Monkeypox is a rare viral zoonosis (a virus transmitted to humans from animals) with symptoms in humans similar to those seen in the past in smallpox patients, although less severe. Smallpox was eradicated in 1980.However, monkeypox still occurs sporadically in some parts of Africa.
Monkeypox is a member of the Orthopoxvirus genus in the family Poxviridae.
The virus was first identified in the State Serum Institute in Copenhagen, Denmark, in 1958 during an investigation into a pox-like disease among monkeys.
Human monkeypox was first identified in humans in 1970 in the Democratic Republic of Congo (then known as Zaire) in a 9 year old boy in a region where smallpox had been eliminated in 1968. Since then, the majority of cases have been reported in rural, rainforest regions of the Congo Basin and western Africa, particularly in the Democratic Republic of Congo, where it is considered to be endemic. In 1996-97, a major outbreak occurred in the Democratic Republic of Congo.
In the spring of 2003, monkeypox cases were confirmed in the Midwest of the United States of America, marking the first reported occurrence of the disease outside of the African continent. Most of the patients had had close contact with pet prairie dogs.
In 2005, a monkeypox outbreak occurred in Unity, Sudan and sporadic cases have been reported from other parts of Africa. In 2009, an outreach campaign among refugees from the Democratic Republic of Congo into the Republic of Congo identified and confirmed two cases of monkeypox. Between August and October 2016, a monkeypox outbreak in the Central African Republic was contained with 26 cases and two deaths.
Infection of index cases results from direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. In Africa human infections have been documented through the handling of infected monkeys, Gambian giant rats and squirrels, with rodents being the major reservoir of the virus. Eating inadequately cooked meat of infected animals is a possible risk factor.
Secondary, or human-to-human, transmission can result from close contact with infected respiratory tract secretions, skin lesions of an infected person or objects recently contaminated by patient fluids or lesion materials. Transmission occurs primarily via droplet respiratory particles usually requiring prolonged face-to-face contact, which puts household members of active cases at greater risk of infection. Transmission can also occur by inoculation or via the placenta (congenital monkeypox). There is no evidence, to date, that person-to-person transmission alone can sustain monkeypox infections in the human population.
In recent animal studies of the prairie dog-human monkeypox model, two distinct clades of the virus were identified – the Congo Basin and the West African clades – with the former found to be more virulent.
Signs and symptoms
The incubation period (interval from infection to onset of symptoms) of monkeypox is usually from 6 to 16 days but can range from 5 to 21 days.
The infection can be divided into two periods:
the invasion period (0-5 days) characterized by fever, intense headache, lymphadenopathy (swelling of the lymph node), back pain, myalgia (muscle ache) and an intense asthenia (lack of energy);
the skin eruption period (within 1-3 days after appearance of fever) where the various stages of the rash appears, often beginning on the face and then spreading elsewhere on the body. The face (in 95% of cases), and palms of the hands and soles of the feet (75%) are most affected. Evolution of the rash from maculopapules (lesions with a flat bases) to vesicles (small fluid-filled blisters), pustules, followed by crusts occurs in approximately 10 days. Three weeks might be necessary before the complete disappearance of the crusts.
The number of the lesions varies from a few to several thousand, affecting oral mucous membranes (in 70% of cases), genitalia (30%), and conjunctivae (eyelid) (20%), as well as the cornea (eyeball).
Some patients develop severe lymphadenopathy (swollen lymph nodes) before the appearance of the rash, which is a distinctive feature of monkeypox compared to other similar diseases.
Monkeypox is usually a self-limited disease with the symptoms lasting from 14 to 21 days. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and severity of complications.
People living in or near the forested areas may have indirect or low-level exposure to infected animals, possibly leading to subclinical (asymptomatic) infection.
The case fatality has varied widely between epidemics but has been less than 10% in documented events, mostly among young children. In general, younger age-groups appear to be more susceptible to monkeypox.
The differential diagnoses that must be considered include other rash illnesses, such as, smallpox, chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies. Lymphadenopathy during the prodromal stage of illness can be a clinical feature to distinguish it from smallpox.
Monkeypox can only be diagnosed definitively in the laboratory where the virus can be identified by a number of different tests:
enzyme-linked immunosorbent assay (ELISA)
antigen detection tests
polymerase chain reaction (PCR) assay
virus isolation by cell culture
Treatment and vaccine
There are no specific treatments or vaccines available for monkeypox infection, but outbreaks can be controlled. Vaccination against smallpox has been proven to be 85% effective in preventing monkeypox in the past but the vaccine is no longer available to the general public after it was discontinued following global smallpox eradication. Nevertheless, prior smallpox vaccination will likely result in a milder disease course.
Natural host of monkeypox virus
In Africa, monkeypox infection has been found in many animal species: rope squirrels, tree squirrels, Gambian rats, striped mice, dormice and primates. Doubts persist on the natural history of the virus and further studies are needed to identify the exact reservoir of the monkeypox virus and how it is maintained in nature.
In the USA, the virus is thought to have been transmitted from African animals to a number of susceptible non-African species (like prairie dogs) with which they were co-housed.
Preventing monkeypox expansion through restrictions on animal trade
Restricting or banning the movement of small African mammals and monkeys may be effective in slowing the expansion of the virus outside Africa.
Captive animals should not be inoculated against smallpox. Instead, potentially infected animals should be isolated from other animals and placed into immediate quarantine. Any animals that might have come into contact with an infected animal should be quarantined, handled with standard precautions and observed for monkeypox symptoms for 30 days.
