Recently many SSB interview aspirants are facing GK questions related to the Monkeypox Virus which is one of the hot topics globally. The World Health Organization (WHO) on Wednesday (July 27, 2022) said that there have been more than 18,000 cases of monkeypox reported globally from 78 countries, with the majority in Europe, and asked the at-risk men to “reduce their number of sexual partners”.
With the monkeypox outbreak spreading globally, the World Health Organization (WHO) has declared it as a PHEIC – a ‘public health emergency of international concern’. This declaration, which is WHO’s highest alarm, is a way to create a wake-up call for countries as they struggle to contain the spread of the monkeypox virus.
So far there have been 4 confirmed monkeypox cases in India – one in Delhi and three in Kerala. Recently, a man suspected to be suffering from monkeypox has been isolated at Delhi’s Lok Nayak hospital.
Here are a few questions that you might face in the SSB interview related to Monkeypox Virus.
What is monkeypox?
Monkeypox is an illness caused by the monkeypox virus. It is a viral zoonotic infection, meaning that it can spread from animals to humans. It can also spread from person to person.
What are the symptoms of monkeypox?
Monkeypox can cause a range of signs and symptoms. While some people have mild symptoms, others may develop more serious symptoms and need care in a health facility. Those at higher risk for severe disease or complications include people who are pregnant, children and persons that are immunocompromised.
The most common symptoms of monkeypox include fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes. This is followed or accompanied by the development of a rash which can last for two to three weeks. The rash can be found on the face, palms of the hands, soles of the feet, eyes, mouth, throat, groin, and genital and/or anal regions of the body. The number of lesions can range from one to several thousand. Lesions begin flat, then fill with liquid before they crust over, dry up and fall off, with a fresh layer of skin forming underneath.
Symptoms typically last two to three weeks and usually go away on their own or with supportive care, such as medication for pain or fever. People remain infectious until all of the lesions have crusted over, the scabs fallen off and a new layer of skin has formed underneath.
Anyone who has symptoms that could be monkeypox or who has been in contact with someone who has monkeypox should call or visit a health care provider and seek their advice.
Can people get seriously ill or die from monkeypox?
In most cases, the symptoms of monkeypox go away on their own within a few weeks. However, in some people, an infection can lead to medical complications and even death. Newborn babies, children and people with underlying immune deficiencies may be at risk of more serious symptoms and death from monkeypox.
Complications from monkeypox include secondary skin infections, pneumonia, confusion, and eye problems. In the past, between 1% to 10% of people with monkeypox have died. It is important to note that death rates in different settings may differ due to a number of factors, such as access to health care. These figures may be an overestimate because surveillance for monkeypox has generally been limited in the past. In the newly affected countries where the current outbreak is taking place, there have been no deaths to date.
How does monkeypox spread from person to person?
Monkeypox spreads from person to person through close contact with someone who has a monkeypox rash, including through face-to-face, skin-to-skin, mouth-to-mouth or mouth-to-skin contact, including sexual contact. We are still learning about how long people with monkeypox are infectious for, but generally they are considered infectious until all of their lesions have crusted over, the scabs have fallen off and a new layer of skin has formed underneath.
Environments can become contaminated with the monkeypox virus, for example when an infectious person touches clothing, bedding, towels, objects, electronics and surfaces. Someone else who touches these items can then become infected. It is also possible to become infected from breathing in skin flakes or virus from clothing, bedding or towels. This is known as fomite transmission.
Ulcers, lesions or sores in the mouth can be infectious, meaning the virus can spread through direct contact with the mouth, respiratory droplets and possibly through short-range aerosols. Possible mechanisms of transmission through the air for monkeypox are not yet well understood and studies are underway to learn more.
The virus can also spread from someone who is pregnant to the fetus, after birth through skin-to-skin contact, or from a parent with monkeypox to an infant or child during close contact.
