Mpox: Public Education

ABSTRACT

Mpox, also known as Monkeypox, is a viral disease that affects both humans and animals. It is caused by the Monkeypox virus, a member of the Orthopoxvirus genus. This article provides information about Mpox, serving as a resource for the public to understand the disease, its causes, risk factors, symptoms, diagnosis, treatment, and preventive measures. Written in simple terms, this article aims to ensure that readers can grasp and manage the risks associated with Mpox effectively.

INTRODUCTION TO MPOX

Mpox, commonly referred to as Monkeypox, is a rare viral zoonosis, meaning it is a disease transmitted from animals to humans. The disease was first identified in laboratory monkeys in 1958, and the first human case was reported in the Democratic Republic of Congo in 1970. Monkeypox is caused by the Monkeypox virus, which is part of the same family of viruses that causes smallpox. However, Monkeypox is less severe than smallpox, with a lower mortality rate. The disease occurs primarily in Central and West African countries, often near tropical rainforests, but has occasionally spread to other regions. Understanding Mpox is crucial for public health due to its potential to cause outbreaks and its similarity to other pox diseases (1-3).

CAUSES OF MPOX INFECTION

Mpox infection is caused by the Monkeypox virus, which can be transmitted to humans from animals and between humans. The primary reservoirs of the virus are wild animals, particularly rodents and primates. Humans can become infected through direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. Consuming undercooked meat or other animal products from infected animals can also lead to infection. Human-to-human transmission occurs through direct contact with infectious sores, scabs, or body fluids, respiratory droplets during prolonged face-to-face contact, and contaminated materials such as bedding or clothing. Men who have sex with men (MSM) have been identified as a group with a higher incidence of Mpox infections, highlighting the importance of targeted prevention and education efforts in this community.

THE STRAINS OF MPOX

There are two distinct genetic clades of the Monkeypox virus: the Central African (Congo Basin) clade and the West African clade. The Central African clade is known to cause more severe disease and has a higher mortality rate compared to the West African clade. The two clades also differ in their geographic distribution, with the Central African clade being found mainly in the Democratic Republic of Congo and the surrounding regions, while the West African clade is found in countries in West Africa. Research into the genetic differences between these clades helps in understanding their transmission dynamics and clinical outcomes, which is crucial for public health management and vaccine development.

RISK FACTORS FOR MPOX

Several factors increase the risk of Mpox infection. People living in or traveling to regions where the Monkeypox virus is endemic are at higher risk. Direct contact with animals that could be reservoirs of the virus, such as rodents and primates, significantly increases the likelihood of infection. Occupations that involve handling animals or animal products, such as hunting, wildlife conservation, and veterinary work, also pose a higher risk. Human-to-human transmission is more likely in settings where close, prolonged contact with an infected person occurs, such as within households or healthcare facilities. MSM have been identified as a group with a higher risk of MPOX infections, necessitating targeted public health interventions and awareness campaigns. Individuals with compromised immune systems or existing skin lesions may be more susceptible to severe disease. Understanding these risk factors is crucial for developing targeted prevention strategies.

HOW COMMON IS MPOX?

Mpox is considered a rare disease, but the incidence has been increasing, particularly in Africa. Outbreaks occur sporadically and have been reported in several Central and West African countries. The Democratic Republic of Congo has experienced the highest number of cases, with frequent outbreaks occurring since the disease was first identified. Cases outside of Africa are rare but have occurred, often linked to travel or imported animals. The increase in human cases is partly due to the cessation of smallpox vaccination, which also provides some protection against Monkeypox. Continuous surveillance and research are essential to monitor the spread of Mpox and implement effective control measures. Notably, recent outbreaks have shown higher incidence rates among men who have sex with men, indicating a shift in transmission dynamics that requires attention.

SIGNS AND SYMPTOMS OF MPOX

The signs and symptoms of Mpox typically begin with a prodromal phase, which includes fever, intense headache, swelling of the lymph nodes, back pain, muscle aches, and severe malaise. This phase is followed by the appearance of a rash, usually within one to three days of the onset of fever. The rash typically starts on the face and then spreads to other parts of the body, including the palms of the hands and soles of the feet. The rash evolves from macules (flat lesions) to papules (raised lesions), vesicles (fluid-filled lesions), pustules (pus-filled lesions), and finally to scabs. The illness usually lasts for two to four weeks. Severe cases can occur, especially in children, pregnant women, individuals with weakened immune systems, and MSM.

