This document provides an overview of human monkeypox virus disease. It discusses the aetiology, transmission, clinical manifestation, diagnosis, case definitions and management of monkeypox. The virus is transmitted from animals and humans. Symptoms include fever, rash, lymphadenopathy and lesions on the face, palms and soles. Diagnosis is by PCR, culture or antibodies. Differentials include chickenpox, measles and bacterial infections. Complications include secondary infections and death may occur.
This is a PowerPoint on the Marburg virus, which is a disease similar to Ebola. I very briefly talk about what the disease is, some of the key facts about the structure and death rate, some outbreak history, prevention and treatment and the social-economical impacts that have been caused.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Ong Hang Cheng, Infectious Disease Physician at University Malaya Medical Center
#dengue #WorldNTDDay #BeatNTDs #BestScienceforAll
Here is a comprehensive and updated presentation on the Monkeypox by noted infectious diseases expert Dr ISHWAR GILADA, Consultant in HIV/STDs, Unison Medicare & Research Centre, and Secretary General, Organised Medicine Academic Guild-OMAG;
President, AIDS Society of India (ASI) &
Governing Council Member, International AIDS Society (IAS)
E-mail: gilada@usa.net, drisgilada@gmail.com
The second major type of observational epidemiology
The subject of interest is individual
The object is testing of hypothesis:
Two distinct type
Case-Control Study
Cohort Study
These studies determine the statistical association between RF & diseases and if yes the strength of the association
Also c/d “retrospective studies”
First approach to test causal hypothesis
Also c/d “retrospective studies”
First approach to test causal hypothesis
Use two group cases & control
Has three distinct features
Both exposure & outcome (disease) occurred before the start of the study
The study proceeds backward from effect to cause
It uses a control or comparison group to support or refute an inference
Monkeypox is a rare zoonosis caused by monkeypox virus. This disease is similar to smallpox disease but with lesser severity. This disease is common among Africans. It can be prevented by avoiding contact with contaminated animal and human fluids as well as respiratory droplets. It require a multidisciplinary approach to achieve cure and prevention.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Fazlina Binti Mohamed Yusoff, Family Medicine Specialist at Klinik Kesihatan (Health Clinic) Anika, Klang, Selangor, Malaysia.
#dengue #WorldNTDDay #BeatNTDs #BestScienceforAll
This document summarizes laboratory diagnosis of COVID-19. It discusses that molecular (rRT-PCR) tests target genes like E, RdRp, N, and ORF 1ab. Specimens collected include nasopharyngeal swabs, oropharyngeal swabs, sputum, and stool. Interpretation of rRT-PCR tests follows WHO and CDC guidelines. Serological tests detect IgM and IgG antibodies but are not recommended for diagnosis. Viral sequencing and culture are also discussed. Abnormal lab findings in COVID-19 patients include decreased lymphocytes and albumin and increased LDH, D-dimer and inflammatory markers.
Monkeypox is a zoonotic disease endemic in the Democratic Republic of Congo (DRC) but prevalent also in other countries of Central and Western Africa. The clinical presentation of monkeypox closely resembles the one of smallpox. The mortality rate is officially about 11% however rates as high as 17% have been observed. The disease has been considered rare and not much attention is paid to it. Nonetheless, the incidence of monkeypox increased 20-fold from 1981-1986 to 2005-2007 (two active surveillance programs). More research, surveillance and effective interventions are needed to ensure it would not gain the potential to become the next global pandemic.
This is a PowerPoint on the Marburg virus, which is a disease similar to Ebola. I very briefly talk about what the disease is, some of the key facts about the structure and death rate, some outbreak history, prevention and treatment and the social-economical impacts that have been caused.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Ong Hang Cheng, Infectious Disease Physician at University Malaya Medical Center
#dengue #WorldNTDDay #BeatNTDs #BestScienceforAll
Here is a comprehensive and updated presentation on the Monkeypox by noted infectious diseases expert Dr ISHWAR GILADA, Consultant in HIV/STDs, Unison Medicare & Research Centre, and Secretary General, Organised Medicine Academic Guild-OMAG;
President, AIDS Society of India (ASI) &
Governing Council Member, International AIDS Society (IAS)
E-mail: gilada@usa.net, drisgilada@gmail.com
The second major type of observational epidemiology
The subject of interest is individual
The object is testing of hypothesis:
Two distinct type
Case-Control Study
Cohort Study
These studies determine the statistical association between RF & diseases and if yes the strength of the association
Also c/d “retrospective studies”
First approach to test causal hypothesis
Also c/d “retrospective studies”
First approach to test causal hypothesis
Use two group cases & control
Has three distinct features
Both exposure & outcome (disease) occurred before the start of the study
The study proceeds backward from effect to cause
It uses a control or comparison group to support or refute an inference
Monkeypox is a rare zoonosis caused by monkeypox virus. This disease is similar to smallpox disease but with lesser severity. This disease is common among Africans. It can be prevented by avoiding contact with contaminated animal and human fluids as well as respiratory droplets. It require a multidisciplinary approach to achieve cure and prevention.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Fazlina Binti Mohamed Yusoff, Family Medicine Specialist at Klinik Kesihatan (Health Clinic) Anika, Klang, Selangor, Malaysia.
#dengue #WorldNTDDay #BeatNTDs #BestScienceforAll
This document summarizes laboratory diagnosis of COVID-19. It discusses that molecular (rRT-PCR) tests target genes like E, RdRp, N, and ORF 1ab. Specimens collected include nasopharyngeal swabs, oropharyngeal swabs, sputum, and stool. Interpretation of rRT-PCR tests follows WHO and CDC guidelines. Serological tests detect IgM and IgG antibodies but are not recommended for diagnosis. Viral sequencing and culture are also discussed. Abnormal lab findings in COVID-19 patients include decreased lymphocytes and albumin and increased LDH, D-dimer and inflammatory markers.
Monkeypox is a zoonotic disease endemic in the Democratic Republic of Congo (DRC) but prevalent also in other countries of Central and Western Africa. The clinical presentation of monkeypox closely resembles the one of smallpox. The mortality rate is officially about 11% however rates as high as 17% have been observed. The disease has been considered rare and not much attention is paid to it. Nonetheless, the incidence of monkeypox increased 20-fold from 1981-1986 to 2005-2007 (two active surveillance programs). More research, surveillance and effective interventions are needed to ensure it would not gain the potential to become the next global pandemic.
Monkeypox is caused by an enveloped double-stranded DNA virus in the orthopoxvirus genus of the Poxviridae family. It can spread through direct contact with infectious rash, scabs, or body fluids, respiratory secretions during prolonged face-to-face contact, or touching items that previously touched the infectious rash or body fluids. The incubation period is usually 6 to 13 days. Diagnosis involves polymerase chain reaction testing, while treatment includes the antiviral tecovirimat and vaccines for smallpox may provide limited protection as both diseases are from the same family.
Screening is the testing of apparently healthy populations to identify previously undiagnosed diseases or people at high risk of developing a disease.
Screening aims to detect early disease before it becomes symptomatic.
Screening is an important aspect of prevention, but not all diseases are suitable for screening.
🔥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...😊
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)Ashraf ElAdawy
The document discusses the 2003 SARS outbreak and the more recent emergence of MERS-CoV. It provides details on:
- The international spread of SARS from Hong Kong to multiple countries in 2003, killing 775 people.
