The document provides an overview of monkeypox, including: - It was first identified in monkeys in 1958 and humans in 1970 in Africa. Recent outbreaks have occurred outside of Africa. - It can spread from animals to humans and between humans via close contact with lesions, body fluids, or respiratory droplets. Sexual contact may also play a role in transmission. - Symptoms include fever, headache, muscle aches, and swollen lymph nodes followed by a rash that starts on the face and spreads to other parts of the body. - There is no proven treatment, but isolation and supportive care are recommended. Vaccination after exposure may help prevent or lessen disease.

2. OPENING PRAYER
DEAR HEAVENLY FATHER,
WE THANK YOU FOR GATHERING ALL OF US TODAY IN THIS IMPORTANT EVENT
MAY YOU BESTOW YOUR GUIDANCE AND BLESSINGS ON THIS EVENT,
SO THAT WE CAN ENJOY AND APPRECIATE ITS SIGNIFICANCE IN OUR LIVES
BLESS EVERYONE PRESENT HERE TODAY,
THAT EACH OF US MAY BE ABLE TO SHARE WHAT HE OR SHE HAVE,
FOR YOUR GLORY AND HONOR
GRANT GOOD HEALTH AND SAFETY TO OUR LOVED ONES LEFT AT HOME, AND PEACE AND GOOD
WILL TO ALL MEN.
MAY THE VARIOUS ACTIVITIES RELATED TO THIS EVENT BE A SUCCESS,
THROUGH YOUR INTERVENTION
WE ASK ALL OF THESE IN YOUR NAME,
AMEN.

3. HUMAN MONKEYPOX
By:
GERESA G. SALTA-SAMONTE,M.D.
Occupational/ Family Medicine
Infectious Diseases & Tropical Medicine

4. Few Questions Before We Start
 1. Are monkeys the natural reservoir of monkeypox
virus?
 2. How can we differentiate monkeypox from
chickenpox?
 3. What is the duration of quarantine if you have
been exposed to someone with monkeypox?

5. Background:

6.  1st identified in monkeys in 1958
 1st human case reported in 1970
 Endemic in areas of Africa
 Typically, only see sporadic cases outside of Africa in people who have traveled to
certain regions or have been in close contact with those travelers
 From the 1970s up until 2003, sporadic cases were identified in central and western
Africa
 Before 1980, case-fatality rate was 17% and secondary transmission was the cause in
9% of cases
 From 1981 to 1986, the case-fatality rate was 10% and secondary transmission was
the cause in 28%
 From 1996 to 1997, the largest outbreak of human monkeypox occurred, which had a
case-fatality rate of 1.5% and secondary transmission was the cause in 78%
 The 2003 outbreak, was the first documented cases in the western hemisphere with a
case-fatality rate of 0% and secondary transmission was the cause in 0%
 Cases of Monkeypox in 2022 from May 6th – 20th [2]:
 UK: 20 (Confirmed)
 Spain: 23 (Unconfirmed)
 Portugal 5 (Confirmed) + 15 (Unconfirmed)
 US 1 (Confirmed)

7. What is Monkeypox?
 Monkeypox is a disease caused by the monkeypox
virus. It is a viral zoonotic disease, meaning that it
can spread from animals to humans. It can also
spread between people.
 The disease is called monkeypox because it was first
identified in colonies of monkeys kept for research in
1958. It was only later detected in humans in 1970.

8. Mode of transmissions:
Primary infection (animal to human)
a) contact with infected animals
b) contact with infected animal products
 Secondary infection (human to human)
a) contact with infected people
b) mother to fetus

11. Is Monkeypox a sexually
transmitted disease?
 Monkeypox can spread from one person to another
through close physical contact, including sexual contact.
It is currently not known whether monkeypox can be
spread through sexual transmission routes (e.g., through
semen or vaginal fluids), but direct skin-to-skin contact
with lesions during sexual activities can spread the virus.
 Monkeypox rashes are sometimes found on genitals and
in the mouth, which is likely to contribute to transmission
during sexual contact. Mouth-to-skin contact could thus
cause transmission where skin or mouth lesions are
present.

12. Signs & symptoms

13. Disease Progression:
 Incubation period (5- 21 days)= the virus enters the
body & replicates. No symptoms. Virus is present in
the blood at the end of this stage
 Febrile stage ( 1-4 days)= fever is present plus other
symptoms like headache, chills, sore throat, malaise,
fatigue, swollen lymph nodes (lymphadenopathy).
Virus is present in the blood & small lesions in the
mouth may appear towards the end.
 Rash stage2 (4 weeks)
 Recovery (days to weeks)

14. Rash Stage
 Rash begins as maculopapular lesions of 2 to 5mm
in diameter
 Typically, centrifugal pattern (from the torso
outwards)
 Skin lesions typically progress from macular, papular,
to vesicular, to pustular, and crust phases over a 14
to 21-day period
 In patients with smallpox vaccination the rash will be
milder and only ≈50% will have lymphadenopathy

15. Rash stage

18.  Rash stage
- virus maybe in the blood in the early stage
- virus is present in the skin lesions
- antibodies are produced & detectable
 Recovery stage
- patient recovers
- antibodies are present in the blood
- scars may remain
- no more symptoms

20. Factors affecting the course of
the disease:
1. Asymptomatic infection may occur
2. Risk factors for severe illness:
a) children
b) immunocompromised
c) invasive route
3. Prior smallpox vaccination

21. Complications:
 Bacterial superinfection of skin
 Skin scarring
 Corneal scarring/vision loss
 Pneumonia
 Dehydration (secondary to painful oral lesions and
insensible fluid loss)
 Encephalitis
 Death (Very rare)

22. How can we protect ourselves
against monkeypox?
 by limiting contact with people who have suspected
or confirmed monkeypox.
 If you do need to have physical contact with
someone who has monkeypox because you are a
health worker or live together, encourage the
infected person to self-isolate and cover any skin
lesion if they can (e.g., by wearing clothing over the
rash).
 wear a medical mask, especially if they are
coughing or have lesions in their mouth. You should
wear one also.

23.  Avoid skin-to-skin contact whenever possible and
use disposable gloves if you have any direct contact
with lesions.
 Wear a mask when handling any clothes or bedding
if the person cannot do it themselves.
 Regularly clean your hands with soap and water or
an alcohol-based hand rub
 Wash the person’s clothes, towels and bedsheets
and eating utensils with warm water and detergent.

24. What to do when you think you
have monkeypox?
 Self-isolate
 Avoid close contact
 Clean hands regularly
 Contact your physicians

25. Treatment:
 There is no proven treatment for monkeypox
 For contacts of a case, recommend twice daily fever/symptom monitoring for 21 days
+ Isolation recommended
 Currently, CDC recommending airborne and contact precautions (i.e. negative
pressure room, N95, gloves, and eye shield)
 Pre-exposure smallpox vaccination has been shown to confer 85% protection against
monkeypox
 Role of post-exposure smallpox vaccination is less clear
 According to the CDC, vaccination within 4 days of exposure may prevent disease
onset and vaccination within 14 days may reduce disease severity