, measles, smallpox).
16. The skin eruption usually begins within 1–3 days of appearance of fever. The rash tends to be
more concentrated on the face and extremities rather than on the trunk. It affects the face (in 95%
of cases), and palms of the hands and soles of the feet (in 75% of cases). Also affected are oral
mucous membranes (in 70% of cases), genitalia (30%), and conjunctivae (20%), as well as the
cornea. The rash evolves sequentially from macules (lesions with a flat base) to papules (slightly
raised firm lesions), vesicles (lesions filled with clear fluid), pustules (lesions filled with yellowish
fluid), and crusts which dry up and fall off. The number of lesions varies from a few to several
thousand. In severe cases, lesions can coalesce until large sections of skin slough off.
17. Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases
occur more commonly among children and are related to the extent of virus exposure, patient health
status and nature of complications. Underlying immune deficiencies may lead to worse outcomes.
Although vaccination against smallpox was protective in the past, today persons younger than 40 to 50
years of age (depending on the country) may be more susceptible to monkeypox due to cessation of
smallpox vaccination campaigns globally after eradication of the disease. Complications of monkeypox
can include secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea
with ensuing loss of vision. The extent to which asymptomatic infection may occur is unknown.
The case fatality ratio of monkeypox has historically ranged from 0 to 11 % in the general population
and has been higher among young children. In recent times, the case fatality ratio has been around 3–6%.
18. Therapeutics
Clinical care for monkeypox should be fully optimized to alleviate symptoms, manage complications and
prevent long-term sequelae. Patients should be offered fluids and food to maintain adequate nutritional status.
Secondary bacterial infections should be treated as indicated. An antiviral agent known as tecovirimat that
was developed for smallpox was licensed by the European Medicines Agency (EMA) for monkeypox in 2022
based on data in animal and human studies. It is not yet widely available. If used for patient care, tecovirimat
should ideally be monitored in a clinical research context with prospective data collection.
19. Vaccination
Vaccination against smallpox was demonstrated
through several observational studies to be about
85% effective in preventing monkeypox. Thus,
prior smallpox vaccination may result in milder
illness. Evidence of prior vaccination against
smallpox can usually be found as a scar on the
upper arm. At the present time, the original (first-
generation) smallpox vaccines are no longer
available to the general public.
20. Some laboratory personnel or health workers may have received a more recent smallpox vaccine to protect
them in the event of exposure to orthopoxviruses in the workplace. A still newer vaccine based on a
modified attenuated vaccinia virus (Ankara strain) was approved for the prevention of monkeypox in 2019.
This is a two-dose vaccine for which availability remains limited. Smallpox and monkeypox vaccines are
developed in formulations based on the vaccinia virus due to cross-protection afforded for the immune
response to orthopoxviruses.
21. Prevention
Raising awareness of risk factors and educating people about the measures they can take to reduce
exposure to the virus is the main prevention strategy for monkeypox. Scientific studies are now underway
to assess the feasibility and appropriateness of vaccination for the prevention and control of monkeypox.
Some countries have, or are developing, policies to offer vaccine to persons who may be at risk such as
laboratory personnel, rapid response teams and health workers.
22. Reducing the risk of human-to-human transmission
Surveillance and rapid identification of new cases is critical for outbreak containment. During human
monkeypox outbreaks, close contact with infected persons is the most significant risk factor for
monkeypox virus infection. Health workers and household members are at a greater risk of infection.
Health workers caring for patients with suspected or confirmed monkeypox virus infection, or handling
specimens from them, should implement standard infection control precautions. If possible, persons
previously vaccinated against smallpox should be selected to care for the patient.
Samples taken from people and animals with suspected monkeypox virus infection should be handled by
trained staff working in suitably equipped laboratories. Patient specimens must be safely prepared for
transport with triple packaging in accordance with WHO guidance for transport of infectious substances.
The identification in May 2022 of clusters of monkeypox cases in several non-endemic countries with no
direct travel links to an endemic area is atypical. Further investigations are underway to determine the
likely source of infection and limit further onward spread. As the source of this outbreak is being
investigated, it is important to look at all possible modes of transmission in order to safeguard public
health.
23. Reducing the risk of zoonotic transmission
Over time, most human infections have resulted from a primary, animal-to-human transmission.
Unprotected contact with wild animals, especially those that are sick or dead, including their meat,
blood and other parts must be avoided. Additionally, all foods containing animal meat or parts must be
thoroughly cooked before eating.
Preventing monkeypox through restrictions on animal trade
Some countries have put in place regulations restricting importation of rodents and non-human primates.
Captive animals that are potentially infected with monkeypox should be isolated from other animals and
placed into immediate quarantine. Any animals that might have come into contact with an infected
animal should be quarantined, handled with standard precautions and observed for monkeypox
symptoms for 30 days.
24. Recent advancements in AI for the prevention of Monkeypox
Researchers recently demonstrated that AI deep models can distinguish between different types of pox,
based on digital skin images of lesions and rashes associated with pox/measles. As well as overfitting and
underfitting, they observed that deep models tend to have biases.
It is therefore critical to ensure a larger sample size for model training in order to achieve better
classification accuracy. According to these scientists, lighter deep models, with fewer trainable parameters,
can also be used for Monkeypox diagnosis via smartphones, because they have fewer trainable parameters.
Monkeypox detection can also be carried out remotely using digital skin images, which will enable
healthcare professionals to isolate patients and contain the spread of the disease within the community as
early as possible.
25. How monkeypox relates to smallpox
The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection
which has been eradicated. Smallpox was more easily transmitted and more often fatal as about 30%
of patients died.
The last case of naturally acquired smallpox occurred in 1977, and in 1980 smallpox was declared to
have been eradicated worldwide after a global campaign of vaccination and containment.
It has been 40 or more years since all countries ceased routine smallpox vaccination with vaccinia-
based vaccines.
As vaccination also protected against monkeypox in west and central Africa, unvaccinated
populations are now also more susceptible to monkeypox virus infection.
26. Whereas smallpox no longer occurs naturally, the global health sector remains vigilant in the event it
could reappear through natural mechanisms, laboratory accident or deliberate release.
To ensure global preparedness in the event of reemergence of smallpox, newer vaccines, diagnostics
and antiviral agents are being developed. These may also now prove useful for prevention and control
of monkeypox.