- Key facts about MERS-CoV, a novel coronavirus first identified in Saudi Arabia in 2012 that is causing severe respiratory illness, with a case fatality rate of around 45%. As of November 2013, 149 cases and 63 deaths had been reported across several countries linked to the Middle East.
- Ongoing research investigating the virus's origin and transmission, though its animal reservoir remains unclear. Bats and camels are suspected but the exact source is still unknown.
The document summarizes key information about several vaccine-preventable diseases including measles, rubella, mumps, diphtheria, tetanus, and chickenpox. It provides details on the infectious agents, reservoirs, modes of transmission, incubation periods, typical clinical manifestations, and potential complications for each disease. Vaccine recommendations for children and adolescents are also listed for measles, mumps, rubella, varicella, and diphtheria-tetanus-pertussis combinations.
The document discusses Sars-Cov-2 and Covid-19. It provides statistics on cases globally and in India. It describes the virus, including that it is a coronavirus similar to SARS. It discusses WHO declaring Covid-19 a public health emergency. It outlines symptoms, high risk groups, diagnosis methods, clinical management including drugs like hydroxychloroquine and remdesivir, and steps to take if experiencing symptoms.
Description about recent outbreak of Ebola virus in West African countries with history, pathogenesis, clinical signs and prevention measures of Filoviruses are presented in comprehensive manner.
This document discusses emerging and re-emerging infectious diseases. It begins by defining emerging infectious diseases as diseases whose incidence in humans has increased in recent times or threatens to increase. Re-emerging infectious diseases are those that were previously under control but are now increasing again. The document then discusses the classification of these diseases by the National Institute of Allergy and Infectious Diseases. It provides historical examples and details recent disease outbreaks in India like plague, diphtheria, leptospirosis, Nipah virus, and Chikungunya fever. It concludes by examining the factors that contribute to the emergence and reemergence of infectious diseases.
This presentation tackles the controversy regarding Lyme disease by reviewing the evidence for immune evasion and persistent infection by the Lyme spiorchete, Borrelia burgdorferi. The evidence shows that physicians called upon to assist patients with this potential diagnosis should be open to the possibility of persistent infection even in patients who have already received antibiotic treatment for their condition. Lacking evidence on how best to treat a chronic infection of this kind, physicians should be allowed to rely on their experience and to exercise their best clinical judgment in managing patients with Lyme disease.
Viral haemorrhagic fevers (vhf) plus questions.Shaikhani.
Viral haemorrhagic fevers are caused by several viruses and occur mostly in rural parts of Africa. Lassa fever is widespread in West Africa with an overall mortality of around 15% for hospitalized cases. Ebola outbreaks occur about once per year in countries like Congo, Uganda, and Sudan. While most have mild symptoms, all can present with fever, body aches, and bleeding. Transmission is through contact with infected individuals, animals, or insect bites. Treatment involves isolation and supportive care, with ribavirin used for Lassa fever and South American haemorrhagic fevers.
This document discusses HIV and TB co-infection. It notes that HIV increases the risk of developing active TB due to immunosuppression. Diagnosing TB is more difficult in HIV patients as sputum smears can be negative and symptoms are atypical. WHO recommends treating TB first before beginning antiretroviral therapy for co-infected patients, and directly observed treatment to ensure adherence. Clinical trials are exploring optimal antiretroviral regimens for co-infected patients.
The document summarizes information about Ebola virus hemorrhagic fever and Lassa virus hemorrhagic fever. It describes the etiology, epidemiology, signs and symptoms, diagnosis, treatment and prevention of the two viral hemorrhagic fevers. Ebola virus causes a severe multisystem disease in humans characterized by fever, headache and bleeding. Lassa fever is endemic in West Africa and transmitted from rodents to humans, causing fever, bleeding and organ dysfunction. Treatment involves supportive care and the antiviral drug ribavirin.
Emerging and Re-emerging Infectious DiseasesFarooq Khan
Overview of literature around the following emerging and re-emerging infectious diseases relevant to Canadian Emergency Physicians in terms of their epidemiology, recognition, and treatment:
- Community-acquired MRSA
- Non-vaccine serotype Pneumococcus
- Fusobacterium Necrophorum
This document provides an overview of viral hemorrhagic fevers (VHFs). It discusses the etiology, epidemiology, pathogenesis, clinical features and treatment of various VHFs. The major viral families that cause VHF are Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae. Common VHFs covered include Lassa fever, Ebola, yellow fever, dengue, Crimean-Congo hemorrhagic fever and hantavirus pulmonary syndrome. The document examines the mechanisms of pathogenesis for Ebola and Lassa virus, including increased vascular permeability, immunosuppression and cytokine storm.
Outbreak management ppt comprises the definition , history , investigations and the steps of management of outbreak. This was my seminar and UG class tpoic
This document provides an introduction to COVID-19 and SARS-CoV-2, the virus that causes it. It discusses the virology of coronaviruses and details of the SARS-CoV-2 virus. It describes the epidemiology of COVID-19, including transmission dynamics, symptoms and disease progression. It also covers variants of concern and the global and local situation of the COVID-19 pandemic.
This document summarizes a seminar presentation on Ebola virus disease (EVD). It provides an overview of EVD outbreaks, case definitions, epidemiology, clinical presentation, diagnosis, treatment, and control/prevention. Key points include: EVD is caused by infection with Ebola virus and transmitted through contact with infected body fluids; symptoms range from fever and fatigue to vomiting and hemorrhaging; diagnosis involves virus detection through antigen/antibody tests or PCR; treatment is supportive care as no vaccine currently exists; control relies on isolation, contact tracing, and barrier precautions.
- Sensitization meeting on surveillance of acute flaccid paralysis (AFP), fever and rash, and diphtheria, pertussis and tetanus (DPT) cases.
- Wild poliovirus transmission ongoing in Afghanistan and Pakistan and circulating vaccine-derived poliovirus type 2 transmission in multiple countries.
- Surveillance for AFP declined in 2020 due to the COVID-19 pandemic, so staff should continue reporting all AFP cases and conducting active case searches.
- One national immunization day and two subnational immunization days for polio are recommended, and conducting safe, high-quality immunization campaigns is important.
Monkeypox is caused by monkeypox virus, an orthopoxvirus. It occurs sporadically in parts of Central and West Africa. Symptoms include fever, headache, lymphadenopathy and a rash that starts on the face and spreads to other parts of the body. It is usually self-limiting but can be serious in children or immunocompromised individuals. Diagnosis involves collecting samples from lesions for laboratory testing. There is no specific treatment but smallpox vaccination provides protection. Prevention focuses on reducing exposure to infected animals or contact with infected humans.
This document discusses several non-specific surgical infections including syphilis, gonorrhea, cancrum oris, anthrax, and actinomycosis. It provides details on the causative agents, transmission, clinical presentation, diagnosis, and treatment of each infection. Key points covered include that syphilis and gonorrhea are sexually transmitted bacterial infections, cancrum oris is a rapidly progressive infection more common in immunocompromised individuals, while anthrax causes skin, respiratory, or intestinal illness depending on transmission route.
Monkeypox is caused by an enveloped double-stranded DNA virus in the orthopoxvirus genus of the Poxviridae family. It can spread through direct contact with infectious rash, scabs, or body fluids, respiratory secretions during prolonged face-to-face contact, or touching items that previously touched the infectious rash or body fluids. The incubation period is usually 6 to 13 days. Diagnosis involves polymerase chain reaction testing, while treatment includes the antiviral tecovirimat and vaccines for smallpox may provide limited protection as both diseases are from the same family.
