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August 13, 2022

Monkeypox is a viral infection caused by the monkeypox virus (monkeypox virus or MPV) and occurs mainly in West and Central Africa. It is a zoonosis (disease that can be passed from animals to humans) that mainly occurs in rodents in Africa. The disease is usually mild in humans. Symptoms begin with fever, headache, muscle aches, swollen lymph nodes, and fatigue. This is followed by a rash that forms blisters and crusts. The time from exposure to the onset of symptoms is approximately ten days. The duration of symptoms is usually two to four weeks. Monkeypox can be spread through the use of bushmeat, an animal's bite or scratch, bodily fluids, contaminated objects, or close contact with an infected person. The virus is believed to normally circulate among certain rodents in Africa. The diagnosis can be confirmed by testing a lesion for the DNA of the virus. The disease can resemble chickenpox. The smallpox vaccine can prevent infection with an effectiveness of 85%. In 2019, a vaccine against monkeypox was approved in the United States. There are no monkeypox-specific treatments. Cidofovir or brincidofovir may be helpful. In Africa, reports of the risk of death without treatment run as high as 10%. The disease occurs mainly in Central and West Africa. It was first identified in 1958 in laboratory monkeys. The first human cases were found in 1970 in the Democratic Republic of the Congo. An outbreak that occurred in the United States in 2003 was traced to a pet store selling rodents imported from Ghana. The first cases of widespread community transmission of monkeypox outside Africa occurred during an outbreak in the United Kingdom in May 2022. On May 20, 2022, the first case of monkey pox was diagnosed in the Netherlands, and two in Belgium on the same day.

Signs and Symptoms

Symptoms start with fever, headache, muscle aches and fatigue. Unlike the much more serious smallpox, there are also swollen glands. Within a few days or more of the fever, lesions appear, usually on the face first before spreading to other parts of the body. They start as small flat spots, before becoming small bumps that then fill with clear fluid first and then pus, which then burst open and form crusts. It looks identical to the rash of smallpox. An affected person can remain unwell for two to four weeks. Limited spread of human-to-human infection has been reported in disease-endemic areas in Africa.

Cause

The monkeypox virus causes the disease in both humans and animals. It was first identified by Preben von Magnus in 1958 as a pathogen of crab-eating macaques (Macaca fascicularis) used as laboratory animals, when two outbreaks of a smallpox-like disease occurred in colonies of monkeys kept for research. The crab-eating macaque is often used for neurological experiments.

Diagnosis

Clinical differential diagnosis should consider other skin rash diseases, such as chickenpox, measles, bacterial skin infections, scabies, syphilis, and drug-related allergies. Lymphadenopathy during the prodromal stage of the disease can distinguish monkeypox from chickenpox or smallpox. The diagnosis can be verified by testing for the virus. Polymerase chain reaction (PCR) testing of skin lesion samples is the preferred laboratory test; PCR blood tests are usually inconclusive because the virus does not stay in the blood for very long. To interpret the test results, information is needed about the date the fever started, the date the rash started, the date the sample was taken, the current stage of your