Mpox in Pakistan: A call for Awareness and Education.

Mpox in Pakistan: A call for Awareness and Education.

Ever heard about mpox(formerly known as monkey pox)? Wondering why is every news channel talking about mpox disease? Are you clueless about what this disease is and how to prevent it from spreading?

This article provides all the crucial information you need to know including the in depth details about the mpox disease, its symptoms, mode of transmission and ways to protect yourself and your loved ones from this disease.

Introduction:

Mpox, a rare but potentially serious zoonotic viral disease, has emerged as a growing concern in Pakistan. It is caused by monkeypox virus (MPXV), an enveloped double-stranded DNA virus of the Orthopoxvirus genus, which also includes variola virus (the cause of smallpox), vaccinia virus, and cowpox virus. Mpox causes symptoms similar to small pox, although less severe.

There are two distinct clades of the mpox virus: clade I (with subclades Ia and Ib) that originated in Central Africa and clade II (with subclades IIa and IIb) that originated in West Africa.

The natural reservoir of the disease is unknown but various animals such as monkeys and rodents are susceptible.

What are the symptoms to look for?

Symptoms usually develop 7 to 10 days after being exposed to the monkeypox virus. However, the time to develop symptoms can range from 1 to 21 days after being exposed.

Common symptoms of mpox are:

• Rash
• • Fever
• • Swollen lymph nodes
• • Sore throat
• • Headache
• • Muscle aches
• • Back pain
• • Low energy

The mpox rash can be painful and itchy and can affect any part of the body, such as

• face and mouth

• arms and legs

• hands and feet

• anus, rectum and genitals

The rash usually lasts between 2 to 4 weeks and goes through different stages. It starts as a flat sore, which turns into a blister filled with liquid. As the rash heals, the lesions dry up, crust over, and finally form scabs that later fall off.

Some people usually present with one or a few lesions, but it can also present with hundreds of lesions throughout the body.

Who does it affect more?

Children, pregnant women, and people with weak immune systems like HIV patients are at higher risk for complications from mpox.

How is mpox transmitted?

Evidence shows that the virus can be transmitted mainly in three ways:

From Person-to-person:

It can be transmitted from one person to the next through:

• Exchange of respiratory droplets during talking, coughing, or sneezing.

• Oral, anal or vaginal sex with the infected person.

• Contact with lesions or scabs that may be found on the genitals, anus, eyes or mouth of a person with the infection.

• Contact with bodily fluids i.e blood, semen, or saliva during hugging, kissing, cuddling or intercourse.

• During pregnancy or birth, a mother may transfer the virus to a baby.

From Animals to Humans:

Mpox can spread from infected animals to people in a few ways:

• Hunting and processing animals for consumption.

• Being exposed to body fluids, such as when cleaning up areas where animals were processed.

• Working with live or dead animals, especially if there were bites or scratches while handling.

Through direct contact with contaminated objects:

You can also get mpox by coming into direct contact with personal items a person with mpox has used, including:

• Towels

• Clothing

• Bedding

What can I do to prevent the spread of mpox virus?

Take these steps to prevent the spread of mpox virus:

• Get the vaccine if you are at high risk of getting mpox disease.

• Avoid close contact with people who have a rash similar to mpox rash.

• Avoid clothes, sheets, blankets or other materials that have been in contact with an infected patient.

• Isolate people who have mpox disease.

• Wash your hands frequently with soap and water or sanitise with alcohol-based sanitiser after any contact with an infected person or animal.

• Avoid all animals that may carry the virus.

Is there a vaccine against mpox virus?

Some smallpox vaccines can prevent mpox.These vaccines can be used to prevent mpox because smallpox and mpox are caused by related viruses.

Mass vaccination is not currently recommended. Only the people who are at high risk should be vaccinated.

Get the vaccine if:

• You’ve been in close contact with someone with mpox.

• Someone you’ve had sex with in the past two weeks has been diagnosed with mpox.

• You’ve had sex at a location where mpox was spreading.

If you’re a man who has sex with men or transgender, you may also be at risk if you’ve:

• Been diagnosed with any sexually transmitted infections in the past six months. This includes acute HIV, gonorrhoea, syphilis, or chlamydia.

• Had sex with multiple people in the last six months.

What is the diagnostic test for mpox?

Since the clinical manifestations caused by different orthopoxviruses are similar, identifying mpox based on symptoms alone is challenging.

The recommended laboratory test for mpox is detection of viral DNA by polymerase chain reaction (PCR). The best diagnostic specimens are taken directly from the rash.In the absence of skin lesions, testing can be done using swabs from the throat or anus.

What is the treatment for mpox?

Most people will recover within 2 – 4 weeks without any specific treatment for mpox disease. The goal is to take care of the rash, manage pain and prevent complications. Early and supportive care is crucial to help manage symptoms and avoid further complications.

Do these things to recover from mpox disease and prevent the spread:

• Wash hands frequently with soap and water, especially before or after touching sores.

• Wear a mask and keep your lesions covered when around other people until your rash heals.

• Keep skin dry and uncovered when no one else is around.

• Take over-the-counter medications to relieve pain, like paracetamol or ibuprofen.

• Take care of your mental health by staying connected with friends and family over phone and by doing things you find relaxing and enjoyable e.g., exercise, yoga, meditation etc.

Avoid:

• Scratching sores or pop blisters, as it can cause delay in healing, spread the rash to other parts of the body, and cause sores to become infected.

• Shaving areas with rash until scabs have healed and you have new skin underneath, as this can spread the rash to other parts of the body.

The Bottom Line:

The last few years have been incredibly challenging for Pakistan due to the COVID-19 pandemic. It changed so much about the way we used to live and work. Now as we’re starting to ease back into regular life, we’re hearing about mpox as an emerging threat. So the question is Will mpox be the next pandemic? And the answer is No. Mpox is not another Covid-19 because there is enough information about the virus and the means to control it. It is only transmitted through close contact. So we should be alert and cautious but not panic.

To take control of the situation, Pakistan needs to implement a national action plan to strengthen its preparedness and response to combat mpox disease.

References:

1. https://www.who.int/health-topics/monkeypox#tab=tab_

2. 1https://www.health.harvard.edu/blog/mpox-is-back-what-to-know-and-do-20240903306

3. 7https://www.cdc.gov/poxvirus/mpox/about

4. /https://www.niaid.nih.gov/diseases-conditions/mpox

5. xhttps://www.ijidonline.com/article/S1201-9712(24)00172-3/fulltex

6. thttps://www.nih.org.pk/wp-content/uploads

7. /https://my.clevelandclinic.org/health/diseases/22371-monkeypo

8. xhttps://www.journalofinfection.com/article/S0163-4453(24)00200-7/fulltex

9. thttps://www.healthline.com/health-news/mpox-global-public-health-emergency