Surokkhagovbd Monkeypox Vaccine Registration 2022 Apply System(Monkeypox Vaccine). Monkeypox virus is a double-stranded DNA virus that causes monkeypox in humans and other animals. It belongs to the genus Orthopoxvirus in the family Poxviridae. It is one of the human orthopoxviruses that includes variola, cowpox, and vaccinia viruses.
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There are currently over 90 confirmed cases and around 28 suspected cases of monkeypox in a dozen countries, according to the World Health Organization.
This outbreak is unusual as cases have popped up in areas of the world where the virus is rarely seen, such as Australia, Canada, and the U.K., as well as other countries in Europe.
In the U.S., the CDC suspects that more cases of monkeypox will likely be discovered in the coming days and weeks.
While monkeypox is a cause of concern, quarantine to help stop its spread probably isn’t needed, according to President Joe Biden.
“I just don’t think it rises to the level of the kind of concern that existed with COVID-19, and the smallpox vaccine works for it,” he said at a recent news conference.
About Monkeypox Virus
Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms similar to those seen in the past in smallpox patients, although it is clinically less severe. With the eradication of smallpox in 1980 and subsequent cessation of smallpox vaccination, monkeypox has emerged as the most important orthopoxvirus for public health.
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Monkeypox primarily occurs in central and west Africa, often in proximity to tropical rainforests, and has been increasingly appearing in urban areas. Animal hosts include a range of rodents and non-human primates.
Key facts about Monkeypox
- Vaccines used during the smallpox eradication programme also provided protection against monkeypox. Newer vaccines have been developed of which one has been approved for prevention of monkeypox
- Monkeypox is caused by monkeypox virus, a member of the Orthopoxvirus genus in the family Poxviridae.
- Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3–6%.
- Monkeypox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus.
- Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.
- Monkeypox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa and is occasionally exported to other regions.
- An antiviral agent developed for the treatment of smallpox has also been licensed for the treatment of monkeypox.
- The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection which was declared eradicated worldwide in 1980. Monkeypox is less contagious than smallpox and causes less severe illness.
- Monkeypox typically presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications.
Why Is Monkeypox Spreading Now?
Reasons behind the current global outbreak are unknown or at least haven’t been made available, says Aaron Glatt, MD, chair of the Department of Medicine at Mount Sinai South Nassau hospital in New York state.
But while some monkeypox questions remain unanswered, the virus is hardly novel.
Monkeypox is endemic in Western and Central Africa, where most cases have been found since the virus’s discovery. Over the last 5 years, many monkeypox cases have appeared in Nigeria, which led to infections in at least nine people in various parts of the world who had recently returned from the country, McQuiston told reporters at a recent news conference.
Human monkeypox cases have been previously discovered in the U.S., including two people who had traveled to Nigeria in 2021.
Forty-seven confirmed and likely cases were also found in the U.S. in 2003. Those were closely linked to animals imported from Ghana, according to the CDC.
But recent global cases of monkeypox were found in people who hadn’t visited West African or other countries where the virus is often found. Infected people had traveled to Canada and countries in Europe, where cases were reported in late April and early May.
Symptoms of Monkeypox
Symptoms of monkeypox are similar but less severe than those of the smallpox virus. They normally appear a week or two after exposure to the virus, though it can take longer in some cases.
The incubation period (interval from infection to onset of symptoms) of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.
The infection can be divided into two periods:
- the invasion period (lasts between 0–5 days) characterized by fever, intense headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle aches) and intense asthenia (lack of energy). Lymphadenopathy is a distinctive feature of monkeypox compared to other diseases that may initially appear similar (chickenpox, measles, smallpox)
- the skin eruption usually begins within 1–3 days of appearance of fever. The rash tends to be more concentrated on the face and extremities rather than on the trunk. It affects the face (in 95% of cases), and palms of the hands and soles of the feet (in 75% of cases). Also affected are oral mucous membranes (in 70% of cases), genitalia (30%), and conjunctivae (20%), as well as the cornea.
- The rash evolves sequentially from macules (lesions with a flat base) to papules (slightly raised firm lesions), vesicles (lesions filled with clear fluid), pustules (lesions filled with yellowish fluid), and crusts which dry up and fall off. The number of lesions varies from a few to several thousand. In severe cases, lesions can coalesce until large sections of skin slough off.
Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and nature of complications. Underlying immune deficiencies may lead to worse outcomes.
Although vaccination against smallpox was protective in the past, today persons younger than 40 to 50 years of age (depending on the country) may be more susceptible to monkeypox due to cessation of smallpox vaccination campaigns globally after eradication of the disease.
Complications of monkeypox can include secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea with ensuing loss of vision. The extent to which asymptomatic infection may occur is unknown.
The case fatality ratio of monkeypox has historically ranged from 0 to 11 % in the general population and has been higher among young children. In recent times, the case fatality ratio has been around 3–6%.
How Does Monkeypox Spread?
Animal-to-human (zoonotic) transmission can occur from direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. In Africa, evidence of monkeypox virus infection has been found in many animals including rope squirrels, tree squirrels, Gambian poached rats, dormice, different species of monkeys and others.
