What to look for: Monkeypox facts from the World Health Organisation | Loop Barbados

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Since the most recent outbreak of monkeypox, the World Health Organisation (WHO) has recorded as of May 21, 92 laboratory-confirmed cases, and 28 suspected cases of monkeypox with investigations ongoing.

The cases have been reported to the WHO from 12 Member States that are not endemic for monkeypox virus, across three WHO regions.

What is monkeypox?

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms very similar to those seen in the past in smallpox patients, although it is clinically less severe. It is caused by the monkeypox virus which belongs to the orthopoxvirus genus of the Poxviridae family. There are two clades of monkeypox virus: the West African clade and the Congo Basin (Central African) clade.

The name monkeypox originates from the initial discovery of the virus in monkeys in a Danish laboratory in 1958.

When was the first case detected in humans?

The first human case was identified in a child in the Democratic Republic of the Congo in 1970.

How is monkeypox transmitted?

Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding. The incubation period of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.

Various animal species have been identified as susceptible to the monkeypox virus. Uncertainty remains on the natural history of the monkeypox virus and further studies are needed to identify the exact reservoir(s) and how virus circulation is maintained in nature. Eating inadequately cooked meat and other animal products of infected animals is a possible risk factor.

Some virologists are now asking if there is the possibility for the virus to be sexually-transmitted since the newest cases have been recorded in unusual countries outside of Africa.

How dangerous is monkeypox?

Monkeypox is usually self-limiting but may be severe in some individuals, such as children, pregnant women or persons with immune suppression due to other health conditions. Human infections with the West African clade appear to cause less severe disease compared to the Congo Basin clade, with a case fatality rate of 3.6 per cent compared to 10.6 per cent for the Congo Basin clade.

No associated deaths have been reported to date from this new outbreak, reports WHO.

Why is the WHO raising awareness of monkeypox now?

Endemic monkeypox disease is normally geographically limited to West and Central Africa. The identification of confirmed and suspected cases of monkeypox without any travel history to an endemic area in multiple countries is atypical, hence, there is an urgent need to raise awareness about monkeypox and undertake comprehensive case finding and isolation (provided with supportive care), contact tracing and supportive care to limit further onward transmission.

What to look out for?

Countries should be on the alert for signals related to patients presenting with an atypical rash that progresses in sequential stages – macules, papules, vesicles, pustules, scabs, at the same stage of development over all affected areas of the body – that may be associated with fever, enlarged lymph nodes, back pain, and muscle aches. These individuals may present to various community and healthcare settings including but not limited to primary care, fever clinics, sexual health services, infectious disease units, obstetrics and gynecology, urology, emergency departments and dermatology clinics. Increasing awareness among potentially affected communities, as well as health care providers and laboratory workers, is essential for identifying and preventing further secondary cases and effective management of the current outbreak.

Where outside of Africa, have cases been detected as of 1 pm, May 21, 2022?

Monkeypox cases detected in these countries up to May 21 2022

Where is monkeypox endemic?

Monkeypox endemic countries are: Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ghana (identified in animals only), C?te d’Ivoire, Liberia, Nigeria, the Republic of the Congo, and Sierra Leone. Benin and South Sudan have documented importations in the past. Countries currently reporting cases of the West African clade are Cameroon and Nigeria.

With this case definition, all countries except these four should report new cases of monkeypox as part of the current multi-country outbreak.

How are cases ruled as suspected monkeypox cases?

WHO has developed surveillance case definitions for the current monkeypox outbreak in non-endemic countries.

(case definitions will be updated as necessary)

Suspected case:

A person of any age presenting in a monkeypox non-endemic countrywith an unexplained acute rash

AND

One or more of the following signs or symptoms, since March 15, 2022:

HeadacheAcute onset of fever (>38.5oC),Lymphadenopathy (swollen lymph nodes)Myalgia (muscle and body aches)Back painAsthenia (profound weakness)

AND

for which the following common causes of acute rash do not explain the clinical picture: varicella zoster, herpes zoster, measles, Zika, dengue, chikungunya, herpes simplex, bacterial skin infections, disseminated gonococcus infection, primary or secondary syphilis, chancroid, lymphogranuloma venereum, granuloma inguinale, molluscum contagiosum, allergic reaction (e.g., to plants); and any other locally relevant common causes of papular or vesicular rash.

N.B. It is not necessary to obtain negative laboratory results for listed common causes of rash illness in order to classify a case as suspected.