SPREAD OF MPOX

Mpox spreads through both animal-to-human and human-to-human transmission. Animal-to-human transmission occurs through direct contact with the blood, bodily fluids, or lesions of infected animals, as well as through bites and scratches. Consuming undercooked meat or other animal products from infected animals can also lead to infection. Human-to-human transmission occurs through direct contact with infectious sores, scabs, or body fluids, respiratory droplets during prolonged face-to-face contact, and contaminated materials such as bedding or clothing. The virus can also be transmitted from mother to fetus through the placenta. Men who have sex with men are at a higher risk of human-to-human transmission due to close and prolonged contact. Preventing the spread of Mpox requires comprehensive public health measures, including surveillance, isolation of infected individuals, and public education on avoiding contact with potentially infected animals.

DIAGNOSIS OF MPOX

Diagnosing Mpox involves a combination of clinical evaluation and laboratory testing. The clinical presentation of Mpox, with its characteristic rash and systemic symptoms, can resemble other poxvirus infections, such as smallpox and chickenpox, making laboratory confirmation essential. Laboratory tests include polymerase chain reaction (PCR) to detect Monkeypox virus DNA, virus isolation by cell culture, and electron microscopy to visualize the virus particles. Serological tests can detect antibodies against the virus, but cross-reactivity with other poxviruses may occur. It is important to collect samples from the lesions, such as fluid from vesicles and pustules, or crusts from scabs, for accurate diagnosis. Early and accurate diagnosis is crucial for initiating appropriate treatment and implementing measures to prevent further spread of the virus.

PATHOPHYSIOLOGY OF MPOX

The pathophysiology of MPOX involves the virus entering the body through broken skin, respiratory tract, or mucous membranes. Once inside the body, the virus targets various cell types, including epithelial cells, endothelial cells, and macrophages. The virus replicates within these cells, leading to cell lysis and the release of new viral particles. The immune response to the virus involves the activation of both the innate and adaptive immune systems, leading to inflammation and the production of antiviral cytokines and antibodies. The characteristic rash of Mpox results from the infection and destruction of epithelial cells in the skin. In severe cases, the virus can cause systemic infection, leading to complications such as pneumonia, encephalitis, and secondary bacterial infections.

TREATMENT OF MPOX

There is no specific antiviral treatment for Mpox. Treatment is primarily supportive and focuses on managing symptoms and preventing complications. Patients with Mpox should receive care in a healthcare facility to ensure proper isolation and infection control measures. Supportive care includes hydration, pain management, and treatment of secondary bacterial infections with antibiotics. Antiviral drugs such as cidofovir and brincidofovir have shown some effectiveness against poxviruses in laboratory studies, but their use in Mpox has not been extensively studied. Vaccinia immune globulin (VIG) may be considered for severe cases.

PREVENTIVE MEASURES OF MPOX

Preventing Mpox requires a multifaceted approach that includes reducing the risk of transmission from animals to humans and from human to human. Avoiding contact with wild animals, particularly rodents and primates, and practicing good hygiene when handling animals or animal products can reduce the risk of animal-to-human transmission. Consuming only properly cooked meat and avoiding consumption of bushmeat are also important preventive measures. For human-to-human transmission, strict infection control practices, including the use of personal protective equipment (PPE), are essential when caring for patients with suspected or confirmed Mpox. Public health education campaigns can raise awareness about the risks and preventive measures associated with Mpox. Vaccination with the smallpox vaccine has been shown to provide some protection against Monkeypox and may be recommended for high-risk individuals, including men who have sex with men, to prevent outbreaks in this vulnerable group.

CONCLUSION

Mpox is a rare but serious viral disease that poses significant public health challenges. Understanding the causes, risk factors, symptoms, and methods of transmission is essential for preventing and controlling outbreaks. While there is no specific antiviral treatment available, supportive care and preventive measures can help manage the disease and reduce the risk of transmission. Public health education and ongoing research are critical for developing effective prevention and treatment strategies. Early detection, appropriate treatment, and preventive measures are key to managing the risks associated with MPOX.

Cite as: Mpox: Public Education. Brisbane (AU): Exon Publications; 2024. Published on 26 Jul 2024. DOI: https://doi.org/10.36255/mpox-public-education

REFERENCES

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2. McCollum AM, Damon IK. Human Monkeypox. Clin Infect Dis. 2014 Jan;58(2):260-7.https://doi.org/10.1093/cid/cit703


3. Di Giulio DB, Eckburg PB. Human Monkeypox: an emerging zoonosis. Lancet Infect Dis. 2004 Jan;4(1):15-25.https://doi.org/10.1016/S1473-3099(03)00856-9