Monkey On The Back

Taking note of the over 16,000 monkeypox cases in 75 countries, the World Health Organization (WHO) on July 23 declared the disease a public health emergency of international concern.

- Sonali Acharjee

First discovered in 1958, the virus was mostly confined to central and western Africa until the past few months when it spread rapidly around the world. Four cases have been reported in India so far. "Previous cases happened when people travelled to the endemic zone. The virus was of less concern when it was confined there, but now it is circulating in large numbers around the world," says virologist Dr Gagandeep Kang.

Some symptoms of monkeypox are similar to those of smallpox, though clinically less severe. During past outbreaks in Africa, the disease was reported to begin with flu-like symptoms, such as fever, fatigue and a swollen lymph node, followed about a week later with painful blisters first on the face and then the hands and feet. The blisters, ranging from 10 to 200 bumps, can get aggravated and filled with pus. As the infection runs its course, the blisters scab over and fall off. "If you scratch the blisters, they could leave scars, just like chickenpox," says Mumbai-based infectious disease expert Dr Anita Mathew. With the global outbreak, however, a slightly different progression is being reported-many of those infected do not have flu-like symptoms and get only one or two open sores or pus-filled blisters near their genitals. "There is still much to learn about how the virus will behave outside its endemic zone," says Dr Sushila Kataria, senior director of internal medicine at Medanta - The Medicity, Gurgaon.

Spreading primarily through large respiratory droplets, the virus can also be transmitted through direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linen. The virus has been found in semen and can spread through sex with an infected person. Though many of the cases in Europe have been among homosexual men, the WHO has since stated that the virus can infect anyone.