Although asymptomatic infection has been reported, it is not clear whether people without any symptoms can spread the disease or whether it can spread through other bodily fluids. Pieces of DNA from the monkeypox virus have been found in semen, but it is not yet known whether infection can spread through semen, vaginal fluids, amniotic fluids, breastmilk or blood. Research is underway to find out more about whether people can spread monkeypox through the exchange of these fluids during and after symptomatic infection.
How does monkeypox spread from animals to humans?
Monkeypox can spread to people when they come into physical contact with an infected animal. Animal hosts include rodents and primates. The risk of catching monkeypox from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including their meat and blood). In endemic countries where animals carry monkeypox, any foods containing animal meat or parts should be cooked thoroughly before eating.
Can monkeypox spread from humans to animals?
While instances of people with monkeypox infecting animals have not been documented, it is a potential risk. People who have confirmed or suspected monkeypox should avoid close contact with animals, including pets (such as cats, dogs, hamsters, gerbils etc.), livestock and wildlife. People with monkeypox should be particularly vigilant around animals that are known to be susceptible to the monkeypox virus, including rodents and non-human primates.
Who is at risk of catching monkeypox?
People who live with or have close contact (including sexual contact) with someone who has monkeypox, or who has regular contact with animals who could be infected, are most at risk. Health workers should follow infection prevention and control measures to protect themselves while caring for monkeypox patients.
Newborn infants, young children and people with underlying immune deficiencies may be at risk of more serious symptoms, and in rare cases, death from monkeypox.
People who were vaccinated against smallpox may have some protection against monkeypox. However, younger people are unlikely to have been vaccinated against smallpox because smallpox vaccination stopped in most settings worldwide after it was eradicated in 1980. People who have been vaccinated against smallpox should continue to take precautions to protect themselves and others.
How can I protect myself and others against monkeypox?
Reduce your risk of catching monkeypox by limiting close contact with people who have suspected or confirmed monkeypox, or with animals who could be infected. Clean and disinfect environments that could have been contaminated with the virus from someone who is infectious regularly. Keep yourself informed about monkeypox in your area and have open conversations with those you come into close contact (especially sexual contact) with about any symptoms you or they may have.
If you think you might have monkeypox, you can act to protect others by seeking medical advice and isolating from others until have been evaluated and tested. If you have probable or confirmed monkeypox, you should isolate from others until all of your lesions have crusted over, the scabs have fallen off and a new layer of skin has formed underneath. This will stop you from passing on the virus to others. Get advice from your health worker on whether you should isolate at home or in a health facility. Until more is understood about transmission through sexual fluids, use condoms as a precaution whilst having sexual contact for 12 weeks after you have recovered.
What should I do if I think I may have monkeypox symptoms or have been exposed to someone who has monkeypox?
If you have had close contact with someone who has monkeypox or an environment that may have been contaminated with the virus, monitor yourself closely for signs and symptoms for 21 days after the time you were last exposed. Limit close contact with other people as much as you can, and when it is unavoidable let your contact know that you have been exposed to monkeypox.
If you think you have symptoms of monkeypox, contact your healthcare provider for advice, testing and medical care. Until you receive your test result, isolate yourself from others if possible. Clean your hands regularly.
If you test positive for monkeypox, your healthcare provider will advise you on whether you should isolate at home or in a health facility, and what care you need.
If I have monkeypox, what should I do to protect other people from getting infected?
If you have monkeypox, your healthcare provider will advise if you should be cared for in hospital or at home. This will depend on how serious your symptoms are, whether you have risk factors that put you at risk for more serious symptoms, and whether you can minimize the risk of infecting anyone you live with.
If you are advised to isolate at home, you should not go out. Protect others you live with as much as possible by:
- Isolating in a separate room
- Using a separate bathroom, or cleaning after each use
- Cleaning frequently touched surfaces with soap and water and a household disinfectant and avoiding sweeping/vacuuming (this might disturb virus particles and cause others to become infected)
- Using separate utensils, towels, bedding and electronics
- Doing your own laundry (lift bedding, clothes and towels carefully without shaking them, put materials in a plastic bag before carrying it to the washing machine and wash them with hot water > 60 degrees)
- Opening windows for good ventilation
- Encouraging everyone in the house to clean their hands regularly with soap and water or an alcohol-based hand sanitizer.
