Disease pattern, transmission, therapy - all important information.
This type of smallpox is a viral disease that can be transmitted from animals to humans as well as from humans to humans. This type of smallpox is triggered by the virus genus Orthopoxvirus simiae, which is also involved in the classic smallpox viruses (variola). In Africa, the viruses are mainly found among rodents, not in monkeys. The virus is named "monkeypox" because it was first observed in monkeys in the laboratory (1958). In humans, the virus was first discovered in Congo in 1970. Infected was a baby at 9 months of age and since then other cases of this infectious disease in humans have been reported. These occur primarily in West and Central Africa. Monkeypox in humans was not reported outside Africa until 2003, and to date only isolated cases of the viral disease have been reported outside Africa. Presumably, the virus was brought out of the country by importing animals from Africa. Currently, the infection occurs exclusively through human-to-human infection.
In humans, the disease is usually mild and self-healing. Exceptions are people with a weak immune system and children. The symptoms have so far been much milder than smallpox (variola), which was declared eradicated in 1980. The most common symptoms include fever, chills, headache, muscle aches and fatigue. Characteristic, however, are skin lesions (rashes) that first appear patchy and progress to pustules until they dry, crust over, and fall off. The rashes can appear on the face, as well as in the genital area, on the hands and feet, and on the chest. The pustules may also appear on mucous membranes. As a rule, the rash is completely healed after four weeks at the latest.
Monkeypox viruses are transmitted through close physical contact, contact with bodily fluids or via the rashes typical of the disease. Transmission via droplet infection cannot be ruled out either. Affected persons are contagious until the rashes have completely healed. Transmission can also occur via objects (e.g. towels, bed linen, door handles) that an infected person has touched/used. In affected areas in Africa, transmission can also occur from animals to humans, usually then from rodents. Animals transmit the viral infection via bites, extremities, secretions, and contaminated fur or material. The incubation period lasts at least 3 to a maximum of 21 days.
Skin and body contact with infected individuals should be limited and open wounds or rashes should not be touched. Sexual contact should also be prevented for the time being, as infection can also be transmitted via sexual intercourse. Condoms can reduce the risk of infection, but cannot prevent it. Incidentally, the use of condoms is still strongly recommended up to eight weeks after the rashes have healed. The virus has been shown to persist in seminal fluid for some time.
Anyone infected with monkeypox must go into quarantine for at least 21 days from the first day symptoms appear. If infection is asymptomatic and diagnosed via specimen collection, isolation begins from the time the specimen is collected. Quarantine may be lifted when rashes are completely healed. Samples are collected from weeping wounds, vesicles, pustules, and crusts. Swabs from skin lesions are also a common method of diagnosis. Although monkeypox belongs to the same genus as human smallpox, which was declared eradicated in 1980, symptoms are milder and the risk of death is much lower. Only patients with typical symptoms and risk factors (travel to endemic areas) are usually tested for infection with these smallpox viruses. Anyone who notices symptoms themselves is best to go into quarantine immediately and seek advice from the health department or family doctor.
Treatment is usually uncomplicated, as the infection clears up on its own within a few weeks (severe courses are possible, however). Therapy is only supportive, so that superinfections via bacteria do not occur. Only recently, the drug Tecovirimat was approved in the EU for the treatment of the viral infection and is also available in Germany to a limited extent.
