A pox on our house
Published Jun 14, 2022 12:05 am
UNDER THE MICROSCOPE
Dr. Raymund W. Lo
Still reeling from the Covid-19 pandemic, we are now faced with another viral zoonotic (animal-transmitted) disease that threatens our health. Monkeypox virus is a member of the Poxviridae family, which includes smallpox. Before you panic, here’s a comforting thought if you were born before 1980: the smallpox vaccination you got then gives 85 percent protection against monkeypox infection. Check for a round scar on your upper arm. If you have it, congratulations!
Here's another fact that comforts: It is transmissible mainly through direct contact with blood, body fluids, or skin and mucosal lesions easily visible to the eye. Infection via respiratory droplets requires prolonged face-to-face contact with active cases. So, folks, keep your face masks on.
Symptoms are initially non-specific: Fever, intense headache, muscle aches, and weakness. But what is characteristic in the first week is the swelling of lymph nodes (kulani). Then the skin lesions appear: First as flat (macules) then raised papules, becoming fluid-filled (vesicles) or pus-filled (pustules) before drying up and crusting, eventually falling off. It doesn’t necessarily become the horrid-looking photos you see on TV or online.
Monkeypox is usually self-limiting from two-four weeks. Severe cases are more common in children and in those with immune deficiencies with three to six percent case fatality ratio.
Should we be worried about monkeypox? With our current public health measures in place, we should be adequately protected. If you are infected, know that there is an approved antiviral drug, tecovirimat, though it isn’t widely available yet.
The original smallpox vaccine is no longer available, but a more recent version has been in use in health care workers to protect against workplace exposure to pox viruses. A newer vaccine was approved in 2019, but it will be a while before it will be widely available.
The DOH has been planning its response for monkeypox with surveillance and rapid identification of cases. The recent experience with the Covid-19 pandemic offers many lessons for dealing with monkeypox, though it will probably not become a pandemic or epidemic, as it is less contagious than SARS-CoV-2.
Of more significance will be ensuring that restrictions in wild animal trade are in place to prevent introduction of monkeypox into the country. Wild animals should not be kept as pets, or worse, eaten, since contact with animal carcasses and body fluids can lead to not only monkeypox but many other, even deadlier infections. This will also protect wildlife from extinction as well.
A more worrying aspect of monkeypox are reports of cases among men who have sex with men (MSM). While monkeypox is not considered a sexually transmitted disease, it can be spread via direct contact during sex. These incidents are still under investigation and we will learn more about monkeypox transmission in the near future.
The association of monkeypox with MSM naturally brings to mind HIV/AIDS, as it is an immunodeficiency-inducing disease that can lead to higher mortality rates. HIV/AIDS really deserves a future discussion as it impacts our society more than monkeypox does now and can worsen its spread.
What we should emphasize is the importance of vaccination, which is the best way to prevent epidemics/pandemics. Yet, it is being demonized to the point where people are more afraid of vaccines than killer diseases like Covid-19, dengue, and many others, zoonotic and non-zoonotic diseases. This is where DISINFORMATION KILLS, LITERALLY. This is the pox that infects our house.
Dr. Raymund W. Lo
Still reeling from the Covid-19 pandemic, we are now faced with another viral zoonotic (animal-transmitted) disease that threatens our health. Monkeypox virus is a member of the Poxviridae family, which includes smallpox. Before you panic, here’s a comforting thought if you were born before 1980: the smallpox vaccination you got then gives 85 percent protection against monkeypox infection. Check for a round scar on your upper arm. If you have it, congratulations!
Here's another fact that comforts: It is transmissible mainly through direct contact with blood, body fluids, or skin and mucosal lesions easily visible to the eye. Infection via respiratory droplets requires prolonged face-to-face contact with active cases. So, folks, keep your face masks on.
Symptoms are initially non-specific: Fever, intense headache, muscle aches, and weakness. But what is characteristic in the first week is the swelling of lymph nodes (kulani). Then the skin lesions appear: First as flat (macules) then raised papules, becoming fluid-filled (vesicles) or pus-filled (pustules) before drying up and crusting, eventually falling off. It doesn’t necessarily become the horrid-looking photos you see on TV or online.
Monkeypox is usually self-limiting from two-four weeks. Severe cases are more common in children and in those with immune deficiencies with three to six percent case fatality ratio.
Should we be worried about monkeypox? With our current public health measures in place, we should be adequately protected. If you are infected, know that there is an approved antiviral drug, tecovirimat, though it isn’t widely available yet.
The original smallpox vaccine is no longer available, but a more recent version has been in use in health care workers to protect against workplace exposure to pox viruses. A newer vaccine was approved in 2019, but it will be a while before it will be widely available.
The DOH has been planning its response for monkeypox with surveillance and rapid identification of cases. The recent experience with the Covid-19 pandemic offers many lessons for dealing with monkeypox, though it will probably not become a pandemic or epidemic, as it is less contagious than SARS-CoV-2.
Of more significance will be ensuring that restrictions in wild animal trade are in place to prevent introduction of monkeypox into the country. Wild animals should not be kept as pets, or worse, eaten, since contact with animal carcasses and body fluids can lead to not only monkeypox but many other, even deadlier infections. This will also protect wildlife from extinction as well.
A more worrying aspect of monkeypox are reports of cases among men who have sex with men (MSM). While monkeypox is not considered a sexually transmitted disease, it can be spread via direct contact during sex. These incidents are still under investigation and we will learn more about monkeypox transmission in the near future.
The association of monkeypox with MSM naturally brings to mind HIV/AIDS, as it is an immunodeficiency-inducing disease that can lead to higher mortality rates. HIV/AIDS really deserves a future discussion as it impacts our society more than monkeypox does now and can worsen its spread.
What we should emphasize is the importance of vaccination, which is the best way to prevent epidemics/pandemics. Yet, it is being demonized to the point where people are more afraid of vaccines than killer diseases like Covid-19, dengue, and many others, zoonotic and non-zoonotic diseases. This is where DISINFORMATION KILLS, LITERALLY. This is the pox that infects our house.