If you cannot avoid being in the same room as someone else or having close contact with another person while isolating at home, then do your best to limit their risk by:
- Avoiding touching each other
- Cleaning your hands often
- Covering your rash with clothing or bandages
- Opening windows throughout the home
- Ensuring you and anyone in the room with you wear well-fitting medical masks
- Maintaining at least 1 meter of distance.
If you cannot do your own laundry and someone else needs to do it for you, they should wear a well-fitting medical mask, disposable gloves and take the laundry precautions listed above.
Is there a vaccine against monkeypox?
Yes. A vaccine was recently approved for preventing monkeypox. Some countries are recommending vaccination for persons at risk. Many years of research have led to development of newer and safer vaccines for an eradicated disease called smallpox, which may also be useful for monkeypox. One of these has been approved for prevention of monkeypox. Only people who are at risk (for example someone who has been a close contact of someone who has monkeypox) should be considered for vaccination. Mass vaccination is not recommended at this time.
While the smallpox vaccine was shown to be protective against monkeypox in the past, current data on the effectiveness of newer smallpox/monkeypox vaccines in the prevention of monkeypox in clinical practice and in field settings are limited. Studying the use of vaccines for monkeypox wherever they are used will allow for rapid generation of additional information on the effectiveness of these vaccines in different settings.
What is the treatment for people with monkeypox?
People with monkeypox should follow the advice of their health care provider. Symptoms normally resolve on their own without the need for treatment. If needed, medication for pain (analgesics) and fever (antipyretics) can be used to relieve some symptoms. It is important for anyone with monkeypox to stay hydrated, eat well, and get enough sleep. People who are self-isolating should take care of their mental health by doing things they find relaxing and enjoyable, staying connected to loved ones using technology, exercising if they feel well enough and can do so while isolating, and asking for support with their mental health if they need it.
People with monkeypox should avoid scratching their skin and take care of their rash by cleaning their hands before and after touching lesions and keeping skin dry and uncovered (unless they are unavoidably in a room with someone else, in which case they should cover it with clothing or a bandage until they are able to isolate again). The rash can be kept clean with sterilised water or antiseptic. Saltwater rinses can be used for lesions in the mouth, and warm baths with baking soda and Epsom salts can help with lesions on the body. Lidocaine can be applied to oral and perianal lesions to relieve pain.
Many years of research on therapeutics for smallpox have led to development of products that may also be useful for treating monkeypox. An antiviral that was developed to treat smallpox (tecovirimat) was approved in January 2022 by the European Medicines Agency for the treatment of monkeypox. Experience with these therapeutics in the context of an outbreak of monkeypox is limited. For this reason, their use is usually accompanied by collection of information that will improve knowledge on how best to use them in future.
Where in the world is there currently a risk of monkeypox?
A multi-country outbreak of monkeypox is currently underway in places where the virus has not been typically found before, in Europe, the Americas, Africa, the Western Pacific, and countries of the Eastern Mediterranean. More cases than normal have been reported in 2022 in parts of Africa that have previously reported cases, such as Nigeria, the Democratic Republic of the Congo, and the Central African Republic. WHO is working with all affected countries to enhance surveillance and provide guidance on how to stop the spread and how to care for patients.
Monkeypox has been reported in some African countries in the years before this outbreak began. These include Cameroon, the Central African Republic, the Republic of the Congo, Côte d’Ivoire, the Democratic Republic of the Congo, Gabon, Liberia, Nigeria, and Sierra Leone. Some of these countries only had a few cases and others have had persistent or recurrent outbreaks. Occasional cases in other countries have been linked to travel from Nigeria. The current outbreak affecting many countries at once is not typical of previous outbreaks.
