Mpox, formerly known as monkeypox, is a viral disease caused by the monkeypox virus, an orthopoxvirus. This virus is closely related to the smallpox virus, but while smallpox was eradicated in 1980, mpox continues to pose health challenges, particularly in central and west Africa. Since May 2022, mpox cases have been reported in countries outside Africa that previously had no documented transmission. Two main clades of the monkeypox virus are recognized: Clade I (formerly the Congo Basin or central African clade) and Clade II (the west African clade).
What is Mpox?
Mpox is a zoonotic disease, meaning it can be transmitted from animals to humans. The virus is commonly found in tropical rainforests where animals like squirrels, Gambian pouched rats, dormice, and various monkey species act as reservoirs. Human-to-human transmission is also possible, occurring through contact with bodily fluids, skin lesions, mucosal surfaces (like the mouth or throat), respiratory droplets, and contaminated objects.
Diagnostic Testing: The most reliable method for diagnosing mpox is polymerase chain reaction (PCR) testing, which detects viral DNA. Samples are ideally taken from skin rashes, fluid, or crusts. Antigen and antibody tests are less effective as they cannot distinguish between orthopoxviruses.
Symptoms of Mpox
Mpox presents with several key symptoms:
- Initial Symptoms: Fever, severe headache, swollen lymph nodes, back pain, muscle aches, and a profound lack of energy (asthenia). This febrile stage typically lasts 1 to 3 days.
- Rash Development: After the initial symptoms, a characteristic rash develops, evolving through stages:
- Macules: Flat lesions
- Papules: Raised, firm, painful lesions
- Vesicles: Fluid-filled blisters
- Pustules: Pus-filled lesions
- Crusts: Final stage where lesions form scabs
The rash stage can last 2 to 4 weeks. The severity of the disease can vary, with the mortality rate ranging from 0% to 11%, particularly higher among young children.
Treatment and Management
Currently, treatment for mpox is supportive and focuses on alleviating symptoms. Research is ongoing to develop effective therapeutics against the virus.
Prevention and Control: Preventive measures include:
- Awareness and Education: Informing communities and health workers about the disease to prevent infection and control its spread.
- Avoiding Contact: Avoid close contact with infected individuals and contaminated materials. Use personal protective equipment (PPE) when caring for sick patients.
- Animal Contact: Avoid contact with sick or dead animals, and ensure all animal meat is thoroughly cooked.
- Vaccination: Routine smallpox vaccination, which provided cross-protection against mpox, has been discontinued, leading to increased susceptibility. Newer vaccines are now available and may offer protection against mpox. Historically, the first-generation smallpox vaccine was about 85% effective in preventing mpox. Today, there are three vaccines specifically for mpox, though they are available in limited quantities and are recommended for high-risk individuals.
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