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Monkeypox in 10 questions

Experts under the Turkish Society of Clinical Microbiology and Infectious Diseases (KLİMİK), which has been observed in 13 countries so far, “Is this causing a new epidemic?” He made an extensive study of the monkeypox virus, which caused his concern.

Here is the ‘monkeypox virus’ in 10 questions…

1- Is monkeypox a new disease?

Monkeypox is not a new disease. After being detected in monkeys in 1958, the first case in humans was observed in 1970 in the Democratic Republic of Congo. The disease, which was discovered in 1958 after a smallpox-like outbreak among monkeys in a research laboratory, was named “monkey pox” for this reason.

The frequency of the disease, which is observed in 11 countries with tropical rainforests in Central and West Africa, particularly in Nigeria and the Democratic Republic of Congo, is not precisely known. It is estimated that there are several hundred cases each year in Africa. The disease is sometimes transmitted from the African continent to other continents by infected animals or humans, but few people are affected and regional clusters of cases are observed.

2- Why has it attracted attention now?

Until now, it was known that all cases outside Africa were caused by people coming from Africa or by imported rodents. However, as the number of cases detected outside Africa increased last week, surpassing the total number of cases seen outside Africa, it has drawn the attention of the World Health Organization and the scientific world.

3- What is the causative agent of the disease?

Monkeypox is a DNA virus related to the smallpox virus. It includes two subtypes, West African and Central African (Congo Basin). West Africa has a milder disease than the Congo type. Although genetic analyzes are not yet complete, cases observed outside Africa are expected to belong to the West African subtype.

4- How is it transmitted?

Contrary to its name, the disease, which is more common in rodents such as squirrels, rats and mice than in monkeys, and is transmitted from them to humans, is also transmitted following close contact with infected people or objects such as clothes. , towels and sheets contaminated with the virus. The virus enters healthy people through invisible cracks/scratches on the skin, mucous membranes (mouth, nose, eyes) or respiratory system.

Human-to-human transmission is thought to occur through large respiratory droplets. Transmission of disease by large droplets that cannot travel long distances occurs through direct, long-term, close contact.

5- What are the signs and symptoms?

Monkeypox causes fever, headache, fatigue, general body aches, swollen lymph nodes, and skin lesions (rash). Swollen lymph nodes are the most prominent symptom of monkeypox, which distinguishes it from smallpox, chickenpox, and measles. Complaints appear on average 6 to 13 days after contact with the virus.

During the first 5 days of illness, fever, severe headache, swollen lymph nodes, back pain and extreme weakness are experienced, and rashes are seen within 1-3 days. the onset of fever. Lesions on the palms, feet, inside of the mouth, genital area and eyes disappear with crusting and dropping.

6- How is the diagnosis made?

If monkeypox is suspected, it is necessary to ask whether people with symptoms have traveled to risk areas in the past month or been in close contact with people with similar symptoms.

The disease, which cannot be diagnosed with blood samples, cannot be detected by PCR because it remains in the blood for a very short time. It is believed that antigen and antibody tests will not always give accurate results for reasons such as the smallpox vaccine applied before.

If disease is suspected, samples collected correctly and with the necessary safety precautions and wrapped over the lesions should be sent to the “biosafety level 2” laboratory.

Those who come into contact with animals or people with confirmed monkeypox should be monitored for signs and symptoms for 21 days after last contact.

7- Can there be an asymptomatic infection?

Although unclear, monkeypox is thought not to cause asymptomatic illnesses like Covid-19.

Monkeypox is not expected to spread in the community as much as Covid-19 or other infections that are transmitted when asymptomatic, as the appearance of symptoms in infected people will ensure that these people are identified and isolated. .

8- Is monkeypox fatal?

Monkeypox usually heals on its own in 2 to 4 weeks. However, severe disease can be seen in immunocompromised people and young children.

Typically, 3-6% of those who get sick die, mostly young children. While the lethality of the Central African subtype of the disease can reach up to 11%, the lethality of the West African subtype, which is thought to cause the current cases, remains at a lower rate of 1%.

9- Does the smallpox vaccine protect against the disease?

Although there is no widely used drug for monkeypox, cases have been controlled with drugs containing active ingredients such as cidofovir and brinsidofovir.

Based on experiences in Africa, the World Health Organization has reported that the smallpox vaccine will provide up to 85% protection against monkeypox. But the smallpox vaccine has not been given since 1980 due to the worldwide end of the disease. Therefore, the people currently vaccinated are people over the age of 40-50. The long timeframe raises concerns about the level of protection.

10- Is it likely to cause an epidemic?

It causes a Covid-19-like epidemic due to factors such as the prominence of signs and symptoms of monkeypox, the absence of asymptomatic infection according to current information, transmission by close and long-term contact, the fact that it mutates less than it is a DNA virus, and changes easily and new variants do not appear.

Source: Cumhuriyet

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