What do we know about the outbreak of monkeypox in several countries in 2022?
Many countries where monkeypox is not typically found have reported cases in 2022. In this current outbreak, we are seeing most (but not all) cases among men who have sex with men who have had recent sexual contact with a new partner or partners. In many cases, fewer symptoms are being reported than what has typically been seen in the past. For the latest information on the case count and which countries are reporting cases, please see here.
As of 11 July 2022, no link with infected animals and no clear link between most individually reported cases and travel from previously affected countries in Africa has been found. Recent travel from other regions of the world is commonly reported in this outbreak.
We understand that this outbreak is concerning for many, especially people whose loved ones or community have been affected. What is most important right now is that we raise awareness about monkeypox among people who are most at risk of getting infected and provide advice on how to limit further spread between people. It is also important that public health workers be able to identify, diagnose and care for patients.
It is essential that no one stigmatize anyone who is affected by this event because anyone can get monkeypox and because stigma can undermine control efforts. WHO is working to support Member States with surveillance, preparedness and outbreak response tools for monkeypox in affected countries.
Studies are underway in affected countries to best determine how people are being exposed to monkeypox. Actions are being taken to provide medical care to those affected and establish public health interventions to limit further spread.
Is there a risk of this becoming a larger outbreak?
Monkeypox is not as contagious as some other infections because it requires close contact with someone who has monkeypox (e.g., face-to-face, skin to skin, mouth-to-skin or mouth-to-mouth), with a contaminated environment or with an infected animal to spread. We have a window of opportunity to control this outbreak by working closely with communities and groups at higher risk to stop transmission. It is essential for everyone to work together now to stop the spread by knowing their risk and taking action to lower it.
WHO is responding to this outbreak as a high priority to avoid further spread. Learning more about how the virus is spreading through this outbreak and protecting more people from becoming infected is a priority for WHO. Raising awareness about this new situation will help to stop further transmission.
What do we know about monkeypox and sex?
Monkeypox can spread through close contact of any kind, including through kissing, touching, oral and penetrative vaginal or anal sex with someone who is infectious. Anyone with new and unusual rashes or skin lesions should avoid sexual contact until they have had been checked for sexually transmitted infections (STIs) and monkeypox. Monkeypox can resemble other infectious disease such as chickenpox, herpes and syphilis. This may explain why several of the cases in the current outbreak have been identified amongst people seeking care in sexual health clinics. Remember that the rash can also be found in places that can be hard to see, including the mouth, throat, genitals, vagina and anus/anal area.
While the monkeypox virus has been found in semen, it is currently not known whether monkeypox can be spread through semen or vaginal fluids. People with monkeypox are advised to use condoms for 12 weeks after they recover until more is known about levels of the virus and potential infectivity in semen during the period that follows recovery. Wearing a condom won’t protect you from catching monkeypox, but it will help protect you and others from a range of other STIs.
When possible, exchange contact details with any new sexual partners, even those you were not planning to see again. This way, you can be notified if your partner develops any symptoms, or you can notify them if it happens to you. People with multiple sexual partners are encouraged to take steps to reduce their risk of being exposed to monkeypox by avoiding close contact with anyone who has symptoms. Reducing your number of sexual partners will reduce your risk.
The virus does not only spread through sexual contact, but also through any form of close contact with someone who is infectious. Persons living in the same household are at higher risk. Anyone who has symptoms that could be monkeypox should seek advice from a health worker immediately.
Are men who have sex with men at higher risk of catching monkeypox?
The risk of monkeypox is not limited to people who are sexually active or men who have sex with men. Anyone who has close contact with someone who has symptoms is at risk.
Many of the cases that have been reported in this outbreak have been identified among men who have sex with men. Given that the virus is currently moving from person to person in these social networks, men who have sex with men may currently be at higher risk of being exposed if they have close contact with someone who is infectious.