Screening is the testing of apparently healthy populations to identify previously undiagnosed diseases or people at high risk of developing a disease.
Screening aims to detect early disease before it becomes symptomatic.
Screening is an important aspect of prevention, but not all diseases are suitable for screening.
🔥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...😊
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)Ashraf ElAdawy
The document discusses the 2003 SARS outbreak and the more recent emergence of MERS-CoV. It provides details on:
- The international spread of SARS from Hong Kong to multiple countries in 2003, killing 775 people.
- Key facts about MERS-CoV, a novel coronavirus first identified in Saudi Arabia in 2012 that is causing severe respiratory illness, with a case fatality rate of around 45%. As of November 2013, 149 cases and 63 deaths had been reported across several countries linked to the Middle East.
- Ongoing research investigating the virus's origin and transmission, though its animal reservoir remains unclear. Bats and camels are suspected but the exact source is still unknown.
The document summarizes key information about several vaccine-preventable diseases including measles, rubella, mumps, diphtheria, tetanus, and chickenpox. It provides details on the infectious agents, reservoirs, modes of transmission, incubation periods, typical clinical manifestations, and potential complications for each disease. Vaccine recommendations for children and adolescents are also listed for measles, mumps, rubella, varicella, and diphtheria-tetanus-pertussis combinations.
The document discusses Sars-Cov-2 and Covid-19. It provides statistics on cases globally and in India. It describes the virus, including that it is a coronavirus similar to SARS. It discusses WHO declaring Covid-19 a public health emergency. It outlines symptoms, high risk groups, diagnosis methods, clinical management including drugs like hydroxychloroquine and remdesivir, and steps to take if experiencing symptoms.
Description about recent outbreak of Ebola virus in West African countries with history, pathogenesis, clinical signs and prevention measures of Filoviruses are presented in comprehensive manner.
This document discusses emerging and re-emerging infectious diseases. It begins by defining emerging infectious diseases as diseases whose incidence in humans has increased in recent times or threatens to increase. Re-emerging infectious diseases are those that were previously under control but are now increasing again. The document then discusses the classification of these diseases by the National Institute of Allergy and Infectious Diseases. It provides historical examples and details recent disease outbreaks in India like plague, diphtheria, leptospirosis, Nipah virus, and Chikungunya fever. It concludes by examining the factors that contribute to the emergence and reemergence of infectious diseases.
This presentation tackles the controversy regarding Lyme disease by reviewing the evidence for immune evasion and persistent infection by the Lyme spiorchete, Borrelia burgdorferi. The evidence shows that physicians called upon to assist patients with this potential diagnosis should be open to the possibility of persistent infection even in patients who have already received antibiotic treatment for their condition. Lacking evidence on how best to treat a chronic infection of this kind, physicians should be allowed to rely on their experience and to exercise their best clinical judgment in managing patients with Lyme disease.
Viral haemorrhagic fevers (vhf) plus questions.Shaikhani.
Viral haemorrhagic fevers are caused by several viruses and occur mostly in rural parts of Africa. Lassa fever is widespread in West Africa with an overall mortality of around 15% for hospitalized cases. Ebola outbreaks occur about once per year in countries like Congo, Uganda, and Sudan. While most have mild symptoms, all can present with fever, body aches, and bleeding. Transmission is through contact with infected individuals, animals, or insect bites. Treatment involves isolation and supportive care, with ribavirin used for Lassa fever and South American haemorrhagic fevers.
This document discusses HIV and TB co-infection. It notes that HIV increases the risk of developing active TB due to immunosuppression. Diagnosing TB is more difficult in HIV patients as sputum smears can be negative and symptoms are atypical. WHO recommends treating TB first before beginning antiretroviral therapy for co-infected patients, and directly observed treatment to ensure adherence. Clinical trials are exploring optimal antiretroviral regimens for co-infected patients.
The document summarizes information about Ebola virus hemorrhagic fever and Lassa virus hemorrhagic fever. It describes the etiology, epidemiology, signs and symptoms, diagnosis, treatment and prevention of the two viral hemorrhagic fevers. Ebola virus causes a severe multisystem disease in humans characterized by fever, headache and bleeding. Lassa fever is endemic in West Africa and transmitted from rodents to humans, causing fever, bleeding and organ dysfunction. Treatment involves supportive care and the antiviral drug ribavirin.
Emerging and Re-emerging Infectious DiseasesFarooq Khan
Overview of literature around the following emerging and re-emerging infectious diseases relevant to Canadian Emergency Physicians in terms of their epidemiology, recognition, and treatment:
- Community-acquired MRSA
- Non-vaccine serotype Pneumococcus
- Fusobacterium Necrophorum
This document provides an overview of viral hemorrhagic fevers (VHFs). It discusses the etiology, epidemiology, pathogenesis, clinical features and treatment of various VHFs. The major viral families that cause VHF are Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae. Common VHFs covered include Lassa fever, Ebola, yellow fever, dengue, Crimean-Congo hemorrhagic fever and hantavirus pulmonary syndrome. The document examines the mechanisms of pathogenesis for Ebola and Lassa virus, including increased vascular permeability, immunosuppression and cytokine storm.
Outbreak management ppt comprises the definition , history , investigations and the steps of management of outbreak. This was my seminar and UG class tpoic
This document provides an introduction to COVID-19 and SARS-CoV-2, the virus that causes it. It discusses the virology of coronaviruses and details of the SARS-CoV-2 virus. It describes the epidemiology of COVID-19, including transmission dynamics, symptoms and disease progression. It also covers variants of concern and the global and local situation of the COVID-19 pandemic.
This document summarizes a seminar presentation on Ebola virus disease (EVD). It provides an overview of EVD outbreaks, case definitions, epidemiology, clinical presentation, diagnosis, treatment, and control/prevention. Key points include: EVD is caused by infection with Ebola virus and transmitted through contact with infected body fluids; symptoms range from fever and fatigue to vomiting and hemorrhaging; diagnosis involves virus detection through antigen/antibody tests or PCR; treatment is supportive care as no vaccine currently exists; control relies on isolation, contact tracing, and barrier precautions.
- Sensitization meeting on surveillance of acute flaccid paralysis (AFP), fever and rash, and diphtheria, pertussis and tetanus (DPT) cases.
- Wild poliovirus transmission ongoing in Afghanistan and Pakistan and circulating vaccine-derived poliovirus type 2 transmission in multiple countries.
- Surveillance for AFP declined in 2020 due to the COVID-19 pandemic, so staff should continue reporting all AFP cases and conducting active case searches.
- One national immunization day and two subnational immunization days for polio are recommended, and conducting safe, high-quality immunization campaigns is important.
Monkeypox is caused by monkeypox virus, an orthopoxvirus. It occurs sporadically in parts of Central and West Africa. Symptoms include fever, headache, lymphadenopathy and a rash that starts on the face and spreads to other parts of the body. It is usually self-limiting but can be serious in children or immunocompromised individuals. Diagnosis involves collecting samples from lesions for laboratory testing. There is no specific treatment but smallpox vaccination provides protection. Prevention focuses on reducing exposure to infected animals or contact with infected humans.
This document discusses several non-specific surgical infections including syphilis, gonorrhea, cancrum oris, anthrax, and actinomycosis. It provides details on the causative agents, transmission, clinical presentation, diagnosis, and treatment of each infection. Key points covered include that syphilis and gonorrhea are sexually transmitted bacterial infections, cancrum oris is a rapidly progressive infection more common in immunocompromised individuals, while anthrax causes skin, respiratory, or intestinal illness depending on transmission route.