The natural reservoir of monkeypox has not yet been identified, though rodents are the most likely. Eating inadequately cooked meat and other animal products of infected animals is a possible risk factor. People living in or near forested areas may have indirect or low-level exposure to infected animals.
Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects. Transmission via droplet respiratory particles usually requires prolonged face-to-face contact, which puts health workers, household members and other close contacts of active cases at greater risk.
However, the longest documented chain of transmission in a community has risen in recent years from 6 to 9 successive person-to-person infections. This may reflect declining immunity in all communities due to cessation of smallpox vaccination.
Transmission can also occur via the placenta from mother to fetus (which can lead to congenital monkeypox) or during close contact during and after birth. While close physical contact is a well-known risk factor for transmission, it is unclear at this time if monkeypox can be transmitted specifically through sexual transmission routes. Studies are needed to better understand this risk.
Monkeypox Vaccination
Vaccination against smallpox was demonstrated through several observational studies to be about 85% effective in preventing monkeypox. Thus, prior smallpox vaccination may result in milder illness. Evidence of prior vaccination against smallpox can usually be found as a scar on the upper arm.
At the present time, the original (first-generation) smallpox vaccines are no longer available to the general public. Some laboratory personnel or health workers may have received a more recent smallpox vaccine to protect them in the event of exposure to orthopoxviruses in the workplace.
A still newer vaccine based on a modified attenuated vaccinia virus (Ankara strain) was approved for the prevention of monkeypox in 2019. This is a two-dose vaccine for which availability remains limited. Smallpox and monkeypox vaccines are developed in formulations based on the vaccinia virus due to cross-protection afforded for the immune response to orthopoxviruses.
How Prevent Monkeypox
Raising awareness of risk factors and educating people about the measures they can take to reduce exposure to the virus is the main prevention strategy for monkeypox. Scientific studies are now underway to assess the feasibility and appropriateness of vaccination for the prevention and control of monkeypox.
Some countries have, or are developing, policies to offer vaccine to persons who may be at risk such as laboratory personnel, rapid response teams and health workers.
Reducing the risk of human-to-human transmission
Surveillance and rapid identification of new cases is critical for outbreak containment. During human monkeypox outbreaks, close contact with infected persons is the most significant risk factor for monkeypox virus infection. Health workers and household members are at a greater risk of infection.
Health workers caring for patients with suspected or confirmed monkeypox virus infection, or handling specimens from them, should implement standard infection control precautions. If possible, persons previously vaccinated against smallpox should be selected to care for the patient.
Reducing the risk of zoonotic transmission
Over time, most human infections have resulted from a primary, animal-to-human transmission. Unprotected contact with wild animals, especially those that are sick or dead, including their meat, blood and other parts must be avoided. Additionally, all foods containing animal meat or parts must be thoroughly cooked before eating.
Preventing monkeypox through restrictions on animal trade
Some countries have put in place regulations restricting importation of rodents and non-human primates. Captive animals that are potentially infected with monkeypox should be isolated from other animals and placed into immediate quarantine. Any animals that might have come into contact with an infected animal should be quarantined, handled with standard precautions and observed for monkeypox symptoms for 30 days.
How monkeypox relates to smallpox
The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection which has been eradicated. Smallpox was more easily transmitted and more often fatal as about 30% of patients died.
Faq About Monkeypox
What is monkeypox?
Monkeypox is caused by infection with monkeypox virus, a member of the genus Orthopoxvirus in the family Poxviridae. There are currently more than 80 poxviruses known to science and these poxviruses have been isolated from different species of birds, insects, reptiles, marsupials and mammals. Poxviruses that may cause human disease include the smallpox (or variola) virus and molluscum contagiosum virus. The former was eradicated by 1980 by mass-vaccination programs. In addition human disease can be caused by infection with monkeypox, orf, cowpox and Tanapoxviruses. These viruses are harbored by different animal species and may spillover to the human population (i.e. they are zoonotic viruses) when there is sufficient exposure. These viruses are not highly transmissible from person-to-person.
Where does monkeypox occur?
Monkeypox was first discovered in 1958 in Denmark 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. Monkeypox is endemic (or naturally occurring) in countries from central and western Africa. This distribution of monkeypox virus is attributed to the fact that it is naturally harboured by animals that are found in this part of Africa. It is believed that rodents, most likely certain species of squirrels found in the deep forested areas of the endemic countries, may be the natural host of the virus. Monkeypox infections in humans are noted in the endemic countries albeit at a relatively low level. An increase of human monkeypox have been noted in recent years from Nigeria but also other locations in the Region. Human cases of monkeypox have been reported outside of the endemic countries in the US in 2003 in an outbreak related to the exotic pet trade. In addition, cases of monkeypox have been reported in Israel, Singapore and the United Kingdom. On 13th May 2022, World Health Organization (WHO) was notified of two laboratory confirmed cases and one probable case of monkeypox, from the same household, in the United Kingdom. Since the disease has been detected in a number of European countries, the USA and Australia.
