Monkeypox Virus: Introduction, Classification, Incubation Period, Symptoms, Transmission, Lab Diagnosis, Treatment, Prevention, and Keynotes

Introduction of Monkeypox Virus

Monkeypox is a rare disease and its causative agent is the monkeypox virus (MPXV). This virus is a double-stranded DNA and it belongs to the Orthopoxvirus genus which includes the variola (smallpox) virus as well as the vaccinia virus, which is utilized in the smallpox vaccine. This rare disease (Monkeypox) is of public health concern since the illness is close to smallpox. It can be spread from infected living things (humans and animals), and materials contaminated with the virus. One beneficial point for us regarding monkeypox is less transmissible than smallpox. The virus was first identified in monkeys in 1958, and in humans in 1970 and occurs primarily in Central and West African countries. Two outbreaks of Monkeypox cases occurred in the 2003 Midwest monkeypox outbreak and the 2022 monkeypox outbreak.

Classification of Monkeypox Virus

Unranked	Virus
Realm	Varidnaviria
Kingdom	Bamfordvirae
Phylum	Nucleocytoviricota
Class	Pokkesviricetes
Order	Chitovirales
Family	Poxviridae
Genus	Orthopoxvirus
Species	Monkeypox virus

Incubation Period of Monkeypox Virus

The incubation period of the Monkeypox Virus is usually 7−14 days.

Symptoms of Monkeypox

Symptoms of the Monkeypox Virus are as follows-

1. Fever
2. Headache
3. Muscle aches
4. Backache
5. Swollen lymph nodes
6. Chills
7. Feeling tired

Transmission of Monkeypox Virus

Transmission of the monkeypox virus happens when a person comes into contact with the virus either from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if invisible), the respiratory tract, or the mucous membranes of the eyes, nose, and mouth.

Lab Diagnosis of Monkeypox Virus

Monkeypox virus is a Hazard Group (HG) 3 pathogen and thus diagnostic samples can be handled in Containment Level (CL) 2 facilities with appropriate precautions.

Specimen: The swab is taken from one or more vesicles or ulcers, or from a dry scraping of the scab and the swabs should be sent in viral transport medium (VTM) while samples for monitoring are as follows-

• a lesion swab and throat swab in VTM
• a blood sample in an EDTA tube
• a urine sample in a universal sterile container

The pathogen can be identified by the following methods-

1. Microscopy: Electron microscopy can be used to evaluate the sample for MPXV but this method is not routinely used for the diagnosis of this high-risk group etiological agent.
2. Serology: It is a rapid test for the detection of antigens/ anybody but kits are under development (25 May 2022).
3. Culture: It is not recommended as a routine diagnostic procedure since it should only be performed in laboratories with appropriate experience and containment facilities because of high-risk group pathogens.
4. Molecular Technique: Laboratory confirmation of specimens from a suspected case is performed using NAAT (nucleic acid amplification testing), such as real-time or conventional polymerase chain reaction (PCR).

Treatment of Monkeypox

Although there are no specific therapies for monkeypox infection at present time, even a monkeypox outbreak can be controlled with a smallpox vaccine, cidofovir, ST-246(tecovirimat), and vaccinia immune globulin (VIG).

Prevention of Monkeypox

It can be prevented by adopting the following points-

• Isolate the patients.
• Keep good hand hygiene after touching infected animals and humans.
• Avoid touching animals that could harbor the virus.
• Use appropriate PPE (personal protective equipment) when caring for patients, that includes gown, gloves, respirator, and eye protection.

Keynotes on Monkeypox

• Monkeypox is a disease while the monkeypox virus is a pathogen.
• On May 8, 1980, the 33rd World Health Assembly declared the world free of smallpox.
• This current monkeypox outbreak (2022) was reported on 6 May 2022, beginning with a British citizen who displayed symptoms compatible with monkeypox on 29 April 2022 after traveling to Nigeria, where monkeypox was epidemic. On 4 May, the resident returned to the United Kingdom, becoming the outbreak’s index case in the country.
• The smallpox vaccine Imvanex is 85% effective against monkeypox.
• The illness commonly lasts for 2−4 weeks.
• Anyone experiencing symptoms of monkeypox, such as rashes or lesions, should seek medical attention straight away.
• Travelers who are exposed to an area where monkeypox cases, contact with the positive case,s and men who have sex with men (MSM) are the common risk factors for monkeypox.
• Monkeypox can appear similar to chickenpox.
• If there is a delay in testing, the Specimen/sample should be refrigerated (2-8 °C) or frozen (-20°C or lower) within 1 hour of the collection; -20°C or lower after 7 days.
• The swab of skin lesion material should have lesion exudate, lesion roofs, and lesion crusts.
• Other probable samples may be rectal swabs, genital swabs, and semen too.

Bibliography

• WHO-MPX-Laboratory-2022.1-eng.pdf
• https://www.gov.uk/guidance/monkeypox-diagnostic-testing
• https://en.wikipedia.org/wiki/Monkeypox_virus
• https://www.sciencedirect.com/science/article/abs/pii/0196655382900037
• Liu, Angus (19 May 2022). “As monkeypox cases emerge in US and Europe, Bavarian Nordic inks vaccine order”. Fierce Pharma. Archived from the original on 20 May 2022. Retrieved 23 May 2022.
• https://www.cdc.gov/poxvirus/monkeypox/clinicians/treatment.html