Monkeypox is a viral zoonotic disease with symptoms similar to smallpox. It was first discovered in 1958 in monkeys and the first human case was in 1970 in the DRC. There are two strains, with the Congo Basin strain causing more severe disease. The 2022 outbreak began in May and has since spread globally, leading the WHO to declare it a global health emergency in July. It is transmitted through contact with lesions, droplets or contaminated materials. Clinical features include fever, rash and lesions. Diagnosis involves testing for orthopoxvirus. Treatment focuses on symptom management and antivirals like tecovirimat. Vaccination can help prevent infection. The case report describes a patient who developed gen
Chikungunya is an emerging mosquito-borne viral disease that presents a growing public health threat. It was first identified in Tanzania in 1952 and causes fever and severe joint pain. The virus is transmitted between humans by Aedes mosquitoes. Recent outbreaks have affected millions of people in Asia and the Americas. While there is no vaccine or specific treatment, prevention relies on controlling mosquito populations and limiting exposure. Physicians should consider chikungunya infection when patients present with acute fever and joint pain, especially after travel to affected regions.
Necrotizing Fasciitis : “Life After Flesh-Eating Bacteria” by Antra Sood,Arna...Arnav Sood
The document summarizes information about necrotizing fasciitis (NF), a rare bacterial infection that spreads quickly in the body and can cause death. It discusses the typical causes, symptoms, diagnosis, treatment, and prevention of NF. The most common cause is Group A Streptococcus bacteria. Symptoms include sudden onset of pain, swelling and redness at the site of a wound. Prevention includes taking care of wounds and seeking medical help if experiencing severe pain. Treatment involves antibiotics and surgery to remove dead tissue. A case study examines 48 NF patients, finding the highest risk groups to be males aged 40-60 with preexisting conditions like diabetes or poor hygiene.
The document discusses several infectious diseases including measles, rubella, chickenpox, diphtheria, meningitis, and dengue hemorrhagic fever. It provides details on the causative agents, modes of transmission, signs and symptoms, diagnostic tests, and treatment for each disease. For dengue hemorrhagic fever specifically, it notes that reported cases in the Philippines were over 24,000 lower in 2011 compared to the previous year, with fewer deaths. Prevention strategies discussed include immunization and controlling the mosquito vector.
Dr. Ishwar Gilada provides an overview of the current monkeypox outbreak. He notes that monkeypox is spreading to more countries than usual. The virus causes symptoms similar to smallpox but less severe. It is transmitted through close contact with infected humans or animals. While risk is not limited to any group, some cases have been identified in communities of gay, bisexual, and other men who have sex with men. Treatment focuses on relieving symptoms and preventing secondary infections. Vaccines may provide protection but no perfect antiviral currently exists. Vigilance and preparedness are needed to contain the outbreak.
The document discusses infectious diseases including measles, rubella, chickenpox, diphtheria, meningitis, and vector-borne diseases like dengue hemorrhagic fever. It provides details on the causative agents, symptoms, transmission, treatment and prevention strategies for controlling outbreaks of these infectious diseases. For dengue hemorrhagic fever specifically, it describes the occurrence in the Philippines, clinical manifestations through different stages, diagnostic tests and grading of severity. Controlling mosquito vectors and immunization were identified as key prevention strategies.
This document summarizes information about smallpox and chickenpox. It provides a history of smallpox, noting that it was one of the major global killers but was eradicated through an international vaccination campaign between 1967-1979. The last known case of smallpox was in 1977. Chickenpox is caused by the varicella zoster virus and presents with a characteristic rash. It is highly contagious but typically mild in children. Complications can be more severe in immunosuppressed individuals. Both diseases can be prevented through vaccination.
1. Viral hemorrhagic fevers are zoonotic diseases caused by several viruses including Ebola, Marburg, Lassa, and Crimean-Congo hemorrhagic fever.
2. They typically present with non-specific flu-like symptoms initially before potentially progressing to hemorrhage, shock, and multi-organ failure.
3. Diagnosis involves blood tests to detect viruses or antibodies, and management is largely supportive though ribavirin may be used for some viruses.
The document discusses the 2022 monkeypox outbreak. As of June 22, 2022, there have been over 3,400 confirmed cases reported globally from 50 countries. The majority are in Europe. India has reported 10 confirmed and 8 suspected cases across several states. Monkeypox is caused by an orthopoxvirus and symptoms include fever, headache, muscle aches and lymphadenopathy followed by a rash. Diagnosis involves PCR on skin lesions. Several Indian companies are developing diagnostic kits while ICMR is working on a vaccine candidate using an isolated Indian strain.
Fournier's gangrene is a necrotizing fasciitis of the genital region that is usually polymicrobial in nature. It is more common in males ages 30-60 and risk factors include diabetes, alcoholism, malignancy, and immunosuppression. The infection spreads rapidly in fascial planes due to bacterial enzymes and can cause tissue death. Treatment involves aggressive surgical debridement and broad spectrum antibiotics. Complications can include organ failure, shock, and death if not treated promptly.
STI & SYNDROMES Finagggggyuuiuhggghle.pdfHappychifunda
This document discusses various sexually transmitted infections (STIs) including their signs, symptoms, diagnosis and treatment. It covers vaginal discharge syndromes like bacterial vaginosis and candidiasis, genital ulcers caused by syphilis, chancroid and lymphogranuloma venereum, urethral discharge from gonorrhea and chlamydia, and genital growths from conditions like condyloma. It provides details on diseases like donovanosis, neonatal conjunctivitis, pelvic inflammatory disease and their management. The document is a reference for health workers on common STIs, aimed to aid accurate diagnosis and guide appropriate therapy.
This document provides information on risk assessment and public health management of monkeypox in Malaysia. It discusses the distribution and transmission of monkeypox, clinical presentation and case definitions. Strategies to prevent monkeypox introduction and transmission in Malaysia include strengthening early detection and surveillance, improving diagnostic capabilities, managing cases and contacts, as well as increasing community awareness and preparedness through multisectoral collaboration. Guidelines have been disseminated to international entry points on traveler screening for monkeypox cases in Malaysia.
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.
- The document provides an orientation on monkeypox, covering topics such as clinical features, surveillance strategies, diagnosis, and treatment.
- It describes monkeypox as a viral infection transmitted through contact with animals or humans. Common symptoms include fever, rash, lymphadenopathy, and lesions progressing from macules to crusts.
- Surveillance aims to rapidly identify cases and contacts to prevent transmission. Confirmed cases require PCR or sequencing detection of the virus. Treatment focuses on isolation, symptom management, and antivirals for severe or high-risk cases.
The document provides background information on monkeypox virus, including its transmission between animals and humans, signs and symptoms, diagnosis, treatment and prevention. It discusses the virus's identification in 1970 in the Democratic Republic of Congo and reemergence in Nigeria in 2017. Two genetic clades of the virus are identified, with the Central African clade typically causing more severe illness. Person-to-person transmission is documented. Supportive treatment aims to relieve symptoms and prevent complications. Prevention involves avoiding contact with infected animals or materials and implementing isolation protocols.
Monkeypox is a zoonotic virus that presents with a rash similar to smallpox. It is endemic to parts of Central and West Africa. The current outbreak has spread to over 70 countries. Transmission occurs through direct contact with lesions, droplets, or fomites. Symptoms include fever, headache, and a rash that starts on the face and spreads. Diagnosis is via PCR testing of lesions. Treatment is supportive with antivirals being studied. Prevention includes isolation, PPE, vaccination, and avoiding contact with sick animals in endemic regions.