How is monkeypox virus transmitted?
Monkeypox virus can be transmitted to a person upon contact with the virus from an animal, human, or materials contaminated with the virus. Entry of the virus is through broken skin, respiratory tract, or the mucous membranes (eyes, nose, or mouth). In endemic countries, the monkeypox virus may be spread from handling infected bush meat, an animal bite or scratch, body fluids and contaminated objects. In Africa, monkeypox infection has been found in many animal species: rope squirrels, tree squirrels,Gambian rats, striped mice, dormice and primates. Certain species of rodents are suspected of being the main disease carrier (reservoir host) of monkeypox, although this has not been proven yet. In non-endemic countries persons are most likely to be exposed to monkeypox through contact with an individual that is already sick with monkeypox. Cases of monkeypox spreading through animals, outside of the endemic areas, are very rare, but may involve the exotic pet trade or potential through contact with infected animal-derived materials such as skins and leather. Person-to-person transmission involves close contact with an infected person or materials that have been contaminated by an infected person.
What are the signs and symptoms of monkeypox?
The incubation period (time from infection to symptoms) for monkeypox is on average 7−14 days but can range from 5−21 days. Initial symptoms include fever, headache, muscle aches, backache, chills and exhaustion. Within 1-3 days of onset of disease, blister-like lesions (very much the same as chickenpox) will develop on the face, the extremities including soles of the feet and palms of the hands. The lesions may however occur on other parts of the body. The number of lesions will vary and not all lesions will be at the same stage of development. The lesions progresses through several stages before scabbing over and resolving. Most human cases resolve within 2-3 weeks of onset without side-effects. The case fatality rate in more recent outbreaks have been on average 1%.
When is a monkeypox infected person no longer contagious?
An infected person is contagious from the onset of the rash/lesions through the scab stage. Once all scabs have fallen off, a person is no longer contagious.
How is monkeypox diagnosed?
Monkeypox is diagnosed by a healthcare worker in consideration of the clinical presentation of the patient. The rash would be the most telling sign. However, the healthcare worker will consider possible exposures for the case with the consideration that the likelihood of contracting monkeypox is very low. Many other diseases, such as chickenpox, may cause similar rashes and are more common. Samples can be tested at the National Institute for Communicable Diseases to confirm a diagnosis of monkeypox.
How is monkeypox treated?
Treatment is supportive, as with most viral infections. Most human cases of monkeypox virus infection do not require any specific treatment and the disease resolves on its own. There are anti-viral drug that a clinician may consider to use for treatment of more severe cases of monkeypox on a case-by-case basis.
How can monkeypox be prevented?
In non-endemic countries persons are most likely to be exposed to monkeypox through contact with an individual that is already sick with monkeypox. The spread of monkeypox can then be interrupted by contact tracing for diagnosed persons and isolating any persons that develop the disease. Residual immunity from smallpox vaccination in the population aged 40 and above may also contribute to preventing cases or lead to more mild infections. There is about 85 % protection offered by the smallpox vaccine (which was used to eradicate the human pox virus disease known as smallpox) and monkeypox.
What is the risk of contracting monkeypox in South Africa?
The implications for South Africa are that the risk of importation of monkeypox is a reality as lessons learnt from COVID-19 have illustrated that outbreaks in another part of the world can fast become a global concern. The WHO have not recommended any travel restrictions and are working with the affected countries to limit transmission and determine sources of exposure. For anybody entering South Africa, any illness during travel or upon return from an endemic area should be reported to a healthcare professional, including information about all recent travel, immunization history and contact with any known cases. Residents and travellers to endemic countries should avoid contact with sick animals that could harbour monkeypox virus such as rodents, marsupials, primates and should refrain from eating or handling wild game. A good history is important to rule out any other differential diagnoses, including malaria. Residents and travellers to countries affected in the current outbreak, should report any illness to a healthcare professional, including information about all recent travel and attendance of mass gathering events, festivals and parties, and contact with any known cases. The importance of hand hygiene by using soap and water or alcohol-based sanitizer should be emphasized.
Where can I find more information?
For healthcare workers: (for medical/clinical and laboratory related queries ONLY): +27 82 883 9920
Other: Centers for Disease Control and Prevention, Atlanta, United States of America. https://www.cdc.gov/poxvirus/monkeypox/index.html
World Health Organization. http://www.who.int/mediacentre/factsheets/fs161/en/
Is monkeypox sexually transmitted?
Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex, i.e., via lesions on the skin. It is currently unknown if it spreads through semen or vaginal fluids. Because rashes can also emerge on genitals and inside the mouth, oral sex could also be a route of transmission for the virus.
Are there any vaccines?
An antiviral developed to treat smallpox (tecovirimat, commercialized as TPOXX) has been approved for treatment of monkeypox.
Other vaccines for smallpox may provide limited protection since both diseases are from the same family. People vaccinated against smallpox will have some protection against monkeypox.
People below the 40-50 age group are unlikely to have been inoculated against smallpox since vaccination ended back in 1980, the WHO said.
(With inputs from World Health Organization)
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