THE PATHOGEN

The monkeypox virus is a subspecies of the orthopoxvirus.

TRANSMISSON

The monkeypox virus considered to be moderately transmissible.

Transmission from animals to humans via bites or close contacts with infected animals and their secretions, and in rare cases through the consumption of insufficiently cooked meat of infected animals.

In the current outbreak the transmisson is primarily from human to human through close contact via:

skin and mucous membranes: eyes, nose, mouth or genitals

vesicles and skin wounds (secretions and blood)

respiratory secretions/droplets.

Indirectly via recently contaminated objects (bed clothes, towels, clothes, door handles).

Even if the infection can be transmitted during sexual activity through skin and mucosa contact, it is still not known for certain if the virus can be pread via spermal and vaginal secretion.

The disease can be transmittel by all people in close contact and is not only limited to certain groups like homosexuals.

SYMPTOMS

Acute skin rash or individual lesions (vesicles, then pustules and finally crusts)

Augmented lymph nodes

Inflammation of the genital and anal region

Fever > 38.5°C

Shivering

Headache, muscle and back pain

Exhaustion

CLINICAL COURSE

Incubation period (time between infection and first symptoms) is estimated between 5 and 21 days.

The course of the disease is generally mild for healthy people. Patients with immune deficiency, pregnant women, children, older people and persons who are not vaccinated previously for smallpox seem to be at higher risk for a severe disease.

Most of the affected peopple recover within few weeks.

Course of the skin lesions is vesicles, then pustules and finally crusts.

TREATMENT

The treatment is mainly symptomatic:

antiinlammatory therapy

antiseptic local treatment of the lesions to prevent secondary infections

antiobiotic treatment of eventual secondary bacterial infections

Antiiviral treatment is reserved to severe cases.

COMPLICATIONS

Complications are rare:

secondary bacterial infections

pneumonia.

sepsis

infection of the cornea

DIFFERENTIAL DIAGNOSES

Chickenpox (Varicella): The skin lesions can be similar but in chickenpos you can find different stages (vesicles, pustules and crusts) at the same time, while in monkeypox you can observe lesions of the same stage at the same time.

Shingles (Herpes Zoster), Syphillis (Lues), Herpes and allergic reactions can sometimes present skin rashes similar to monkeypox.

PREVENTION

At the moment there is no specific vaccine against monkeypox.

First- and second generation vaccines for smallpox seem to provide good protection against monkeypox.

For the vaccination of adults in Europe and the United States a third generation vacine against smallpox has been authorised.

In Italy the monkeypox vaccine is only available through the public hospitals.

It is recommended to avoid close contact to people with skin rashes.

 WHAT TO DO IF YOU HAVE HAD CONTACT TO AN AFFECTED PERSON

Monitoring your state of health, maesure every day your temperature.

You should not have bodily or sexual contact with anyone for 21 days or until infection can be ruled out.

You should avoid any contact to animals for 21 days or until infection can be rueld out.

IF YOU HAVE BEEN TESTED POSITIVE FOR MONKEYPOX

Avoid contact to other people until the last scabs have fallen off.

Avoid all sexual contacts for 21 days after the positive test results

After you have been recovered, use a condom for eight weeks to protect your partner.

Cover skin wounds well because they contain the virus.

Wash and disinfect your hands regulary.

Avoid public transport.

Do not share bed clothes, towels or clothes with other people. Wash everything with a temperature of at least 60°C.

Do not share dishes with other people.

Disinfect surfaces.

Avoid contact to animals because you can transmit the virus to animals and they can infect other persons.

IF YOU HAVE SYMPTOMS OF MONKEYPOX

Contact your doctor.

Before going to the doctor plaese tell him about your symptoms.

Avoid contact to other people and mammals.