Monkeypox is a viral zoonotic disease caused by the monkeypox virus. It was first discovered in 1958 in monkeys but the first human case was reported in 1970. While historically endemic to parts of Africa, recent outbreaks have occurred in non-endemic countries. The virus can spread through contact with infected animals or humans. It has an incubation period of 5-21 days and symptoms include fever, rash, and swollen lymph nodes. Management involves isolation, treatment of symptoms, monitoring for complications, contact tracing, and infection control measures. Vaccination and risk communication are also important to control further spread.
Renal function tests are important for identifying, diagnosing, monitoring renal dysfunction and disease. Key tests include urinalysis to detect abnormalities in urine appearance, composition and sediments. Glomerular filtration rate (GFR) is a key measure of renal function and can be estimated using creatinine clearance from plasma and urine creatinine levels or formulas. Other tests evaluate tubular function like handling of electrolytes, acids, proteins and determine if renal issues are pre-renal or intrinsic to the kidneys. Together these tests provide vital information about renal health and disease.
This document discusses hypoglycemic agents or anti-diabetic drugs used to treat diabetes mellitus. It describes diabetes as a metabolic syndrome caused by insulin deficiency and excess glucagon that can lead to acute manifestations like hyperglycemia and chronic complications affecting small blood vessels and arteries. It outlines the different types of diabetes and treatments including insulin therapies using rapid, short, intermediate and long-acting insulins. It also discusses oral hypoglycemic drugs for type 2 diabetes including sulfonylureas, biguanides, glitazones and alpha-glucosidase inhibitors providing details on their mechanisms, uses, and potential toxicities in treatment.
Echocardiography uses ultrasound to generate images of cardiac anatomy and function. The echocardiogram machine includes a transducer probe that transmits and receives ultrasound waves, and a display monitor. Different echocardiography modes exist, including M-mode for measuring dimensions, 2D/3D for morphology, and various Doppler modes for assessing blood flow velocity and direction. Trans-esophageal echocardiography uses a probe attached to an endoscope to obtain high resolution internal images of the heart. Echocardiography is used to evaluate conditions like thrombi, aneurysms, valves, and septal defects.
DISEASES OF THE THYROID GLAND NOVEMBER 2018.pptxKemi Adaramola
This document discusses diseases of the thyroid gland. It begins by describing the anatomy and physiology of the thyroid, including its location in the neck, histological structure, embryological development, and hormone production process. It then discusses the main thyroid diseases - thyrotoxicosis (Graves' disease, toxic nodular goiter, etc.) and hypothyroidism. For each condition, it outlines the etiology, clinical features, investigations, and treatment approaches. It also describes thyroid storm, a medical emergency representing severe thyrotoxicosis, and myxedema coma, a severe form of hypothyroidism.
This document discusses the management of diabetes mellitus in children beyond typical norms. It begins with an introduction to diabetes and classifications of types of diabetes including type 1, type 2, and maturity onset diabetes of the young (MODY). It then discusses epidemiology and the local experience with childhood diabetes at Ekiti State University Teaching Hospital. The remainder of the document focuses on treatment and management of type 1 diabetes in children, including insulin regimens, therapeutic goals, and sick day rules. It also briefly discusses type 2 diabetes in children and the differences between type 1 and type 2 diabetes.
Defibrillation is a process that delivers an electric shock to the heart to stop an irregular heartbeat and restore normal rhythm. It is the only effective treatment for cardiac arrest caused by ventricular fibrillation or pulseless ventricular tachycardia. Early defibrillation is critical, as survival rates decrease by 10% each minute without treatment. Different types of defibrillators include automated external defibrillators and implantable cardioverter defibrillators. Key factors that influence defibrillation success include transthoracic impedance, electrode placement and position, and shock waveform and energy level delivered.
PULMONARYHYPERTENSION IN HEART FAILURE.pptxKemi Adaramola
This patient presented with bilateral leg swelling, abdominal swelling, facial swelling, and exertional dyspnea over the past 2 years. She has a history of recurrent productive cough as a child treated with antibiotics. On examination she had clubbing, leg swelling up to the knees, enlarged liver, ascites, and signs of right heart failure. Investigations showed features consistent with constrictive pericarditis and severe pulmonary hypertension likely due to tuberculous pericarditis in the past. She was treated unsuccessfully for heart failure and later developed venous thrombosis, remaining in the hospital for over 50 days before leaving against medical advice due to financial constraints.
This document outlines the causes, clinical features, diagnosis, and management of an Addisonian crisis, which is a life-threatening adrenal insufficiency emergency. It may be triggered by stress, infection, trauma, or withdrawal from steroids. Symptoms include nausea, vomiting, abdominal pain, hypotension, and electrolyte imbalances. Treatment involves intravenous hydrocortisone, fluids, glucose, and identifying and treating any precipitating causes. Long term management consists of glucocorticoid and mineralocorticoid replacement therapy and patient education.
This document outlines an introduction to pulmonary hypertension including its epidemiology, etiology, pathogenesis, clinical features, treatment, and future directions. It defines pulmonary hypertension and notes the most common causes are lung diseases like COPD. In Nigeria, common causes include COPD, tuberculosis, connective tissue diseases, and sickle cell disease. The pathogenesis involves remodeling of the pulmonary vasculature from factors like endothelial dysfunction and an imbalance of vasoconstrictors and vasodilators. Over time, this can lead to right heart failure if the right ventricle can no longer compensate for the increased resistance.
This document discusses cardiovascular disease risk factors. It begins by introducing the topic and outlines the sections. The introduction notes that CVD is a leading cause of death worldwide. The epidemiology section describes the prevalence of CVD globally and in certain regions. The pathophysiology section explains the development of atherosclerosis. The traditional risk factors section lists established risks like hypertension, diabetes, and smoking. The document focuses on emerging risk factors, describing biomarkers like lipoprotein(a), apolipoprotein B, and homocysteine that can help identify risk beyond traditional factors. It discusses the evidence supporting these novel factors and their clinical implications.
This document provides an overview of the management of ascites. It discusses the epidemiology, etiology, pathophysiology, evaluation, treatment, and complications of ascites. Ascites is most often caused by portal hypertension from liver cirrhosis. Other causes include malignancy, infection, heart failure, and nephrotic syndrome. Evaluation involves diagnostic paracentesis and ascitic fluid analysis. Treatment depends on the underlying cause but typically involves dietary sodium restriction and diuretic medication. Complications include spontaneous bacterial peritonitis.
Bronchiectasis, lung abscess, and empyema are chronic lung infections that can result from complications of pneumonia. They often occur in people with underlying lung disease or immune disorders. Key features include recurrent chest infections, coughing, sputum production, and life-threatening complications like respiratory failure. Treatment involves identifying and addressing the underlying cause, airway clearance techniques, long-term antibiotics, and surgery in some cases.
This document discusses impetigo, a common bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. It presents in two forms: non-bullous and bullous. Symptoms include lesions on the face or limbs that may crust over. While usually mild, impetigo can develop into ecthyma if untreated. Treatment involves cleaning the skin, removing crusts, and using topical or oral antibiotics like mupirocin, retapamulin, cloxacillin, or erythromycin. Complications may include regional lymphadenopathy or ecthyma, a deeper skin ulceration.
