The Singapore government has confirmed the monkeypox virus or monkey pox in their country.
The virus was carried by a 38-year-old Nigerian who arrived in Singapore on April 28, 2019. Before traveling to Singapore, he had worked in the Delta state of Nigeria, and attended a wedding on April 21, 2019 in a village in Ebonyi State, Nigeria.
The patient had fever, muscle aches, cold and skin rashes on April 30. He reported that he remained in his hotel room most of the time between May 1 and 7. He was transferred to a public hospital by ambulance on May 7 and referred to the National Center for Infectious Diseases (NCID) on the same day, where he was isolated for further management. Skin lesion samples were taken on May 8 and tested positive for monkeypox by the National Public Health Laboratory on the same day. He is currently in a stable condition.
Facts about monkeypox or Singapore monkey smallpox
Monkeypox is a rare disease that occurs mainly in rainforest countries in Central and Western Africa.
Monkeypox is similar to smallpox, and the monkeypox virus causes monkeypox.
Health researchers have identified viral infections in laboratory monkeys, African tree squirrels, rats, mice and rabbits.
Monkeypox can spread to humans. Initial symptoms include fever, headache, muscle aches, back pain, swollen lymph nodes, general discomfort, and fatigue.
Symptoms then appear one to three days or more after the appearance of a fever and include a rash with raised bumps, often first developing on the face.
Monkeypox can spread to humans from infected animals through animal bites or direct contact with animal lesions or body fluids.
This disease can spread from person to person, although it is not contagious like smallpox.
Monkeypox can have fatal consequences of up to 10% of cases.
There is currently no treatment for monkeypox.
History of Monkeypox Outbreaks
Human monkeypox was first identified in humans in 1970 in the Democratic Republic of Congo (later known as Zaire) in a 9-year-old boy in an area where smallpox was removed in 1968. Since then, most cases have been reported in rural areas, rainforests in the Congo Basin and western Africa, especially in the Democratic Republic of the Congo, where it is considered endemic. In 1996-97, a major outbreak occurred in the Democratic Republic of the Congo.
In the spring of 2003, monkey cases were confirmed in the United States, marking the first reported disease out of the African continent. Most patients have reported close contact with pet grassland dogs infected by African mice that have been imported into the country.
Sporadic monkeypox cases have been reported from western and central African countries, and with increasing awareness, more and more countries are identifying and reporting cases. Since 1970, cases of monkeypox in humans have been reported from 10 African countries – the Democratic Republic of the Congo, Republic of Congo, Cameroon, Central African Republic, Nigeria, Ivory Coast, Liberia, Sierra Leone, Gabon and South Sudan. In 2017 Nigeria experienced the largest documented outbreak, around 40 years since the country confirmed the last monkeypox case.
Signs and symptoms
The incubation period (interval from infection to symptoms) from monkeypox is usually from 6 to 16 days but can range from 5 to 21 days.
Infection can be divided into two periods:
- The invasion period (0-5 days) is characterized by fever, severe headache, lymphadenopathy (swollen lymph nodes), back pain, myalgia (muscle pain) and intense asthenia (lack of energy);
- Period of skin eruption (within 1-3 days after the appearance of fever) where various stages of the rash appear often starting on the face and then spreading elsewhere in the body. The face (in 95% of cases), and the palms and soles of the feet (in 75% of cases) are most affected. The evolution of rashes from maculopapules (flat-base lesions) to vesicles (small fluid-filled blisters), pustules, followed by crust occur in about 10 days. Three weeks may be needed before the disappearance of the skin.
The number of lesions varies from a few to several thousand, affecting the oral mucous membrane (in 70% of cases), genitalia (30%), and conjunctiva (eyelids) (20%), and the cornea (eyeball). Some patients experience severe lymphadenopathy (swollen lymph nodes) before the appearance of the rash, which is characteristic of the monkeypox compared to other similar diseases.
Monkeypox is usually a self-healing disease with symptoms lasting from 14 to 21 days. Severe cases occur more frequently in children and are associated with levels of exposure to the virus, patient health status and severity of complications.
Treatment and vaccines
There is no special treatment or vaccine available for monkey infection, but the outbreak can be controlled. Vaccination against smallpox has proven 85% effective in preventing monkeypox in the past but vaccines are no longer available to the general public after being stopped after the eradication of global smallpox.
During the human monkeypox outbreak, close contact with other patients is the most significant risk factor for monkeypox virus infection. In the absence of specific medications or vaccines, the only way to reduce infection in people is to raise awareness about risk factors and educate people about the steps they can take to reduce exposure to the virus. The monitoring and rapid identification of new cases is very important for outbreak prevention.
- Reducing the risk of transmission from animals to humans. Efforts to prevent transmission in endemic areas should focus first on avoiding contact with rats and primates and secondly to limit direct exposure to blood and meat, and cook it thoroughly before consumption.
- Reducing the risk of transmission from human to human. Physical contact close to people infected with monkeypox or contaminated material should be avoided. Gloves and protective equipment must be worn when treating sick people. Regular hand washing must be done after treating or visiting a sick person.