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Doc, what is this monkey-small-pox?

Point of correction – what we have in Nigeria now is not called monkey-small-pox but Monkey-Pox-Virus(MPV). When transmitted into humans it becomes Human Monkey Pox Virus(HMPV).

This was among several texts, e-mails and calls that I received from my patients and responders wishing to be educated and updated on this monkey pox virus.

What is the update on monkey-pox-virus.

1) As I am writing this now – 31 suspected cases of monkey-pox-virus have been recorded and has spread to 7 States of Nigeria viz 1) Bayelsa. 2) Rivers 3) Ekiti 4) Akwa Ibom 5) Lagos 6) Ogun 7) Cross River and still counting as at Monday October 8, 2017.

2) The latest release from Nigeria Centre for Disease Control, is for everyone to assume that monkey pox has come to one’s State and take precautionary measures.

   • Luckily no death has been recorded, and all samples have been sent to World Health Organisation Laboratory in Dakar Senegal for analysis.

How do we explain monkey-pox-virus? 

1) Monkey pox virus was first described by Prof Preben Von Magnus in Copenhagen, Denmark in 1958 in crab-eating macaque monkeys – Macaca fascicularis.

2) The first community-acquired outbreak in the United States of monkey-pox-virus occurred in 2003 in Wisconsin and other States of upper Midwest. The source appeared to be imported Gambian giant rats, via consequent exposure of prairie dogs. 

3) Monkey pox virus is a double stranded DNA, zoonotic virus, and a species of the genus Orthopoxvirus in the family of Poviridae. It is one of human ortho-pox-viruses that includes variola, cowpox and vaccinia.

4) Note that monkey pox virus is not a direct ancestor to, nor a direct descendant of the variola virus which causes small-pox. Although small pox vaccine could protect against both. That was why I decided to educate us a little when one of my responders called it monkey-small-pox.

5) The monkey pox virus causes a disease that is similar to small-pox, but with a milder, though more multiple rash, and lower death rate.

6) Monkey pox strains from Central Africa are more virulent than those from Western Africa, but this is no reasons for West Africans especially Nigerians to be complacent. Especially now there is an epidemic.

7) Monkey pox virus can be spread both from animal to human, and from human to human.

8) Incubation period of monkey-pox-virus is 10 – 14 days.

7 Ways to prevent contact with monkey-pox-virus.

• As released by Minister of Health Prof Isaac Adewale on how not to contract monkey-pox-virus, we must avoid:

1) Contact with infected monkeys.

2) Contact with infected rodents.

3) Bites and scratches from infected animals.

4) Eating inadequately cooked meat.

5) Contact with respiratory secretions of infected person.

6) Contact with blood, body fluids, rash of an infected person.

7) Contact with clothing of an infected person.

What are the signs and symptoms of monkey-pox-virus?

i) Swelling of lymph nodes.

ii) Muscle spasms.

iii) Headache.

iv) Fever.

v) Chills.

vi) Drenching sweats.

vii) Non-productive-coughs.

viii) myalgia – generalized muscle pain

ix) Then lastly after 10 to 14 days – maculopapular rashes appear that progress through stages, of vesiculation, pustulation, umbilication, and crusting – and in some cases ulceration. The rashes start on the head, trunk, and extremities, with occasional satellite lesions on the palms, soles and extremities.  The rashes in some cases cover every part of the body except the tongue and anus.

x) Confusion of clinical presentation of monkey pox with smallpox is usually frequent, but lymph node enlargement  is usually only commonly seen in monkey-pox-virus.

xi) Other animals that transmit monkey-pox-virus include nonhuman primates, rabbits and rodents.

How do we treat monkey-pox-virus?

1) Currently there is no proven safe treatment for monkey-pox-virus.

2) Treatment is mostly symptomatic.

3) The patient is quarantined and barrier nursed, to prevent further spread.

4) Person’s who have had close or intimate contact with individuals or animals confirmed to have monkey-pox-virus, could be vaccinated with smallpox vaccine, sourced from Word Health Organisation(WHO)

Vaccination and prevention of monkey-pox-virus.

λ Centre for Disease Control (CDC), recommends smallpox vaccination to individuals if their exposure to infected animals or humans is sufficient. That is if the candidate vaccinee has no contra-indications for small-pox.

λ Some researchers have shown that cidofovir anti-viral drug might be more effective in reducing mortality than small-pox vaccination, but the research is not conclusive.

What is our take this week?

Report any of the above symptoms noticed on any patient to the nearest primary health care centre.

Be medically guided.

Please follow me on twitter ; @ _ DRSUN

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