Indians born after 1979 (the year in which the smallpox vaccine was discontinued) are not protected against monkeypox. Chickenpox infection doesn't provide protection against monkeypox.
As people are slowly coming out of the Covid-19 scare, the news about monkeypox, a milder cousin of smallpox, is causing growing unease amongst people. First described in 1958, fewer than 19000 cases reported in humans since 1970. The majority were reported from Central and West Africa. Only 8 cases were reported outside of Africa over last 5 years since a small epidemic broke out in Nigeria in 2017. Each of these 8 cases had a history of travel or contact with an infected person. What is puzzling is the simultaneous appearance of the cases in multiple countries without a travel or contact history. There were 104 reported cases in 14 countries on May 22nd. The numbers increased to 600 cases in 26 countries by May 31st says Dr. Krishna Reddy Nallamalla, President, InOrder, Regional Director, South Asia, ACCESS Health International.
What is Monkeypox?
While Covid-19 is caused by an RNA virus, monkeypox is caused by a DNA virus. Though related to the smallpox virus, it causes mild illness in the majority with a case fatality rate of less than 4%. Smallpox carries a case fatality rate of ~30%. It spreads through close contact with affected people, contact with clothes worn by the affected person, and also through air droplets. It takes about one to two weeks for the symptoms to appear after a contact. It generally starts as fever, headache, muscle pains, and enlargement of lymph nodes followed by the appearance of a rash with firm lesions that soon evolve into blisters that dry out into scabs.
How does monkeypox differ from Covid-19?
Being a DNA virus, monkeypox evolves slowly compared to Covid-19. Asymptomatic people do not spread the infection with monkeypox, while Covid-19 can spread from asymptomatic people also. Unlike Covid-19, lungs are not involved in monkeypox. Monkeypox is less contagious than Covid-19. However, the contagiousness of the current outbreak of monkeypox is still under evaluation.
How to prevent and treat monkeypox?
Treatments that were earlier tested against smallpox may work in smallpox. However, they have not been evaluated adequately. The smallpox vaccine is effective in preventing monkeypox. However, routine use of the smallpox vaccine has been discontinued in 1979 in India. Hence, people who were born before 1979 and received the smallpox vaccine will have protection against monkeypox. Some countries are offering the vaccine to people at high risk. The vaccine is also effective if given up to 4 days after exposure as the incubation period is long in monkeypox compared to Covid-19.
What we do not know about monkeypox?
We do not know why there is a sudden spread of the virus across the globe. Smallpox vaccination has been decreasing since 1980 when smallpox was declared eradicated. We do not know why the majority of the cases are reported in men who have sex with men. It may be because of the close contact involved. We do not know whether new variants have emerged recently with different transmission characteristics. We do know that there has been no death so far in affected cases.
What is it telling us?
Monkeypox is a reminder that the world now is interconnected and interdependent more than ever. As our contact with wild animals is increasing through trade, deforestation, and urbanization, we are at risk of contracting more zoonotic diseases. Climate change is altering ecological systems in unknown ways. We need to do what we can do at a personal level, family level, and community level. Governments should strengthen public health system to have robust disease surveillance, alert, and containment systems and should provide resources to prevent, detect, and treat novel pathogens.
Also Read: Is Monkeypox a Cause for Concern in India?