Monkeypox Virus, Pandemic And the Pursuit of Good Health

We are all pandemic fatigued. Are you old enough to remember the monkeypox outbreak which occurred in the United States of America almost two decades ago? Many of you might be wondering what the hell is monkeypox. Undoubtedly, we are all familiar with the coronavirus which has upended our lives since early 2020; resulting in a global death tally of more than 4 million. Unfortunately, it seems as if we are living in the age of viruses, diseases and pandemics. Monkeypox virus is very common in parts of Africa. The Centers for Disease Control and Prevention (CDC) states that monkeypox is a rare disease that is caused by infection with monkeypox virus. Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus (the cause of smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus. Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘monkeypox.’ The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then, monkeypox has been reported in humans in other Central and Western African countries. Human monkeypox infections have only been documented six times outside of Africa; in the United States in 2003 (47 cases), in both the United Kingdom (3 cases) and Israel (1 case) in 2018, in Singapore in 2019 (1 case) and in both the United Kingdom (3 cases) and the United States (1 case) in 2021. The CDC states there are two distinct genetic groups (clades) of monkeypox virus; Central African and West African. Human infections with the Central African monkeypox virus clade are typically more severe compared to those with the West African virus clade and have a higher mortality. Person-to-person spread is well-documented for Central African monkeypox virus and limited with West African monkeypox. Recently, a passenger who flew from Dallas, Texas to Nigeria was diagnosed with monkeypox. It is the first case of the virus seen in the United States in nearly two decades. The news reported that the patient is hospitalized in isolation in Dallas and is in stable condition. The illness, caused by the monkeypox virus, has not been detected in the U.S. since a 2003 outbreak, which involved 47 people. That outbreak was traced to pet prairie dogs in the Midwest that harboured the virus. Monkeypox can also spread from person to person through respiratory droplets or other bodily fluids. According to officials one reason the risk of spread may be low in this case is that the patient as well as fellow airline passengers wore masks on the flight. Additionally, two other recent cases of monkeypox were reported in North Wales recently. There have been two cases of monkeypox identified in north Wales, health officials have said. Public Health Wales (PHW) said the initial case was acquired overseas and both cases were identified in two people from the same household. Signs and Symptoms In humans, the symptoms of monkeypox are similar to but milder than the symptoms of smallpox. Monkeypox begins with fever, headache, muscle aches, and exhaustion. The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not. The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days. According to the CDC within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a rash, often beginning on the face then spreading to other parts of the body. Lesions progress through the following stages before falling off. The illness typically lasts for 2−4 weeks. In Africa, monkeypox has been shown to cause death in as many as 1 in 10 persons who contract the disease. Interestingly, some of the symptoms of monkeypox mimic those of the coronavirus. It is important that we see our primary caregiver once these symptoms present themselves. Prevention There are a number of measures that can be taken to prevent infection with monkeypox virus: Avoid contact with animals that could harbor the virus (including animals that are sick or that have been found dead in areas where monkeypox occurs). Avoid contact with any materials, such as bedding, that has been in contact with a sick animal. Isolate infected patients from others who could be at risk for infection. Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer and the use of personal protective equipment (PPE) when caring for patients. Transmission Transmission of monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth). Animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding. Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required. Other human-to-human methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens. Treatment Currently, there is no proven, safe treatment for monkeypox virus infection. For purposes of controlling a monkeypox outbreak in the United States, smallpox vaccine, antivirals, and vaccinia immune globulin (VIG) can be used. Medical community agrees that within a week of symptom onset, an infected person develops a bumpy, raised rash that often spreads to the entire body. The person is considered contagious until those raised bumps have scabbed over and fallen off. Most patients recover within a month. In rare cases, the virus can be fatal. No one in the 2003 outbreak in the United States of America died. The virus got its name because it was first found in laboratory monkeys in the late 1950s. It wasn't until 1970 that it was detected in humans in Congo. Cases have almost exclusively been contained to remote areas of Central and West Africa. A New Normal The world as we knew it will never return; the pandemic has changed the world forever. As global citizens we have a responsibility not only to ourselves and immediate family but also to the wider community. We need to see each other as our brother’s keeper and as such respect each other accordingly. We must also be mindful that Jamaica is a signatory to the United Nations Sustainable Development Goals; goal #3 speaks to ensuring healthy lives and the well-being for all citizens. Those of us with Non-Communicable Diseases must take the necessary steps to avoid contracting this monkeypox virus or another virus for that matter. Globally, 74% of all deaths in 2019 were caused by Non- Communicable Diseases (NCDs). The probability of dying from any of the four main NCDs (cardiovascular disease, cancer, diabetes or chronic respiratory disease) between age 30 and 70 declined from 19.9% in 2010 to 17.8% in 2019. This rate of decline is insufficient to meet SDG target. The COVID-19 pandemic underscores the need for further attention to NCD interventions as people with underlying NCD conditions have higher risks of severe illness and death from the coronavirus. We must keep ourselves informed of current health issues. Furthermore, we must remain vigilant regarding our health. In the words of Jeffrey Klugger, There's no one place a virus goes to die but that doesn't make its demise any less a public health victory. Throughout human history, viral diseases have had their way with us, and for just as long, we have hunted them down and done our best to wipe them out. Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. waykam@yahoo.com @WayneCamo #monkeypoxvirus #pandemic ©