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Monkeypox: Causes, Symptoms, Treatment and Prevention

By Dr. Sandeep Budhiraja in Internal Medicine

Jun 14 , 2022 | 4 min read

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Monkeypox is a smallpox-like viral disease. The first case was discovered in 1958 when a pox-like disease occurred in monkeys undergoing research; therefore, the name of the disease is Monkeypox. The first human case of Monkeypox was reported in 1970 in the Democratic Republic of Congo. Since then, cases have been reported primarily in Central and West Africa. Though it can affect anyone, children tend to get affected more than adults.

The symptoms are generally mild such as fever, rashes, body ache, and headache. But there can be complications, according to WHO. There are two variants- the Congo strain (up to 10% mortality) and the West African strain (1% fatality rate).


Cause of Monkeypox

Monkeypox is a rare disease caused by a double-stranded enveloped virus of the Orthopoxvirus genus. As Monkeys have been used for conducting research, the name of the illness is Monkeypox.


Symptoms to Look Out For

The symptoms are similar to smallpox infection but are comparatively milder. Generally, the incubation period of Monkeypox is 7-14 days which means there is a gap of 7-14 days between infection and the appearance of symptoms, but the incubation period can even range between 5-21 days.

Though it is a self-limiting disease and patients recover between 2 to 4 weeks, severe cases can lead to death. Severe cases are reported more commonly among children. Historically, the fatality rate has been recorded as 0-11%. However, lately, the ratio has been 3-6%.


Early-stage symptoms (0-5 days)

  1. Fever

  2. Headache

  3. Exhaustion

  4. Chills and/or sweat

  5. Backache

  6. Lymphadenopathy - Swollen and painful lumps can occur in front of ears, underarm, head, neck, groin, or lower limbs regions. It can occur on one side or both sides of the body.

  7. Sore throat

  8. Cough


Rashes: Involvement of the skin

Within 1 to 3 days of fever, rashes appear on the face and other body parts, which last for 2-4 weeks. It progresses from reddening of the skin to bumps on the skin. These are painful deep-seated lesions with a definite outline and navel-like depression in the center. Once the healing begins, they become itchy and are less painful.


Following are the key stages of the appearance of rashes-

  1. Enanthem- First lesion (red spots) appear on the tongue and mouth.

  2. Macule- These are flat, discoloured regions of skin that spread in a centrifugal pattern, i.e. from face to legs, arms, palms, and soles, within 24 hours.

  3. Papules- The lesions progress to papules by the 3rd day. Papules are solid raised areas on the skin with less than 1 cm diameter.

  4. Vesicles- These lesions turn into vesicles (thin-walled fluid-filled sacs) by the 4th to 5th day.

  5. Pustules- These lesions become pustules by the 6th to 7th day. Pustules are tiny, pus-filled blisters on the skin.

  6. Scabs- As healing begins, these lesions become dry and itchy. These scabs remain for 1 week before they fall off on their own.


Treatment of Monkeypox

Following are the basic elements in the management of Monkeypox.

  1. Patient isolation

  1. Patients need to isolate themselves in a separate room until all the lesions heal and scabs fall off.
  2. The patient should wear a triple-layer mask.
  3. The patient should be encouraged to wear long pants and full sleeve shirts to minimize the contact and spread of skin lesions.
  1. Protection of skin lesions

Management of skin lesions depends on the location of skin lesions-

  1. Skin rash

    Your doctor might clean your lesion with antiseptic and cover it with a light dressing if the lesions are severe. You should not touch or scratch those lesions at all. If your doctor suspects an infection, he might suggest antibiotics.

  2. Oral ulcers

    Your doctor may advise you warm saline gargles for fast recovery and topical anti-inflammatory medications to relieve pain and inflammation.

  3. Conjunctivitis

    Generally reddening of eyes/ conjunctivitis heals on its own, but if you face vision problems or symptoms persist for an extended period, you should consult your doctor immediately.

  1. Nutritional support and rehydration

Dehydration can occur due to the inability to take food due to a general feeling of illness, fever, headache, and other symptoms. Your doctor may suggest increasing fluid intake and taking Oral Rehydration Solution (ORS). Apart from this, you should try taking healthy and nutritious food for early recovery.

  1. Symptomatic treatment

Fever- Lukewarm sponge bath and paracetamol is advised to decrease the body temperature.

Skin itching- Your doctor may suggest topical lotions and antihistamines that relieve skin itching and redness.

Nausea and vomiting- Your doctor may suggest antiemetic drugs to prevent vomiting.

Headache/Body ache- Paracetamol gives relief from pain.

You should consult your doctor immediately if any of the following symptoms appear-

  1. Blurred vision

  2. Breathing difficulty

  3. Chest pain

  4. Decreased urine excretion

  5. Poor intake of food

  6. Altered consciousness

  7. Seizures

  8. Lethargy


Prevention of Monkeypox

The virus can get transmitted from an infected person, animal, or material. You can prevent the spread by adhering to the following tips.

  1. Avoid direct contact with body fluids such as respiratory secretions or skin lesions.

  2. Avoid having intimate contact like face-to-face contact for a prolonged period, kissing, cuddling, or sex.

  3. Avoid contact with sick animals or dead animals in areas prone to Monkeypox.

  4. Isolation of the infected person is essential.

  5. Wash your hands with soap and water frequently.

  6. Cook animal meat thoroughly.

  7. Wear a Personal Protective Equipment (PPE) kit when taking care of a patient suffering from Monkeypox.