Can monkeypox spread like Covid-19? Who is at higher risk? Dr Rajiv Dang explains

The World Health Organisation has declared monkeypox as a global emergency as more than 75 countries where the virus is not endemic have reported outbreaks of the viral disease. The virus has also been reported in India with nine confirmed cases so far.

Monkeypox is a simple viral illness, which presents like any other viral flu, but associated with this are lymph nodes Enlargement or Lymphadenopathy. These are the check post which are there around the neck which doctor can examine and detect.

Mint spoke to Dr Rajiv Dang, senior director and HOD of Internal Medicine and Medical Director at the Max Hospital in Gurugram to get an overview of the situation. Here is what he said.

1) Does monkeypox spread via air? Is it an STD? How does it spread?

It is not STD. Essentially the virus spreads by coming in touch with the affected patient's bodily fluids either directly or indirectly. Whether, it is spread only via sex is still not proven by experts yet. 

Monkeypox is not an airborne disease and thus it does not spread via air.

The virus can spread directly by coming in contact with an infected person, animal, or material contaminated with the virus. Close contact with the infectious rash, lesions, body fluids, respiratory droplets/secretions.

2. How can one protect oneself from this infectious disease?

Vaccines used during the smallpox eradication programme also provided protection against monkeypox.

- Basic hygiene care, which means a proper hand hygiene, proper masking, avoiding unnecessary crowded places to prevent this disease from spreading, sterilising common surfaces and do contact with the medical practitioners at the earliest if any of the symptoms starts developing.

- Keep your distance from contaminated individuals and seek medical attention as soon as any symptoms emerge. Do not handle a person's personal goods, such as their bedding, towels, or clothing, if they are displaying monkeypox symptoms.

3. The stages of monkeypox symptoms

Rashes and the development of nodes (lymph nodes enlargement) in several areas of the body are the two main symptoms that set this viral infection apart from others. Other than these, fever, headache, muscle pain, exhaustion are some other symptoms of this infection.

The incubation period (interval from infection to onset of symptoms) of monkeypox is usually from six to 13 days but can range from five to 21 days.

The infection can be divided into two periods:

Invasion period (lasts between 0–5 days) characterised by fever, intense headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle aches) and intense asthenia (lack of energy).

Skin eruption usually begins within 1–3 days of appearance of fever - face and extremities, mouth, eyes – macule to papule - vesicle – pustules – crust - skin slough.

4. What to do if you have monkeypox symptoms?

The symptoms of monkeypox typically last for two to four weeks and are a self-limited illness.

Avoid close physical contact with people who are sick. Do not kiss, hug, or share eating utensils or cups with others.

Wash your hands often with soap and water. Keep your hands away from your eyes, nose, and mouth.

Raising awareness of risk factors and educating.

Samples taken from people and animals with suspected monkeypox virus infection should be handled by trained staff working in suitably equipped laboratories.

5. Is everyone at high risk of contacting the disease? Please specify

Vulnerability of this new disease is higher among the people in the extreme age brackets (0 to 2 years toddlers) and the geriatric population (60 and above). Those with pre-existing co-morbidity like those on hemodialysis, undergone renal transplant, on medication for auto immune disorders, heart patients are highly susceptible to monkey pox infection. Though is one casualty reported in the country so far, cases or patients are still being observed for their symptoms.

Children are more likely to suffer in severe cases. Worse outcomes could result from underlying immune deficiencies. 

Although the smallpox vaccination provided protection in the past, the eradication of smallpox may make people under the age of 40 to 50 more susceptible to monkeypox.

6. Do monkeypox patients require immediate hospitalisation? Severity, fatality risks here

Since, in the recent cases of monkeypox found in India, Patients are under observation due to varied symptoms, and thus it Is essential to closely monitor, isolate to prevent further transmission. Optimal clinical care need to be provided to alleviate the symptoms and prevent further deterioration (long term sequelae), which otherwise may complicate the case and prove fatal.

7. Can monkeypox spread like Covid in india?

It is unlikely to spread like Covid, as Covid was way more concerning than monkeypox as it was an airborne virus which is luckily not in the case of monkeypox. Although the Covid-19 infection was more contagious, monkeypox infection only develops after prolonged contact with an infected individual. As a result, Covid has a very high infection rate and an infected person can spread the disease to many. Monkeypox, however, is less infectious and will only spread if there is a close contact.

8. Monkeypox vs Covid: How the two infections differ

While coronavirus was a relatively new outbreak throughout the world creating havoc, with hardly any options to prevent its spread due to its high proliferation rate. Comparatively, monkeypox may still be in its nascent stages in terms of doubling rate or how fast it spreads. Fortunately, experts have identified that small pox vaccination is also effective against monkey pox.

Since the symptoms of monkey pox have subsided with timely medication it is expected that the monkeypox outbreak is relatively easier to contain that SARS COV-2. Also, unlike during the first wave of Covid, where initial diagnosis seemed to be a challenge, people infected with monkeypox are easier to identify, as of now.