Monkeypox Fact Check with Dr Devesh & Dr Peeyusha Rajani of Medical Care Centre & Hospital, Lucknow

The post-pandemic world looks different with the surfacing of new viruses, infections and diseases in the backdrop of growing COVID cases, everyday. Naturally when these perilous health conditions arise, a man trying to get through the fear and hysteria of the inevitable lands on the internet to find the answers to his questions. And then, begins the myths.

A pattern, similar to this has surfaced again, with people trying to understand monkeypox virus. Is it caused by monkeys, is it deadly or if meat aggravates the intensity?! There are no enquiries and thus, no end to fables or misinformation.

To right the wrong, get a fact check and provide informed medical advice to you, Knocksense got in touch with Dr. Peeyusha Wadhwani Rajani of Medical Care Centre & Hospital, Lucknow to breakdown what is monkeypox for you.

Fact Check: Monkeypox in both humans and animals is caused by infection with the monkeypox virus – a double-stranded DNA virus. The virus is found mainly in tropical rainforest regions of Central and West Africa. The virus is split into Congo Basin and West African clades, matching the geographical areas. Most human cases of monkeypox are acquired from an infected animal, though the route of transmission remains unknown.

Fact Check: The virus is thought to enter the body through broken skin, the respiratory tract, or the mucous membranes of the eyes, nose, or mouth. Once a human is infected, transmission to other humans is common, with family members and hospital staff at particularly high risk of infection.

Human-to-human transmission is thought to occur primarily through close contact with an infected subject. There are indications that transmission occurs during sexual intercourse. Animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding.

Humans can be infected by an animal via a bite, or by direct contact with an infected animal’s bodily fluids. The virus can also spread from human to human, by respiratory (airborne) contact or by contact with an infected person's bodily fluids. Risk factors for transmission include sharing a bed or room, or using the same utensils as an infected person. Increased transmission risk is associated with factors involving the introduction of virus to the oral mucosa.

Fact Check: Monkey pox is far less contagious as compared to smallpox, measles, or COVID-19.

The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection which has been eradicated. Smallpox was more easily transmitted and more often fatal as about 30% of patients died.

Fact Check: Vaccination against smallpox was demonstrated through several observational studies to be about 85% effective in preventing monkeypox. Thus, prior smallpox vaccination may result in milder illness. Evidence of prior vaccination against smallpox can usually be found as a scar on the upper arm. At the present time, the original (first-generation) smallpox vaccines are no longer available to the general public. Some laboratory personnel or health workers may have received a more recent smallpox vaccine to protect them in the event of exposure to orthopoxviruses in the workplace. A still newer vaccine based on a modified attenuated vaccinia virus (Ankara strain) was approved for the prevention of monkeypox in 2019. This is a two-dose vaccine for which availability remains limited. Smallpox and monkeypox vaccines are developed in formulations based on the vaccinia virus due to cross-protection afforded for the immune response to orthopoxviruses.

In the European Union and the United States, tecovirimat is approved for the treatment of several poxviruses, including monkeypox. BMJ Best Practice recommends tecovirimat or the smallpox treatment brincidofovir as the first line antiviral treatment if required, alongside supportive care (including antipyretic, fluid balance and oxygenation). Empirical antibiotic therapy or aciclovir may be used if secondary bacterial or varicella zoster infection is suspected, respectively.

Fact Check: Early symptoms include headache, muscle pains, fever and fatigue. It may initially appear like flu. The disease can resemble chickenpox, measles and smallpox, but is distinguished by the presence of swollen glands. These characteristically appear behind the ear, below the jaw, in the neck or in the groin, before the onset of the rash. Within a few days of the fever, lesions characteristically appear on the face before appearing elsewhere such as palms of the hands and soles of the feet in a centrifugal distribution.

Lymphadenopathy during the prodromal stage of illness can be a clinical feature to distinguish monkeypox from chickenpox or smallpox.

Three-quarters of affected people have lesions on the palms and soles, more than two-thirds in the mouth, a third on the genitals and one in five have lesions in the eyes. They begin as small flat spots, before becoming small bumps which then fill with at first clear fluid and then yellow fluid, which subsequently burst and scab over. There may be a few lesions or several thousand, sometimes merging to produce large lesions.

In each part of the body affected, the lesions evolve in the same stage. It looks identical to the rash of smallpox. The rash typically lasts around 10-days. An affected person may remain unwell for two to four weeks. After healing, the lesions may leave pale marks before becoming dark scars.

Fact Check: Reinfection with monkeypox is very rare due to development of antibodies in the exposed individuals, but further studies are yet to confirm it.

Fact Check: Viruses have been in the environment and have been infecting the human race since the beginning. There have been multiple outbreaks as seen through history. With the advancement of research and scientific equipment, it is now possible to distinguish and diagnose these different viral outbreaks.

With the current COVID-19 outbreak, the medical fraternity has realized that the goal is to break the chain of transmission at the earliest, because once the outbreak turns into a pandemic, it becomes deadly. Healthy lifestyle should be adopted to maintain a good body immunity along with regular and timely vaccination.

Dr. Peeyusha W Rajani (Obstetrician & Gynaecologist) is the co-founder of the Medical Care Centre and Hospital in Alambagh, Lucknow. She along with her husband Dr. Devesh Rajani (Physician), are the dynamic doctor-duo of the city that oversee the management and operations of MMC, providing a one-stop medical and health solution to the city dwellers.

MCC boasts of a massive team of specialist doctors, and feature services like general medicine, general surgery, obstetrics and gynaecology, infertility, high risk pregnancy, dialysis, pediatrics, orthopaedics, anesthesia and pain management, gastroenterology, urology, neurology, neurosurgery, oncosurgery, plastic surgery, maxillofacial surgery, physiotherapy, laboratory, ICU, NICU, pharmacy, X Ray and ultrasound.

The hospital is also among the few health centres in Lucknow to have a state of art modular operation theatre, which is equipped with the latest machines and equipment that run on most advanced technology. Similarly, the ICU at MCC is also equipped with latest machines and patients get the best of facilities and treatment.

In addition to that, the dialysis unit is the latest service extended by the MCC. An entire floor is dedicated to the proper care take and treatment of patients who require dialysis; which stands as the testament of MCC's dedication to its patients and the general wellbeing of all.

MEDICAL CARE CENTER & HOSPITAL

Address: 9 Laxmi Complex, PNB, Kanpur Road, Alambagh, Lucknow-226005

Ph No: 8881708881,

8756111103, 0522-4000370