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Much ado about Mpox

Our planet is full of Pox diseases; Cowpox, a rodent disease that can infect cattle, and also transmissible to humans; used for vaccination against smallpox ,Goatpox, (Sheeppox), an infectious disease of sheep and goats. Horse pox, an infectious disease of horses, Smallpox, an eradicated infectious disease unique to humans. Mousepox, an iatrogenic (a disease induced by scientific experiment or medical treatment) infectious disease of laboratory mice, Rabbitpox, an iatrogenic infectious disease of laboratory rabbits, Squirrel pox, an infectious disease of squirrels, Monkeypox, an infectious rodent disease than can infect primates. Canarypox, a disease of wild and captive birds, Pigeon pox, an infectious disease of pigeons, Fowlpox, an infectious disease of poultry, Plum pox, the most devastating viral disease of stone fruit from the genus Prunus. White pox disease, a coral disease. Chickenpox, a highly contagious illness caused by primary infection with varicella zoster virus (VZV) . Syphilis, also known as grande verole, the “great pox”, a sexually transmitted disease. Rickettsialpox, a rickettsial disease spread by mites. Since 2017, there has been recurrent outbreaks of Monkeypox infection in Nigeria.
At the last count (from January till date), the NCDC confirmed 157 cases and 4 deaths….

What it is
It is an infectious disease caused by the Monkeypox virus. The disease was first identified in laboratory monkeys, hence its name, but in its natural state it seems to infect rodents more often than primates. The disease is indigenous to Central and West Africa. Monkeypox virus is a zoonotic viral disease (spread between animals and humans) that occurs primarily in remote villages of Central and West Africa in proximity to tropical rainforests where there is more frequent contact with infected animals. It is usually transmitted to humans from rodents, pets, and primates through contact with the animal’s blood or through a bite, it has limited secondary spread through human-to-human transmission. Human monkeypox can be difficult to distinguish clinically from smallpox (to which it is closely related) and chickenpox (to which it is not).
History of Outbreaks
According to W.H.O. factsheet, Human monkeypox was first identified in humans in 1970 in the Democratic Republic of Congo (then known as Zaire) in a 9-year-old boy in a region where smallpox had been eliminated in 1968. Since then, the majority of cases have been reported in rural, rainforest regions of the Congo Basin and western Africa, particularly in the Democratic Republic of Congo, where it is considered to be endemic. In 1996-97, a major outbreak occurred in the Democratic Republic of Congo.
In the spring of 2003, monkeypox cases were confirmed in the Midwest of the United States of America, marking the first reported occurrence of the disease outside of the African continent. Most of the patients had had close contact with pet prairie dogs. In 2005, a monkeypox outbreak occurred in Unity, Sudan.
Transmission
Infection of index cases (the first identified case in a group of related cases of a particular communicable or heritable disease). results from direct contact with the blood, bodily fluids, or skin or mucosal sores of infected animals. In Africa human infections have been documented through the handling of infected monkeys, Gambian giant rats and squirrels, with rodents being the major reservoir of the virus. Eating inadequately cooked meat of infected animals is a possible risk factor.
Secondary, or human-to-human, transmission can result from close contact with infected respiratory tract secretions, skin lesions of an infected person or objects recently contaminated by patient fluids or lesion materials. Transmission occurs primarily via droplet respiratory particles usually requiring prolonged face-to-face contact, which puts household members of active cases at greater risk of infection. Transmission can also occur by inoculation or via the placenta (congenital)
What may give it away
According to WHO, the interval from infection to onset of symptoms (incubation period) is usually from 6 to 16 days but can range from 5 to 21 days. The infection can be divided into two periods: the invasion period (0-5 days) characterized by fever, intense headache, swelling of the lymph node, back pain, muscle ache and lack of energy; the skin eruption period (within 1-3 days after appearance of fever) where the various stages of the rash appears, often beginning on the face and then spreading elsewhere on the body. The face (in 95% of cases), and palms of the hands and soles of the feet (75%) are most affected.
Laboratory catch
Usually via enzyme-linked immunosorbent assay (ELISA), antigen detection tests, polymerase chain reaction (PCR) assay and virus isolation by cell culture.

Treatment
It is usually a self-limited disease with the symptoms lasting from 14 to 21 days. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and severity of complications. There are no specific treatments or vaccines available for monkeypox infection, but outbreaks can be controlled. Vaccination against smallpox has been proven to be 85% effective in preventing monkeypox.

Prevention
• Reducing the risk of human-to-human transmission. Close physical contact with monkeypox infected people should be avoided. Gloves and protective equipment should be worn when taking care of ill people. Regular hand washing should be carried out after caring for or visiting sick people.
• Reducing the risk of animal-to-human transmission. Efforts to prevent transmission in endemic regions should focus on thoroughly cooking all animal products (blood, meat) before eating. Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues, and during slaughtering procedures.
• Isolate infected patients from others who could be at risk for infection.
• Vaccination against smallpox seems to afford about an 85% chance of avoiding monkeypox because of the close relationship between the two. However, there is no commercially available vaccine specifically for monkeypox.
• Anyone who has been exposed to monkeypox in the past 14 days should get the smallpox vaccine, including children under 1 year of age and pregnant women

Take Home
Hand washing, Hand washing, Hand washing and Hand washing!S

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