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Making Sense of the Monkeypox Outbreak

“The global tally of monkeypox cases has passed 800 and continues to increase daily across more than two dozen countries where the virus isn’t typically found”, according to the latest report from the World Health Organization. No deaths have been associated with the current disease outbreak in non-endemic countries, although countries such as Central and West Africa have reported the endemic.

Monkeypox is a viral virus transmitted to humans by animals. Moreover, the virus has two common ancestors: the Central African clade and the West African clade. Nevertheless, the Central African strain has been found to have caused severe disease and is presumed to be more transmissible. Africa has been shown as the epicenter for the virus, occurring near tropical rainforests and emerging in urban areas. Several animal species such as squirrels, rats, primates, and more are susceptible to monkeypox. However, further studies are needed on records of the virus and circulation of the virus supported in nature.

Global Outbreaks

A human variant of monkeypox was first in an area of the Democratic Republic of the Congo, where smallpox has ceased. Since then, more and more cases have been disclosed from Central and West Africa. Currently, cases have been reported in 11 African countries, Nigeria experienced a large outbreak with over 500 suspected cases and over 200 confirmed cases with a fatality ratio of 3%. Not only does the virus affect the residents of Africa but also people worldwide, as the spread of the virus is of global public health importance. For example, in 2003, the first sighting of the virus in the United States was linked to rodents imported from Gahan that were in contact with pet prairie dogs. Incidents like these have advanced to travelers from Nigeria to Israel visiting countries such as the UK and Singapore. Although, in recent years, studies have been conducted to comprehend further the epidemiology, transmission patterns, and sources of infection for the disease. Monkeypox is transferred from animals to humans via direct contact with blood, bodily fluids, or alterations in skin lesions such as rashes. However, human transmissions result from close contact with recently contaminated objects, the skin lesions of an infected person, or respiratory secretions. Another upsetting finding is that the disease can transfer from mother to fetus during or after birth.

Symptoms and Diagnosis

The incubation period from infection to onset of symptoms of monkeypox is generally between 6 and 13 days. There are two periods of illness, the first being the invasion period shown by fever, headache, back pain, asthenia, and lymphadenopathy. Lymphadenopathy is a feature distinctive of the virus, unlike other diseases. The second period of the disease appears as an eruption of rashes concentrated on the face, extremities, genitalia, or mouth. Historically, the case fatality of monkeypox for the general population has been between 0 and 11% and higher among young children. However, the case fatality ratio has been around 3 to 6% today. Clinical care should be made for symptoms such as rash, bacterial skin infections, syphilis, and medication-associated allergies. Although, if monkeypox is suspected, health workers should sample the patient and have the sample sent to a laboratory. Confirmation of the disease depends on the quality, specimen type, and laboratory test type. Polymerase chain reaction (PCR) is the preferred laboratory for monkeypox due to its accuracy and sensitivity. Since orthopoxviruses are based on properties and reactions of blood serum cross-reactivity, methods such as antigen and antibody detection do not confirm the disease. For accurate test results, patient information needed is the date of onset of fever, data of onset of rash, date of specimen collection, age, and current status of the individual.


Uncovering treatment against monkeypox led to the discovery of 85% effectiveness when vaccinated against smallpox, resulting in milder illness. However, the first generation of smallpox vaccinations is no longer available to the general public; therefore, the latest vaccine based on the Ankara strain, a weaker strain, was approved for the prevention of monkeypox, though limited in 2019. Currently, vaccines for smallpox and monkeypox are being developed based on the Ankara strain for cross-protection for the immune response for orthopoxviruses.


Raising awareness of the risk factors and educating about the measures available to reduce exposure to the virus is a primary prevention strategy for monkeypox. Some countries are developing policies to offer vaccines to people who may be at risk, like health workers and rapid response teams. Most human infections result from unprotected contact with wild animals, from consuming infected or undercooked food, and further to bypassing regulations on the animal trade that could be infected. Without a doubt, preventing the transmission of monkeypox will be an essential step in eradicating the disease's spread.

Thanks for reading

- Evonna Chisom


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