This document discusses acute leukaemias in adults, including acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). It covers the incidence, risk factors, pathogenesis, clinical features, classification, prognostic factors, treatment for induction and post-remission, and supportive care for AML and ALL. The prognosis for ALL in adults remains poor despite high initial response rates to therapy. Improved supportive care and bone marrow transplantation are utilized while awaiting new, better therapies for these aggressive malignancies.
This document provides an overview of blood components therapy, including their indications and guidelines for use. It discusses the various components that can be derived from whole blood, such as packed red blood cells, platelets, fresh frozen plasma, cryoprecipitate, and granulocytes. Storage conditions, shelf lives, and therapeutic doses are provided. The main reasons for transfusion in Africa are described as childhood malaria, hemoglobinopathies, obstetric bleeding, trauma, and certain surgical procedures. Contraindications and risks of transfusion-transmitted infections are also covered. The document emphasizes considering alternatives to transfusion and whether benefits outweigh risks in each clinical situation.
This document provides an overview of haemoglobinopathies with an emphasis on sickle cell anaemia (SCA). It describes the complications and types of crises seen in SCA, how to identify them, and the modalities for treating various crises in the local environment. The introduction defines qualitative and quantitative haemoglobin abnormalities. It then outlines SCA pathogenesis, epidemiology, complications including vaso-occlusive crisis, management of crises through treatment of pain and infections, and prevention of sickle cell crises.
This document discusses Lassa fever, an endemic viral hemorrhagic fever found in parts of West Africa including Nigeria. It was first identified in 1969 after an outbreak infected and killed healthcare workers. The virus is transmitted from rodents to humans and can also spread between humans. Symptoms include fever, headache and bleeding. Diagnosis involves ELISA, virus isolation or PCR. Treatment is supportive, though the antiviral ribavirin may help if given early. Prevention focuses on rodent control, barrier nursing and safe medical practices. Nosocomial outbreaks remain a risk where infection control is poor. The document provides extensive details on the virus, epidemiology, transmission, clinical features, treatment and control of Lassa fever.
This document provides an overview of pituitary disorders, including:
- The pituitary gland regulates other endocrine glands and is regulated by the hypothalamus. It has anterior and posterior lobes.
- Anterior pituitary disorders include hyposecretion (hypopituitarism), hypersecretion (adenomas like prolactinomas and Cushing's disease), and sella enlargement.
- Causes of hypopituitarism include invasion, infarction, infiltration, injury, infections, immunologic issues, being iatrogenic, or being idiopathic. Symptom onset is gradual and follows a sequence of hormone deficiencies.
- Hyperfunctioning disorders include prolactinomas, acromegaly/
1. Stroke is defined as an acute brain attack caused by a disruption of blood flow, leading to neurological dysfunction lasting more than 24 hours.
2. Stroke is a leading cause of long-term disability worldwide and a major risk factor is hypertension. Diagnosis involves assessing symptoms, risk factors, and imaging of the brain.
3. There are two main types of stroke - ischemia caused by blockage of a blood vessel and hemorrhage caused by bleeding within the brain. Imaging is needed to distinguish between types and guide treatment.
Primary adrenal insufficiency, also known as Addison's disease, is caused by destruction or dysfunction of the adrenal cortex resulting in deficiencies of glucocorticoids and mineralocorticoids. Thomas Addison first described the clinical presentation in 1855. It most commonly presents with hyperpigmentation, dizziness, weakness, and weight loss. Diagnosis involves tests showing a lack of response to ACTH stimulation and electrolyte abnormalities. Treatment is lifelong glucocorticoid and mineralocorticoid hormone replacement to prevent adrenal crises.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
OVERVIEW OF HUMAN MONKEY POX VIRUS DISEASE.pptx
1. OVERVIEW OF HUMAN
MONKEY POX VIRUS DISEASE
BY
Dr. ABDULLAHI Asara Mohammed
Department of Internal Medicine,
Infectious and Tropical Diseases Unit,
ABUTH, SHIKA.
2. OUTLINE
• INTRODUCTION
• AETIOLOGY AND CHAIN OF TRANSMISSION
• CLINICAL MANIFESTATION
• CASE DEFINITION
• DIAGNOSIS
• DIFFERENTIALS
• CASE MANAGEMENT
• PROGNOSIS
• CONCLUSION
3. INTRODUCTION
• Monkeypox (MPX) is a viral zoonotic disease
• MPX occurs primarily around the rainforest of West and Central Africa……..
• Geographical spread of cases increasing…………………
• Causative virus first isolated in 1958 ( Statens Serum institute, Copenhagen,
Denmark)……………….
• First human MPX identified in 1970 in a 9/12 old boy (DRC)………………..
• First reported cases in Nigeria (1971)…………………………………
4. INTRODUCTION
• First reported human cases outside Africa 2003…………………………
• Re-emergence in Nigeria 2017…………………..
• Prior Smallpox vaccination offers some cross-protection to Monkey pox
• Children, pregnant women and immune-compromised are prone to severe
disease
• Prevention remains the key………………………………
5. AETIOLOGY/CHAIN OF TRANSMISSION/TRANSMISSION
Aetiology
• MPX virus a DS DNA virus
• Family: Poxviridae Genus: Orthopoxvirus
• Virus divided into two clades: WA and CA or Congo basin clade……
• Other important viruses in the Orthopoxvirus genus are
I. Variola virus….
II. Vaccinia virus..
III. Cowpox virus
7. AETIOLOGY/CHAIN OF TRANSMISSION/
TRANSMISSION
GENERIC DIAGRAM ILLUSTRATING CHAIN OF TRANSMISSION
PRIMARY LINKS: Infectious Agent, Susceptible host and Route of
transmission
SECONDARY LINKS: Reservoir, portal of entry and portal of Exit.
10. NIGERIA CENTRE FOR DISEASE CONTROL
10
Human
Environment
to man
Animal
Human to
human
Exposure
Portal of
entry
Mucosa
Skin Respiratory
Transmission
11. AETIOLOGY/CHAIN OF TRANSMISSION/MODE
OF TRANSMISSION
Animal to Human transmission Human to Human transmission Env. to Human transmission
• From bites or scratches,
• From activities such as hunting,
skinning, trapping, cooking,
playing with carcasses,
• Eating animals, such as NHP,
terrestrial rodents, antelopes
and gazelles, and tree squirrels
• Direct contact with infectious
skin or mucocutaneous
lesions……..
• Respiratory droplets (and
possibly short-range aerosols
requiring prolonged close
contact)
• From contaminated
clothing or linens that have
infectious skin particles (also
described as fomite transmission)
• Contaminated surfaces and
equipment
12. MPX UPDATE
Disease Outbreak News by WHO as at 8/6/2022
• From 28 countries in four regions where MPX is not usual or had not
previously occurred.
