What is monkeypox: Everything you need to know about this rare disease

What is monkeypox? This rare disease recently made news in Singapore after a man from Nigeria carried the disease over from the African continent. This disease is very foreign-sounding and we know little about it because it is very rarely found in Asia. So here is everything you need to know about monkeypox and monkeypox in Singapore.

History of monkeypox

Monkeypox was first identified in humans in 1970 in the Democratic Republic of Congo and occurs mainly in parts of central and western Africa, near tropical rainforests. In 1996-1997, the Democratic Republic of Congo suffered a major outbreak. 71 suspected human monkeypox cases were reported from the Katako-Kombe Health Zone, Kasai Oriental, DRC.

It spread to the United States of America in 2003, which is the first time the disease had left the continent. 

In 2017, Nigeria experienced the largest documented outbreak. Seven people died of the disease and 262 suspected cases were recorded since the start of the outbreak and August 2018.

This is the first time the disease is coming to Singapore.

What is monkeypox?

Monkeypox is a rare viral disease that usually occurs in West and Central Africa, and is primarily transmitted to humans from animals. The virus is similar to smallpox, a disease that has been eradicated in 1980. Though monkeypox is milder than smallpox, it can be fatal.

World Health Organization reports that monkeypox outbreaks have caused fatalities between 1% and 10% of those infected, with most deaths occurring in younger age groups.

Why is it called monkeypox?

The name is derived from the fact that it was first discovered in laboratory monkeys in 1958.

How is monkeypox passed on from one to another?

Transmission of monkeypox mainly occurs when a person comes into close contact with infected animals (typically rodents) through the hunting and consumption of bush meat.

Human-to-human transmission, while possible, is limited. A person is infectious only during the period when he has symptoms, particularly skin rash. You could contract monkeypox by coming into close face-to-face contact with a person over a prolonged period of time.

Transmission typically occurs from close contact with the respiratory tract secretions or skin lesions of an infected person, or objects recently contaminated by an infected person’s fluids or lesion materials.

Any chance of you catching it in Singapore?

MOH said the risk of monkeypox spreading in Singapore is low.

What is monkeypox: Infection and symptoms

Those infected with monkeypox will experience these initial symptoms: Fever, headache, swelling of the lymph nodes, back pain, muscle ache and lack of energy.

But the infection has stages. 

First, is the incubation period (this is the interval between infection to onset of symptoms). It 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 (Between 0-5 days)

This period is characterised by fever, headache, swelling of the lymph node, back pain, muscle ache and lack of energy.

• The skin eruption period (Within 1-3 days after onset of fever)

In this period, 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 (in 75% of cases) are most affected.

Evolution of the rash from lesions with a flat base to small fluid-filled blisters, pustules, followed by crusts occurs in approximately 10 days.

Three weeks might be necessary before the complete disappearance of the crusts.

Some patients develop severe lymphadenopathy (swollen lymph nodes) before the appearance of the rash, which is a distinctive feature of monkeypox compared to other similar diseases.

“The disease is usually self-limiting, with most patients recovering within two to three weeks,” says MOH.

In some cases, however, the virus can cause serious complications such as pneumonia, sepsis, encephalitis (brain inflammation) and eye infection with ensuing loss of vision.

What is monkeypox: Diagnosis and treatment

Right now, monkeypox can only be diagnosed in specialised laboratories with a number of different tests, according to WHO.

Additionally, there are no specific treatments or vaccines available for monkeypox infection. Reports have said that the smallpox vaccine was proven to be 85 per cent effective in preventing monkeypox. However, smallpox vaccination has been discontinued since the disease was eradicated globally.

Those reported to have monkeypox will have to be quarantined and put into an isolation ward. 

Precautions to be taken

While there are no specific treatments or vaccines available for monkeypox infection, but outbreaks can be controlled by following these steps:

• Close physical contact with monkeypox infected people or contaminated materials 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.
• Isolation of patients either at home or in health facilities is recommended.

If you’re travelling to areas affected by monkeypox in Central and Western Africa:

• Maintain a high standard of personal hygiene, including frequent hand washing after going to the toilet, or when hands are soiled.
• Avoid direct contact with skin lesions of infected living or dead persons or animals, as well as objects that may have become contaminated with infectious fluids, such as soiled clothing or linens (e.g. bedding or towels) used by an infected person.
• Avoid contact with wild animals, and consumption of bush meat.
• Returning travellers from areas affected by monkeypox should seek immediate medical attention if they develop any disease symptoms (e.g. sudden onset of high fever, swollen lymph nodes and rash) within three weeks of their return. They should inform their doctor of their recent travel history.

Read also: MOH confirms first case of monkeypox in Singapore: Here is what you need to know