Monkeypox is a viral disease that occurs in humans and some animals. It is caused by the monkeypox virus, which belongs to the same family of viruses as smallpox. Monkeypox most commonly spreads through direct contact with infected animals or humans. Initial symptoms include fever, headache, muscle aches, and swollen lymph nodes. Within a few days, a rash develops on the face and spreads to other parts of the body. While monkeypox is generally mild, it can cause severe illness and has a fatality rate of around 1 in 10 people in parts of Africa. There are vaccines and treatments available to prevent and treat monkeypox infections.

1. MONKEYPOX
Introduction:
Monkeypox is an infectious viral disease that can occur in both human and some
animals. It is an enveloped double stranded DNA virus that belongs to the genus
Orthopoxvirus of the family Poxviridae. The Orthopoxvirus genus also includes
variola virus (which causes smallpox), and cowpox virus. It is clinically less
severe with monkeypox has emerged as the most important orthopoxvirus for
public health. Monkeypox occurs in central and Weast Africa, often in proximity
to tropical rainforests and has been increasingly appearing in urban areas. Now
monkeypox has been reported in non-endemic countries. It's also needed the
animal host.
child-Multiview-monkeypox microscopic view in German, France reported case
Virus classification:
Realm: varidnaviria
Kingdome: Bamfordvirae
Phylum: Nucleocytoviricota

2. Class: Pokkesviricetes
Order: Chitovirales
Family: poxviridae
Genus: orthopoxvirus
Species: monkeypox virus
The pathogen:
Monkeypox virus is an enveloped dsDNA virus that belongs to the orthipoxvirus
genus of the poxiviridae family. There are two distinct clades of the monkeypox
virus.
“The central African clade (Congo Basin) and the west African clade.” (“Spread
of monkeypox: what you need to know – Ticked Off and Fed Up”) The Congo
basin clade has historically cause more severe disease and a highly transmissible.
Nature of Host:
Various animal species have been identified as susceptible to monkeypox virus
likes rope squirrels, tree squirrels, Gambian pouched rats etc.
Outbreaks:
Human monkeypox was first found in humans in 1970 in the Democratic
Republic of the Congo in 9 months- old Boy. The most of the cases have been
reported from rural, rainforest regions of the Congo Basin. (“Monkeypox - WHO
| World Health Organization”) In the Democratic Republic of the Congo human
cases have increasingly been reported from across central and west Africa.
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. 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

3. America in July and November 2021. In May 2022, multiple cases of monkeypox
were identified in several non-endemic countries. monkeypox virus is currently
study in epidemiology, sources of infection and transmission patterns.
Transmission:
It is a zoonotic transmission (animal to human) can occur from the direct contact
with the blood, body fluids or cutaneous or mucosal lesions of infected animals.
in Africa, many animals are infected by monkeypox virus including rope
squirrels, tree squirrels and varied species of monkey and others.
Monkeypox virus can spread when a person come into contact with the infected
animal, infected person or materials contaminated with the virus. This virus can
also cross the placenta from the mother to the fetus (which can lead to congenital
monkeypox).
Monkeypox spreads between people primarily through direct contact sores, scabs,
or body fluids. It also can be spread by the respiratory secretion during prolonged,
face to face contact.
Signs and symptoms:
The incubation period of monkeypox is usually from 6 to 13 day (about 2 weeks)
but can range from 5 to 21 days (about 3 weeks).
In human, the symptoms of the monkeypox are like the symptoms of smallpox.
The main difference between symptoms of smallpox and monkeypox is that
monkeypox cause the lymphadenopathy while smallpox does not cause the
lymphadenopathy (swelling of the lymph nodes). The illness begins with:
 Fever
 Headache
 Muscle aches
 Backache
 Swollen lymph node
 Chills
Within 1 to 3 days after the appearance of fever, the patient develops a rash,
often beginning on the face then spreading to other parts of the body.
The illness typically lasts for 2-4 weeks. In Africa, monkeypox has been shown
the cause of death is 1 in 10 persons who contract the disease.

4. Diagnosis:
Clinical differential diagnosis must consider other rash illnesses, such as
chickenpox, measles, bacterial skin infections, scabies, syphilis and medication-
associated allergies. Lymphadenopathy during the prodromal stage of illness
can distinguish monkeypox from chickenpox or smallpox. Diagnosis can be
verified by testing for the virus.
Polymerase chain reaction (PCR) testing of samples from skin lesions is the
preferred laboratory test. PCR blood tests are usually inconclusive because the
virus does not remain very long in the blood. To interpret test results,
information is required on date of onset of fever, date of onset of rash, date of
specimen collection, current stage of rash, and patient age.
Electronic microscopic figure:
Prevention:
There are number of measures that can be taken to prevent infection with
monkeypox virus:
 Avoid contact with animals that could harbor the virus (including animals
that are sick or that have been found dead in areas where monkeypox
occurs).
 Avoid contact with any materials, such as bedding, that has been in
contact with a sick animal.
 Isolate infected patients from others who could be at risk for infection.

5.  Practice good hand hygiene after contact with infected animals or
humans. For example, washing your hands with soap and water or using
an alcohol-based hand sanitizer.
 Use personal protective equipment (PPE) when caring for patients.
Treatment:
In the European Union and the United States, tecovirimat is approved for the
treatment of several poxviruses, including monkeypox. BMJ Best Practice
recommends tecovirimat or the smallpox treatment brincidofovir as the first line
antiviral treatment if required, alongside supportive care (including antipyretic,
fluid balance and oxygenation)
Reference:
https://en.wikipedia.org/wiki/Monkeypox
https://www.cdc.gov/poxvirus/monkeypox
https://www.who.int/news
Name: Anil khadka
B.Sc.MLT