Some cases of monkeypox have been identified at sexual health clinics. One reason we are currently hearing more reports of cases of monkeypox in communities of men who have sex with men may be because of positive health seeking behaviour in this population group. Monkeypox rashes can resemble some sexually transmitted diseases, including herpes and syphilis, which may partly explain why these cases are being picked up at sexual health clinics. As we learn more, we may identify more cases in the broader community. Engaging communities of gay, bisexual and other men who have sex with men to raise awareness is essential to protect those most at risk. If you are a man who has sex with men, know your risk and take steps to protect yourself and others. Anyone who has symptoms that could be monkeypox should seek advice from a health care provider immediately to get tested and access care.
What is WHO’s response to stigmatising messaging circulating online related to monkeypox?
We have seen messages stigmatising certain groups of people around this outbreak of monkeypox. We want to make it very clear that this is not right. First of all, anyone who has close physical contact of any kind with someone who has monkeypox is at risk, regardless of who they are, what they do, who they have sex with or any other factor. Secondly, stigmatising people because of an illness or a disease is unacceptable. Stigma is only likely to make things worse and stop us from ending this outbreak as fast as we can. We need to all pull together to support anyone who has been infected or who is helping to take care of people who are unwell. We know how to stop this disease, and how we can all protect ourselves and others. Stigma and discrimination is never ok, and it is not ok in relation to this outbreak. We are all in this together.
Is my risk of becoming infected, developing serious symptoms or dying from monkeypox higher if I am living with HIV?
Anyone who has close contact with someone who has monkeypox is at risk of infection.
If untreated, HIV can weaken your immune system. There is some evidence that being immunocompromised may increase your risk of becoming infected if you are exposed, and of having serious illness or dying from monkeypox. However, more data is needed to understand this fully.
People with underlying immune deficiencies may be at risk of more serious illness from monkeypox. People living with HIV who know their status and have access to and properly use treatment can reach the point of viral suppression. This means that their immune systems are less vulnerable to other infections than they would be without treatment. Many people in the current outbreak have been HIV positive, but there have been few severe cases, likely because their HIV infection was well-controlled. Studies are underway to better understand these questions.
People with multiple sexual partners, including people who are living with HIV, are encouraged to take steps to reduce their risk of being exposed to monkeypox by avoiding close contact with anyone who has symptoms. Reducing the number of sexual partners may reduce your risk.
Is my risk of catching or getting serious symptoms from monkeypox higher if I have COVID-19, or if I am suffering from long-COVID?
This is a question that health professionals are currently trying to answer. At this time, we don’t yet know whether having COVID-19 or post COVID-19 condition (long-COVID) makes you more vulnerable to monkeypox. More studies are needed on patients who have or have had infection with the virus that causes COVID-19 or post-COVID-19 condition and now have monkeypox.
If you currently have COVID-19, follow WHO guidance. Avoid contact with others to prevent passing on the virus, and monitor your symptoms to be able to get the right care. If you think you have post-COVID condition, contact a health worker to get the support you need.
My local sexual health care services are overwhelmed – what can I do to reduce the burden on them?
You can support your local health services by doing what you can to stay healthy, including by practicing safer sex. If online, video or phone services are available and appropriate for your questions or symptoms, using them can help reduce the pressure on in person services. Taking action to protect yourself and others against monkeypox will help to reduce the number of cases, end this outbreak and will therefore reduce the burden on health services.
If you have symptoms that could be monkeypox, it is important that you contact a healthcare provider for advice, testing and care, even if they are busy. Because monkeypox spreads through close contact, take care to avoid exposing health workers to the virus – call ahead before your visit to warn them that you suspect your symptoms could be due to monkeypox, wear a mask and cover your skin with clothing when seeking care.
Can children get monkeypox?
Children can catch monkeypox if they have close contact with someone who has symptoms. Data from previously affected countries show that children are typically more prone to severe disease than adolescents and adults. There have been a small number of children with monkeypox in the current outbreak.
