After Corona, there is now the next infectious ghost – monkeypox is currently on everyone’s lips and has been haunting the media regularly for some time. But what is the virus all about, where does it come from and what do I do if I am infected?
Monkeypox is the next infectious bogeyman to haunt the media in the last few months after Corona. But what is it all about and how real is the threat posed by the virus?
What is monkeypox and where does it come from?
They are caused by monkeypox virus (MPXV), formerly Orthopoxvirus simiae, which predominantly focuses on rodent hosts. Sometimes there are also miscolonizations, for example in the eponymous mammal, where it was first discovered in 1958 in Javanese monkeys. The DNA virus multiplies in the cell fluid and can change some genes there in such a way that various defense mechanisms of the immune system are weakened. An adaptation to the conditions in the human immune system was also observed. After the eradication of smallpox, transmission to humans was observed primarily in the tropical regions of Central and West Africa. Infection usually occurs through bites from infected animals, through consumption of infected meat that has not been sufficiently heated, through contact with the typical skin lesions or other secretions of the animals or objects contaminated as a result.
According to the current state of science, transmission from person to person is only possible with close physical contact. Through contact with bodily fluids, the contents of the skin blisters caused by smallpox or the skin scabs that develop as a result of wound healing. Transmission by droplet infection can occur via minimal lesions of the (mucous) skin (e.g. in the eyes, mouth, nose, genitals or anus) on the body and probably also in the respiratory tract. The viruses reach their next victim via these entry points and continue to multiply there.
What is the course of infection with MPXV?
About five to 21 days after infection, non-specific symptoms such as fever, chills, reduced performance, headache and back pain, muscle soreness and swollen lymph nodes often, but not always, occur. As the disease progresses, the typical pock-like skin lesions develop, some of which are very painful. In addition to redness, there is a pustule or blister formation on the skin. These skin lesions crust over time and then fall off. The rashes can appear on the trunk, extremities and head. But the mucous membranes, especially around the mouth, eyes and genitals, are often not spared either. Healing usually takes two to four weeks, but can be delayed by additional infections with skin-specific or foreign germs. After these not uncommon wound healing disorders, the eponymous scarred skin changes, smallpox, usually occur. In rare cases, MPV causes serious complications such as pneumonia and brain inflammation as well as damage to the conjunctiva of the eye and even blindness. Deaths are also described in three to six percent of the known cases in the countries of origin.
How do I know that I really have contracted MPXV?
Monkeypox is detected by the typical skin lesions. A swab is rubbed intensively over the fluid-filled blisters or pustules until it has absorbed the fluid. Or the liquid can be sucked out with a small syringe and sent in. Alternatively, the skin crusts – packed in a sterile tube – can be sent in later.
Criteria for the highly suspected case are the symptoms described above, corresponding symptoms of the disease and skin changes and a suitable history according to the product information:
“Close contact with a person confirmed to be infected with monkeypox within the last 21 days before the onset of symptoms
OR
sexual contact with casual partners in the last 21 days – especially among men who have sex with other men
OR
Animal contacts or a stay in endemic areas.”
The Robert Koch Institute emphasizes that the risk of infection is not limited to sexually active or homosexual people. It can get, quite simply, anyone. Nevertheless, in the current cases there is an extreme accumulation in men, especially in those who have changing male sex partners. Skin lesions in these cases are found in a specific pattern that suggests sexual transmission. This possibility has not yet been conclusively confirmed, but is nevertheless very likely.
What is there to know about vaccination against monkeypox?
Even if the risk of a severe course with monkeypox is not too high, there is a vaccination recommendation if there is an increased risk of infection: Personnel who have dealt with the virus, people who have already been proven to be infected without symptoms and the risk group mentioned above can be vaccinated with the vaccine since July 2022 Imvanex/Jynneos vaccine available on the market. A basic immunization consists of two vaccinations within a period of 28 days. The allocation takes place exclusively via certain vaccination centers and due to vaccine shortages only in compliance with the specified requirements. It’s free. In Regensburg, it is not available from all doctors, but only from the well-known practices specializing in infectious diseases and clinic departments.
What do I have to do if an infection is detected?
If the suspicion is confirmed and vaccination is no longer possible due to existing symptoms, hygiene measures are recommended that are comparable to those after a corona infection. So isolation and, as a rule, due to the existing obligation to report, also a quarantine to be issued by the health department, which according to the current status must be imposed for at least 21 days. In severe cases, an antiviral drug called Tecovirimat is currently used to prevent the worst and speed up healing.
If you have further questions about monkeypox, you can find detailed information on the RKI homepage, the Charité “PoxApp”, the local health department and your trusted family doctor.
guest article dr Heinz Lehmann