Reducing the risk of infection in people
During human monkeypox outbreaks, close contact with other patients is the most significant risk factor for monkeypox virus infection. In the absence of specific treatment or vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus. Surveillance measures and rapid identification of new cases is critical for outbreak containment.
Public health educational messages should focus on the following risks:
Reducing the risk of human-to-human transmission. Close physical contact with monkeypox infected people should be avoided. Gloves and protective equipment should be worn when taking care of ill people. Regular hand washing should be carried out after caring for or visiting sick people.
Reducing the risk of animal-to-human transmission. Efforts to prevent transmission in endemic regions should focus on thoroughly cooking all animal products (blood, meat) before eating. Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues, and during slaughtering procedures.
Controlling infection in health-care settings
Health-care workers caring for patients with suspected or confirmed monkeypox virus infection, or handling specimens from them, should implement standard infection control precautions.
Healthcare workers and those treating or exposed to patients with monkeypox or their samples should consider being immunized against smallpox via their national health authorities. Older smallpox vaccines should not be administered to people with comprised immune systems.
Samples taken from people and animals with suspected monkeypox virus infection should be handled by trained staff working in suitably equipped laboratories.
WHO supports Member States with surveillance, preparedness and outbreak response activities in affected countries.
Employment seeking girl steals N108k from her prospective employer
Opportunity comes but once, this young girl believes as she stole N108k from her prospective employer. A female jobseeker has been captured for taking One Hundred and Eight Thousand Naira amid her prospective employee meeting in Delta State.
It was accumulated that the businessperson at the organization had ventured out to get something, leaving the suspect in the workplace. The young lady professedly utilized the chance to take N108k and fled.
Good fortune, be that as it may, ran out on her, days after the fact, while going through the road where the workplace is found. She was expeditiously caught and dragged to her home where the rest of the cash was recovered.
Lagos tenant uses Landlord’s apartment to dupe house appliance vendors of N50 million
Hey peepz, I have a gist tho I don’t know if it’s true or not..But I will say it Sha. I was just walking on the street 2receive fresh air when I saw a couple. d man was telling his wife about an incident. I kukuma slowed down an walked behind them to hear d full gist.
It was more like a scam story. A certain man walked up to a Landlord in our area and requested to rent his apartment for 2 months, with the excuse that he was traveling to Canada and just came to Lagos for the Visa Processing.. They agreed on 150K.
The man paid and took ownership of the apartment.He then went out to Vendors in town and negotiated to buy expensive items on lease. With installment payment plans.. He was said to have collected home appliance worth N50,000,000 from various vendors.
He then took them all to the apartment one by one to build trust. At least once they know he lives there, they can easily come around and pack their stuffs if he defaults, these people didn’t know what would hit them was going to be deadlier than Tsunami.
As agreed with the Landlord, the man packed out even earlier than expected… Left with all the items, of which he had not finished the payment..and the Landlord was so happy to have struck a better deal He immediately rented out the apartment to another family.
One by one, the creditors began to come in and same story was relieved to them.. Some fainted, some threatened hell fire …. To cut the long story short, Baba Ijebu was arrested alongside the new tenant.. You know Naija now… #POLICE no wan hear wuen
They were only saved after a Landlord intervened. He is a legal practitioner and took up the case. But sincerely speaking. I wonder how some people feel at rest knowing fully well their victims would suffer. I guess it all centers on lack of conscience. This is bad #dojon
It was more like a scam story. 🙆 A certain man walked up to a Landlord in our area and requested to rent his apartment for 2 months, with the excuse that he was traveling to Canada 🍁 and just came to Lagos for the Visa Processing.. They agreed on 150K.
— Diary of a Jobless Nigerian Youth (@wenogetjob) May 15, 2018
How a middle-aged man died after withdrawing N100,200 from the bank will shock you
What could have taken the life of a middle-aged man, identified only as Muyibi, who collapsed and died in a commercial cab in the Ojota area of Lagos State.
PUNCH Metro reports that Muyibi boarded the cab after withdrawing money from a United Bank for Africa branch in the Ogudu area. Then the driver had turned to to take his fee from Muyibi when he realized the man had become motionless. After reaching the terminus, a resident told Punch’s correspondent that the driver alighted from the cab to slightly push Muyibi, who was cold.
The resident, who did not want to be identified, said,
“The driver had picked some other passengers along the way, and they had all paid and dropped off at their various bus stops.
“When the victim did not respond when they got to the terminus, the driver parked the cab to rouse him, but he was cold.
The driver raised the alarm, which drew the attention of commuters and passersby to the scene. People checked him and discovered that the man was dead.”
Policemen from the Ogudu division were said to have been alerted to the incident. The driver’s vehicle was impounded just like that, while the man’s body was deposited in a morgue.
A source person at the terminus who spoke with Punch newspaper confirmed the incident, saying:
“It happened around 3pm on Friday. The man went to withdraw some money in UBA. The Ogudu Divisional Police Officer was compassionate; she pitied the cab driver, who had become jittery.
Although the man was not detained, his cab was impounded at the station pending when the deceased’s family would show up,” he added.
Lagos state Police Public Relations Officer, SP Chike Oti, said the police recovered N100,200 from the victim’s bag.
“The man was on his way to Ojota when he collapsed and died. We recovered the sum of N100,200 from his bag.
He also had a phone, which had a new SIM card. There is no contact on the phone and nobody has called him. We have a lead as to where he could be living.
His body has been deposited in a morgue for autopsy.”
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