Confirmed Cases: 1285 majority from EU(1112)
Probable case: 1 Death: 0
• From Africa
Suspected cases: 1536
Confirmed Cases: 59
Death: 72
Source: Multi-country monkeypox outbreak: situation update( WHO June
2022)
13. MPX UPDATE
COUNTRY CONFIRMED CASES SUSPECTED CASES DEATH
CAMEROON 3 28 2
CAR 8 17 2
REPUBLIC OF CONGO 2 7 3
DRC 10 1356 64
LIBERIA 0 4 0
NIGERIA 31 110 1
SIERRIA LEONE 0 2 0
GHANA 5 12 0
CUMULATIVE 59 1536 72
Source: Multi-country monkeypox outbreak: situation update( WHO June 2022)
15. MPX UPDATE
NUMBER OF CONFIRMED CASES PER CLADES
DECADE CA CLADE(N) WA CLADE(N) TOTAL CONFIRMED
CASES*
1970-1979 38 9 47
1980-1989 355 1 356
1990-1999 520 0 520
2000-2009 92 47 139
2010-2019 85 195 280
Adapted from:Bunge EM et al. (2022) The changing epidemiology of human monkeypox—
A potential threat? A systematic review. PLoS Negl Trop Dis 16(2): e0010141.
https://doi.org/10.1371/ journal.pntd.0010141
16. MPX UPDATE
Pooled CFR for MPX SOME MAJOR CONCERNS
• Re-emergence in WA
• Increasing global spread
• Some identified cases with no
known epidemiological link
• ? Emerging route of transmission,
reservoirs,…………………..
• Adapted: PLOS Neglected Tropical
Diseases |
https://doi.org/10.1371/journal.pn
td.0010141
17. CLINICAL MANIFESTATION
• Patients may be symptomatic or Asymptomatic
• I.P:5–21 days. Usually 6-13 days
• Infection usually mild-to-moderate in nature
• Clinical course divided into two periods: Invasion/prodromal period
and Skin eruption period
18. NIGERIA CENTRE FOR DISEASE CONTROL
18
Pathophysiology…Cond
Oral sores, genital
ulcers, cornea lesions,
pneumonia
Skin rash
Lymphadenopathy
Fever, systemic
symptoms
Human
Environment
to man
Animal
Respiratory
Skin
Human to
human
Lymphatics
Mucosa-GIT,
others
Skin Blood
Mucosa-GIT,
others
Exposure
Portal of
entry
Primary viremia
Secondary viremia
Specific symptoms and
signs
19. CLINICAL MANIFESTATION
Invasion/Prodromal Period/Pre-eruptive stage(0-5
days)
Skin Eruption Period( within 1-3 days of fever onset)
• Fever,
• Intense headache,
• Lymphadenopathy,
• Back pain,
• Myalgia (muscle ache) and an intense asthenia
• Conjunctivitis
• Photophobia
• Pruritus
• Mouth sores
• Rashes appear in various stages often beginning on
the face and then spreading elsewhere on the
body.
• The face (in 95% of cases), and palms of the hands
and soles of the feet (in 75% of cases) are most
affected.
• The rashes are evolving in nature: Maculpapular,
vesicles, pustules, crusts….
20. NIGERIA CENTRE FOR DISEASE CONTROL
20
The rash lesions evolve from
macules (lesions with a flat base) to
papules (raised firm lesions) to
vesicles (filled with clear fluid) to
pustules (filled with yellowish fluid)
Crusting is the last stage
The rash affects
The Face in 95% of cases
The Palms and soles of the feet (75%)
Oral mucous membranes (70%)
Genitalia (30%)
The Conjunctivae and Cornea (20%)
It may take three weeks for crusts to disappear
Rash resolved, Pitted scars and/or areas of lighter or
darker skin may remain after scabs have fallen off.
Once all scabs have fallen off, a person is no
longer contagious.
21. NIGERIA CENTRE FOR DISEASE CONTROL
21
Usually 6 to 16 days, but can range
from 5 to 21 days
Develops within 1-3 days after
appearance of fever
14 to 21 days after appearance
of rash
Incubation period
Fever and constitutional
symptoms
Skin rash/mucosal lesions
Systemic manifestations
Sequelae and
complications
Complete resolution
Exposure to monkeypox virus
Chronology of signs and symptoms
22. COMPLICATIONS
• Secondary bacteria infection of
skin lesions
• Septic dermatitis
• Sepsis
• Bronchopneumonia
• GIT: Vomiting, diarrhea,
• Malnutrition
• AKI
• Eye: Keratitis, corneal ulceration
• Encephalitis
• Seizures
• Ulcers
• Mental health
• Death
23. NIGERIA CENTRE FOR DISEASE CONTROL
23
Sequelae
Skin colour changes
• Hyperpigmentation
• Hypopigmentation
Scars
• Pitted scars
• Hypertrophic scars
Contractures
Alopecia
• Usually partial and reversible
Deformity
• May follow poorly treated skin lesions and
ulcers , urethral strictures
Psychological dysfunction
28. CASE DEFINITIONS
Case Definition: NCDC guidelines
Suspected Case Probable Case Confirmed case
• An acute illness with fever >38.3oC,
intense headache,
lymphadenopathy, back pain, myalgia, and
intense asthenia followed
one to three days later by a progressively
developing rash often
beginning on the face (most dense) then
spreading elsewhere on the
body, including soles of feet and palms of
hand.
• A case that meets the clinical case
definition, is not laboratory
confirmed, but has an
epidemiological link to a
confirmed case
• A clinically compatible case
that is laboratory
confirmed………..
29. CASE DEFINITIONS
• So who is a contact?.................................................
Contact
• Any person who has been in direct or indirect contact with a
confirmed case since onset of symptoms i.e. contact with skin lesions,
oral secretions, urine, faeces, vomitus, blood, sexual contact, sharing
a common space (anyone who has been in close proximity with or
without physical contact with a confirmed case).
30. CASE DEFINITIONS
RECOMMENDED CONTACT CATEGORIZATION FOR MPX
Type 1:Direct contact with skin lesions of a confirmed MPX case
- vesicles, pustules, crusts etc. (including sexual contact) OR direct
contact with a confirmed animal case
Type 2:Direct contact with body fluids of confirmed MPX
case (blood, urine, vomitus, faeces, stool, sputum etc.)
Type 3: Sharing of common space with case…………………………….
31. DIAGNOSIS
Laboratory investigations done for various reasons
I. Definitive diagnosis of MPX- PCR with or without sequencing, Viral
Culture.
II. Suggestive but no definitive test……
III. Investigation for underlying co-morbidities……
IV. Investigation to rule out differentials
V. Investigation for Complications
VI. Investigation for Monitoring
32. DIAGNOSIS
Test Description
PCR (including real-time PCR) Tests for the presence of MPXV specific DNA signatures
Viral culture/isolation Live virus is grown and characterized from a patient specimen
Electron microscopy Clear image of a brick-shaped particle for visual classification of a poxvirus
Immunohistochemistry Tests for the presence of OPXV specific antigens
Anti-OPXV IgG Tests for the presence of OPXV antibodies
Anti-OPXV IgM Tests for the presence of OPXV antibodies
Tetracore OrthopoxBioThreat Alert test for the presence of OPXV antigens
Source: Katy Brown K and Leggat P.A. Human Monkeypox: Current State of Knowledge and Implications for the
Future. Trop. Med. Infect. Dis. 2016, 1, 8; doi:10.3390/tropicalmed1010008
34. NIGERIA CENTRE FOR DISEASE CONTROL
34
Monkeypox: Differential diagnosis
Symptoms Monkeypox Chickenpox Measles
Fever Fever >38°C
Rash after 1-3
days
Fever to 39°C
Rash after 0-2
days
High fever to
40.5°C, Rash
after 2-4 days
Rash
appearance
Maculopapular,
vesicles,
pustules
present at the
same stage on
any area
Macules,
papules,
vesicles,
present in
several
stages
Non-vesicular
rash in
different
stages
Rash
development
Slow, 3-4 weeks Rapid, appear in
crops over
several days
Rapid, 5-7 days
Rash
distribution
Starts on head;
more dense on
face and limbs;
appears on
palms and soles
Starts on head;
more dense on
body; absent on
palms and soles
Starts on
head and
spreads; may
reach hands
and feet
Classic
feature
Lymphadenopathy Itchy rash Koplik spots
Death Up to 11% Rare Varies widely
35. DIFFERENTIALS
Important STI to rule out depending on site of lesions
I. Syphillis
II. LGV
III. Chancroid
IV. Granuloma inguinale
V. Genital Herpes
36. CASE MANAGEMENT
• Human MPx is essentially a self limiting illness in majority of cases
• Complete resolution expected in 3-4 weeks in most cases
• Management is mainly symptomatic and supportive guided by
principles
• Tecovirimat an antiviral is not widely available……………….