What should I do if a child in my care has symptoms that could be monkeypox?
The monkeypox rash can resemble other common childhood illnesses, such as chickenpox and other viral infections. If a child you are caring for has symptoms that could be monkeypox, seek advice from a healthcare provider. They will help to get them tested, and to access the care they need.Children may be at greater risk of severe monkeypox than adults. They should be closely monitored until they have recovered in case they need additional care. A health worker responsible for the child may advise that they are cared for in a health facility. In this situation, a parent or caregiver who is healthy and at low risk of monkeypox will be allowed to isolate with them.
What are the risks of monkeypox during pregnancy?
The monkeypox rash can resemble other common childhood illnesses, such as chickenpox and other viral
More research is needed to better understand the risks of monkeypox during pregnancy, and how the virus can be passed to the fetus in the womb or to the newborn during or after birth or while breastfeeding. Available information suggests that contracting monkeypox during pregnancy can be dangerous for the fetus.
If you are pregnant, avoid close contact with anyone who has monkeypox. Anyone who has close contact with someone who is infectious can get monkeypox, regardless of who they are.
If you think you have been exposed to or are showing symptoms that could be monkeypox, contact your healthcare provider. They will help you get tested and access the care you need.
Can I continue to breastfeed if I have been diagnosed with monkeypox?
If you have confirmed or suspected monkeypox and you are breastfeeding, talk to your healthcare provider for advice. They will assess the risk of transmitting monkeypox as well as the risk of withholding breastfeeding to your infant. If it is possible for you to continue to breastfeed and have close contact, they will advise you on how to reduce the risk by taking measures such as covering your lesions and wearing a mask to reduce the risk of passing on the virus. The risk of infection will need to be carefully balanced with the potential harm and distress caused by interrupting breastfeeding and close contact between parent and child. It is not yet known whether the monkeypox virus can be spread from parent to child through breastmilk; this is an area in need of further study.
Why is this disease called ‘monkeypox’?
The disease is called monkeypox because it was first identified in colonies of monkeys kept for research in 1958. It was only later detected in humans in 1970.
Can the monkeypox virus be spread through a blood transfusion?
You should never give blood when feeling unwell. If you have an appointment to give blood, self-assess your health and monitor any symptoms of monkeypox and reschedule your appointment if you don’t feel well.
There are strict protocols in place for when people can give blood. The prospective donor is asked questions about how they feel, and any symptoms they are currently experiencing. This is done to reduce the risk of anyone with an infectious disease giving blood.
There have not been any reports of monkeypox spreading through blood transfusions.
Does past exposure to chickenpox provide any protection against monkeypox?
Chickenpox is caused by a different virus (the varicella virus). Past exposure to chickenpox does not provide protection against monkeypox (caused by the monkeypox virus, which is an orthopoxvirus).
Is there a test to check whether I have had monkeypox in the past?
There are tests available that detect whether you have antibodies to orthopoxviruses (the family of viruses that monkeypox belongs to). These tests can help to confirm whether you have been vaccinated against smallpox or monkeypox or exposed to an orthopoxvirus in the past. However, the tests cannot specify whether it was a vaccine, the monkeypox virus or another orthopoxvirus that you were exposed to in the past. For this reason, antibody tests are not often used to test for previous monkeypox exposure or diagnosis of a suspected new case.
I’ve had monkeypox in the past. Can I catch it again?
Our understanding of how long immunity lasts following monkeypox infection is currently limited. We do not yet have a clear understanding whether a previous monkeypox infection gives you immunity against future infections and for how long, if so. Even if you have had monkeypox in the past, you should be doing everything you can to avoid getting re-infected.
If you have had monkeypox in the past and someone in your household has it now, you can protect others by being the designated caregiver, as you are more likely to have some immunity than others are. However, you should still take all precautions to avoid becoming infected.
In your opinion, how can we control the monkeypox virus in India?
Share your opinions in the comment section below.
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