Mpox, monkeypox: what to know, how it occurs, what causes

It seemed only a story to be read in the history of medicine manuals, that of the country doctor Edward Jenner who in the eighteenth century had identified the method of prevention of human smallpoxauthentic scourge of humanity, based on the observation that milkers who had contracted a benign form of cowpox then resisted infection by the human one.

Today, apart from those who still have the “sign” of smallpox on their arm, talking about this disease seems almost out of time. But as is often the case in medicine, sometimes viruses also come back. Maybe not perfectly identical to those we already know, but similar. Thus, 2022, in addition to the many human health problems that are often talked about, brought back to the fore a virus that hadn’t made the news for some time. It is the virus that causes it monkeypoxor monkey pox. Since the end of November 2022, WHO has decided to replace these terms with the name Mpoxbut little changes. This pathology, which can also affect humans, represents a classic case of zoonosis with humans becoming hosts of viruses that previously reproduced exclusively in animals. And it must be known, also in order to limit the risks.

What is the difference between monkeypox and classic smallpox?

While the name may be deceiving, the two diseases are profoundly different. And I’m viruses are very different which cause them. Smallpox was declared eradicated in 1980 by the World Health Organization.

Mpox, on the other hand, although it belongs to the Orthopoxvirus family and is therefore similar to the one that causes human smallpox, nevertheless has characteristics that make it very different. It is in fact determined by a viral strain that differs from the human one due to its lower diffusivity and severity. It must be said that this is not a new virus.

Mpox is present in an endemic form in countries of central and western Africa. It is a zoonosis that can also affect humans, through contact with infected animals, especially primates and small rodents, or even through the ingestion of game. Transmission can also take place by human-to-human contagion, but this is a method that appears to be ineffective and above all requires very close contact.

Why are we talking about zoonoses

Do not think that environmental change does not also reverberate in industrialized countries. And of many diseases, unfortunately, we do not know enough. Just think in this sense of the case of West Nile virusresponsible for a syndrome called precisely Nile fever, characterized by fever, headache, general malaise, body aches, loss of appetite. In about half of the cases, a maculopapular rash appears and about 1% of the infected can develop meningitis and/or encephalitis, even serious ones.

It’s just an example of how diseases can pass from animals to humans and in this sense, for years now, the USA has been dealing with the Monkey-pox caused by the analogous virus. However, the epicenter of the infection is far away, in some areas of Africa where the first human case was identified in 1970.

It’s about a zoonotic infection (transmitted from animals to humans) caused by a virus of the same smallpox family (Poxviridae) but which differs from this due to the lower transmissibility and severity of the disease it causes. The name derives from the first identification of the virus, discovered in monkeys in a Danish laboratory in 1958. It is particularly widespread among primates and small rodentsmainly in Africa. In endemic areas it is transmitted to humans through a bite or direct contact with blood, the meat, body fluids or skin lesions of an infected animal. The virus was first identified as a human pathogen in 1970 in the Democratic Republic of the Congo.

These are just examples of how viruses can pass from animals to humans, because they change and are capable of overcoming the species barrier. Just the leap of species, a natural consequence of the increase in contacts between human beings, would be at the origin of real “transformations”. History says so. The inhabitants of the new continent, who had no pets except dogs and did not “know” the infections developed in Europe, were literally decimated by the new viruses of the old continent. And the epidemics brought by the first explorers, such as smallpox, measles and diphtheria, were fatal to the local populations. Nearly 90 percent of North and Central America’s population died in the first century after the invasions, largely from the “new” animal-borne infectious diseases.

Can monkeypox be transmitted between people?

Yup. The risk exists. But it’s very limited. There is evidence of a possible transmission through material of the skin lesions, through the breath and above all during sexual intercourse. Although it cannot be completely ruled out, possible transmission through healthy skin appears very unlikely.

For this reason, there are no major concerns for the general population, even if one should not let one’s guard down in a preventive key for people who have a particularly fragile immune system, due to age or the presence of diseases, and in any case for younger children and for pregnant women. Finally, it is always advisable for healthcare professionals to use protective devices, from gloves to masks to goggles, to counteract potential risks.

Incubation can be long

If you think of a cold or in any case of one of the classic viruses we deal with, it usually takes a few days for the symptoms of the infection to appear. In this case however the incubation to go on too up to three weeksalthough generally we focus in one or two weeks to see the appearance of symptoms after infection.

The viral transmission, which is not particularly easy for mankind, can be had above all through the droplets that are produced by those who are sick or from direct contact with skin lesions in which the infection is present, as well as through contaminated materials. According to reports from the World Health Organization, in general the ailments are the classic ones of a form of flu, such as a rise in temperature, headache and muscle pain, with one substantial difference.

Given the type of virus that causes the infection, there are two different strains in Africa, skin involvement is to be expected. What does it mean? appearing lesions that cause itching and in some cases they can also indicate pain. However, it should not be forgotten that there may be completely asymptomatic cases. Particular attention should be paid in the event of pregnancy, given that pictures capable of impacting the health of the unborn child in the presence of infection may occur.

Can monkeypox be prevented?

As far as is known so far, who has been vaccinated with the classic “anti-smallpox” of a time should also be substantially protected by this form. However, given the substantial presence in a very limited geographical area of ​​the African continent as regards human cases of monkeypox, it is to be thought that many people are potentially exposed to an infectious risk. This is why attention is needed, especially for the under-50s who have not had vaccination protection for smallpox.

In terms of prevention, however, it must be said that there is a targeted pharmacological treatment and that there is an approved vaccine for this form. However, it must be said that it can exist a wide variability in the severity of symptoms induced by the infection, with many cases resolving themselves without particular problems. However, attention must be paid and the health authorities are monitoring the situation: in particular, normal hygiene and prevention rules must always be followed, especially for those who travel a lot, given that cases have already been reported in various European countries.

Is there a specific vaccine for Mpox?

As the institutional sites report, there is a vaccine it contains modified vaccine virus. It is however indicated for a small category of people, without having to think of a mass vaccination, also due to the reduced availability of doses. In general terms, vaccination is offered to specific categories, from people who have had multiple partners in recent months or in any case have potentially risky behaviors up to laboratory personnel who could be in contact with the virus. These are very specific definitions, which should be recommended on a case-by-case basis.

It is important to remember that vaccination can be offered above the age of 18 as pre-exposure prophylaxis. The vaccine, for those who have never had a previous vaccination for the human smallpox virus, must be administered in a double dose. A single dose is sufficient for the booster. The Mpox vaccine can be administered intradermally or subcutaneously.

How to cure monkeypox

In general the symptoms and signs of the infection are very limited. The important thing is to rest at home and talk to your doctor if small blisters appear on the skin or other manifestations. It is also important to limit the risk of contagion for others in the presence of fever, skin lesions, swelling of the lymphatic glands. In terms of therapies, in general, it is sufficient to keep symptoms such as pain, weakness, headachefever, lymphadenopathy.

Bibliographic sources

Monkeypox, what we know, Higher Institute of Health.

Monkeypox – MPX, Ministry of Health.

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Mpox, monkeypox: what to know, how it occurs, what causes

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