Facts About Monkey Pox Raging in Bayelsa Nigeria

FACTS ON MONKEYPOX
Monkeypox is an infectious disease (caused by the monkeypox virus) that occurs primarily in remote villages of Central and West Africa in proximity to tropical rainforests where there is more frequent contact with infected animals
HISTORICAL PERSPECTIVE
The disease was first identified in laboratory monkeys, hence its name, but in its natural state it seems to infect rodents more often than primates
The first known human case occurred in the Democratic Republic of Congo [DRC]) when a 9-year-old boy developed a smallpox-like illness, which was eventually confirmed as human monkeypox by the World Health Organization.
Retrospectively, similar cases occurring in 1970-1971 from the Ivory Coast, Liberia, Nigeria, and Sierra Leone were attributed to monkeypox infection.
In 2003, a small outbreak of human monkeypox occurred in the United States among owners of pet prairie dogs.
TRANSMISSION
Transmission of monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus.
The virus enters the body through broken skin (even if not visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth).
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.
Human-to-human transmission is thought to occur primarily through large respiratory droplets, direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.
Risk factors for transmission include sharing a bed, room, or using the same utensils as an infected patient.
Incubation period is about 12 days (range, 7 - 21 days) and
The course of the disease is about two to four weeks.
Outbreaks in western and central Africa have been linked to exposure to:
Rats
Rabbits
Squirrels
Monkeys
Porcupines and gazelles.
Inhabitants of remote tropical rain forests may become infected from direct contact while capturing, slaughtering, and/or preparing these animals for food; ingestion has also been linked to infection.

CLINICAL FEATURES

Prodrome or Preeruptive stage (lasts 1-10 d),
 Fever is commonly the first symptom (usually 38.5-40.5°C). The febrile illness is often accompanied by
Chills 
Drenching sweats
Severe headache
Backache
Myalgia
Malaise
Anorexia
Prostration 
Pharyngitis 
Shortness of breath
Cough (with or without sputum).
Lymphadenopathy appears within 2-3 days after the fever. (cervical and submental areas)

Exanthem (Eruptive) stage
Most persons develop a rash within 1-10 days after the onset of fever.
The rash often starts on the face and then spreads to the rest of the body.
It persists for 2-4 weeks until all lesions have shed the crusts

COMPLICATIONS
Pitted  scars
Deforming   scars
Bronchopneumonia
Keratitis
Corneal ulceration
Blindness
Septicemia , and encephalitis.

MANAGEMENT
The disease is usually self-limited; resolution occurs in 2-4 weeks.
Patients often feel poorly during the febrile stage of the illness; therefore, bed rest along with supportive care is the main principle of management.
Cases MUST be Isolated, and Isolation must be continued until the last crust is shed.
In the African cases, the mortality rate was 1-10%, and death was related to the patients' health status, and other comorbidities.
Most patients died of secondary infections.
The CDC recommends a smallpox vaccination within 2 weeks of exposure, ideally within 4 days, for exposed health care workers and household contacts of confirmed cases.
Cidofovir has been suggested as a possible treatment option in severe, life-threatening cases only.

PREVENTION
Animals, especially those implicated above or those in contact with them, demonstrating signs of respiratory distress, mucocutaneous lesions, rhinorrhea, ocular discharge, and/or lymphadenopathy should be quarantined immediately.
Avoidance of contact, especially bites, scratches, and exposure to fluids/secretions, is essential.
Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer.
Use personal protective equipment (PPE) when caring for patients.
Patients and unexposed contacts should wear masks until respiratory symptoms resolve.
Direct contact with skin lesions or fomites is considered infectious until the crust detaches from the last skin lesion.
Health care workers and others who are asymptomatic and in contact with patients who are infected must closely monitor their symptoms and their temperature for 21 days after the last known contact.
CDC does not recommend pre-exposure vaccination for unexposed veterinarians, veterinary staff, or animal control officers, unless such persons are involved in field investigations.