37. CASE MANAGEMENT
Principles of management( Credit:NCDC)
• Protection of compromised skin and/or mucous membranes
• Rehydration therapy
• Alleviation of distressful symptoms
• Provision of nutritional support
• Treatment of complications
• Prevention and management of long term sequelae
• Psychosocial support
• Treatment of comorbidities
38. NIGERIA CENTRE FOR DISEASE CONTROL
38
System affected/
syndrome
Treatment
objective
Therapeutic considerations/
Clinical setting
Follow-
up/Monitoring
Fever Prevent and treat
episodes of fever
Antipyretic medications, external cooling Routine
temperature
monitoring
Pain Relieve pain Analgesics Pain monitoring
Pruritus Prevent and relieve skin
itching
Warm bath/warm clothing
Calamine Lotion
Antihistamines
Evidence of scratch
marks
Exfoliation, skin
compromise
Minimize insensible
fluid loss, promote
lesion healing
Clean with normal saline , clean ulcers with
povidone-iodine solution or other antiseptic
solution, moisturized dressings, topical antibiotics
(e.g., mupiricon, surgical debridement, skin grafts
if necessary
Lesion count / rash
burden, body
weight, fluid intake /
output
Superinfection skin Prevention/treatment of
secondary bacterial
infections, promote
lesion healing
Oral/intravenous antibiotics, incision and
drainage, advanced wound management (e.g.,
negative pressure wound therapy)
Fever,
pain/tenderness,
erythema, edema,
exudate, warmth
Inflammation/
lymphadenopathy
Minimize pain and
decrease size of
lymphadenopathy
Oral/intravenous anti-inflammatory/analgesic
medications
Size of
lymphadenopathy,
pain/ tenderness
Supportive Treatment Considerations - 1
39. NIGERIA CENTRE FOR DISEASE CONTROL
39
System affected/
syndrome
Treatment objective Therapeutic considerations/
Clinical setting
Follow-up/Monitoring
Respiratory tract Maintain patent airways,
prevent respiratory
infection, atelectasis, and
respiratory compromise
Suctioning of the nasopharynx and airways,
incentive spirometry, chest physiotherapy,
bronchodilation, oral/intravenous antibiotics for
prophylaxis/treatment, nebulizer treatments,
bronchoscopy, noninvasive ventilation (e.g., BiPAP
or CPAP), intubation/ventilation
Respiratory rate, pulse oximetry
Sepsis Hemodynamic stabilization Oral/intravenous antibiotics, hemodynamic (e.g.,
intravenous fluid hydration and vasopressors),
supplemental oxygen, corticosteroids, insulin
Hemodynamic monitoring (e.g.,
pulse rate, blood pressure)
Gastrointestinal/ mouth &
throat sores
Minimize mucosal pain and
disruption of food intake,
promote lesion healing
Oral/topical analgesic medications
I.V Antibiotics
Lesion burden, pain scale,
food/fluid intake
Gastrointestinal/ vomiting,
diarrhea
Minimize gastrointestinal
fluid losses
Oral/intramuscular antiemetic and antidiarrheal
medications, oral/intravenous rehydration
Frequency and volume of
emesis and diarrhea, body
weight, fluid intake / output
Ocular infection Prevent corneal scarring
and vision impairment
Ophthalmic antibiotics/antivirals and corticosteroids.
Refer to Ophthalmologists
Vision testing
Supportive Treatment Considerations -2
40. CASE MANAGEMENT
THERAPEUTICS AND VACCINE PIPELINE
Antivirals
• In patients with MPX, it is preferable to use antivirals under
randomized clinical trials (RCTs)…………….
Antiviral Brief description
Tecovirimat Inhibit viral env formation by inh. VP37…..
Brincidofovir Approved for treatment of smallpox, embryo fetal toxicity
Cidofovir DNA polymerase inhibitor, Approval is for CMV, Found to have activity against
poxviruses…….,nephrotoxic
NIOCH-14 Tecovirimat analogue……………………….
42. CASE MANAGEMENT
Vaccines examples Generation Approval for Smallpox Approval for monkeypox
Vaccinia, various strains*
from national production
1 Various countries Various national
production (SEP), held by various
countries
NO
ACAM20 (Emergent
BioSolutions)
2 USA - Approved USA - EIND for PEP
LC16m8 (KM Biologics) 3 Japan - Full MA (1975) USA - EIND
(2014)
NO
MVA-BN (Bavarian
Nordic)
3 EU: Imvanex has been authorised
under exceptional circumstances
(2013) Canada: Full MA (2013) USA:
Full MA (2019)
USA, full MA (2019)
Canada, full MA (2019)
LC16m8∆ 4
43. CASE MANAGEMENT
Vaccines and Immunization: Interim guidance by WHO(14/6/2022)
Few points from the document
I. Currently Mass vaccination for MPX is nor required nor
recommended
II. PEP recommended for contact of cases ideally within 4 days of
exposure to prevent onset of disease………
III. PrEP for High risk group……………..
IV. Decision for use of vaccines should based on full assessment of risk
and benefit on a case by case basis……………
44. PROGNOSIS
• Generally good if promptly recognized and managed well…………….
• Certain factors have been shown to affect prognosis with associated
unfavourable outcome
• Prompt recognition of these bad prognostic factors with prompt
management is necessary to reduce morbidity and mortality
45. PROGNOSIS
Some factors shown to affect MPX severity and prognosis
Factors Remark
Belonging to high risk group Children, Pregnant women, Immunosuppresion
Clade of MPX virus CB clade> WA clade
Presence of clinical signs and
symptoms of complications
………………………………………………
Laboratory Abnormalities Elevated
transaminases,hypoalbuminaemia,leukocytosis,low
BUN, thrombocytopenia e.t.c
Skin lesions severity…….. Mild(<25 lesions), Mod(25-99), Sev(100-250) and Very
severe(>250)
46. CONCLUSION
• MPX is a viral zoonotic disease
• Rising global cases worrisome
• Need for increase index of suspicion for prompt diagnosis and
management
• Global response through coordinated one health approach necessary
to control and/or prevent MPX…………..
47. REFERENCES
• National Monkeypox Public Health Response Guidelines NCDC 2019
• Clinical management and IPC for Monkeypox. Interim rapid response guidance.
WHO(10/6/2022)
• NCDC Regional MPX Case management training slides
• Ladnyj, I. D., Ziegler, P., & Kima, E. (1972). A human infection caused by
monkeypox virus in Basankusu Territory, Democratic Republic of the
Congo. Bulletin of the World Health Organization, 46(5), 593–597.
• Kidokoro, M., & Shida, H. (2014). Vaccinia Virus LC16m8∆ as a Vaccine Vector for
Clinical Applications. Vaccines, 2(4), 755–771.
https://doi.org/10.3390/vaccines2040755