Mpox: What You Need to Know About the Emerging Disease

Mpox is a viral disease that can infect humans and some animals. It causes a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. Mpox is similar to smallpox, but less severe and less contagious. However, it can still be fatal in some cases, especially for children, pregnant women, or people with weakened immune systems.

Mpox was first discovered in 1970 in the Democratic Republic of Congo, where it was initially called monkeypox. Since then, it has spread to other parts of Africa, and in 2022, it reached Europe and the Americas, causing a global outbreak. The World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC) between July 2022 and May 2023.

In this article, we will explain what Mpox is, how it is transmitted, how it is diagnosed and treated, and how to prevent and control it.

What is Mpox and what causes it?

Mpox is an infectious disease caused by the Mpox virus, a member of the Orthopoxvirus genus, which also includes the variola virus, the causative agent of smallpox. Mpox virus has two distinct clades: Clade I and Clade II, which differ in their genetic makeup, geographic distribution, and severity of symptoms.

Mpox virus is a zoonotic virus, which means it can be transmitted from animals to humans. The natural reservoir of the virus is unknown, but evidence suggests that several species of rodents, such as squirrels, dormice, and Gambian pouched rats, may carry the virus and infect other animals, such as monkeys, or humans.

How is Mpox transmitted?

Mpox can be transmitted in several ways:

• Through direct contact with infected animals, their body fluids, or their meat. This can happen when people hunt, handle, or consume infected animals, or when they are bitten or scratched by them.
• Through direct contact with infected humans, their body fluids, or their lesions. This can happen when people touch, kiss, or have sex with infected people, or when they share personal items, such as clothing, bedding, or utensils.
• Through respiratory droplets or aerosols. This can happen when people cough, sneeze, or breathe near infected people, or when they are exposed to contaminated air in enclosed spaces.

The risk of human-to-human transmission is low, but it can increase if the infected person has a severe rash or a high viral load in their body fluids. The incubation period of Mpox, which is the time between exposure and onset of symptoms, ranges from 5 to 21 days, with an average of 13 days. People are infectious from the onset of symptoms until all their lesions have scabbed and healed, which can take up to four weeks.

How is Mpox diagnosed and treated?

Mpox can be diagnosed by clinical examination and laboratory testing. The clinical signs of Mpox include:

• Fever, headache, muscle ache, and fatigue
• Swollen lymph nodes, especially in the neck, armpits, and groin
• Rash that starts on the face and spreads to the rest of the body, forming blisters that fill with fluid and then crust over

The rash of Mpox is similar to that of smallpox, but it usually affects the palms of the hands and the soles of the feet, which are spared in smallpox. The rash can also be confused with other diseases, such as chickenpox, measles, or scabies.

To confirm the diagnosis of Mpox, laboratory testing is needed. The preferred method is to detect the viral DNA in a sample taken from a lesion, using a technique called polymerase chain reaction (PCR). Other methods, such as antigen or antibody detection, may not be reliable, as they do not distinguish between different orthopoxviruses.

There is no specific treatment for Mpox, and most people recover without complications. The aim of treatment is to manage the symptoms and prevent secondary infections or complications, such as bacterial skin infections, pneumonia, encephalitis, or eye problems. The treatment options include:

• Antipyretics and analgesics, such as paracetamol or ibuprofen, to reduce fever and pain
• Antihistamines, such as diphenhydramine or cetirizine, to reduce itching and inflammation
• Antibiotics, such as penicillin or erythromycin, to treat bacterial infections
• Antivirals, such as tecovirimat or cidofovir, to inhibit the replication of the virus

Antivirals are not widely available and their effectiveness is not proven, but they may be used in severe cases or for high-risk groups, such as pregnant women, immunocompromised people, or health care workers.

How to prevent and control Mpox?

The best way to prevent Mpox is to avoid contact with infected animals or humans, and to practice good hygiene and infection prevention and control measures. These include:

• Washing hands frequently with soap and water, or using alcohol-based hand rubs
• Wearing gloves, masks, and protective clothing when handling or caring for infected animals or humans
• Disinfecting or disposing of contaminated objects, such as clothing, bedding, or utensils
• Isolating or quarantining infected animals or humans until they are no longer infectious
• Reporting any suspected cases of Mpox to the local health authorities

Vaccination is another way to prevent Mpox, but it is not widely available or recommended for the general population. Vaccination may be offered to people who are at high risk of exposure or infection, such as travelers, hunters, veterinarians, or health care workers. The vaccines that can protect against Mpox are:

• The smallpox vaccine, which contains a live attenuated virus called vaccinia, which is closely related to the Mpox virus. The smallpox vaccine is effective, but it can cause serious side effects, such as eczema, allergic reactions, or encephalitis.
• The MVA-BN vaccine, which contains a modified version of the vaccinia virus that cannot replicate in human cells. The MVA-BN vaccine is safer, but it may not be as effective as the smallpox vaccine. It requires two doses, four weeks apart, to induce immunity.

Both vaccines are administered by a needle-free device that delivers the virus into the skin. The vaccination site may develop a small blister, which scabs and heals within two to three weeks. The vaccinated person should cover the site with a bandage and avoid touching or scratching it, to prevent spreading the virus to other parts of the body or to other people.

Conclusion

Mpox is a rare but emerging disease that can affect humans and some animals. It causes a rash, fever, and swollen lymph nodes, and it can be fatal in some cases. Mpox can be transmitted by contact with infected animals or humans, or by respiratory droplets or aerosols. Mpox can be diagnosed by clinical examination and laboratory testing, and treated by symptomatic and supportive care. Mpox can be prevented by avoiding contact with infected animals or humans, practicing good hygiene and infection prevention and control measures, and getting vaccinated if indicated.