04/10/2024
The World Health Organization has declared a "global emergency" due to the monkeypox outbreak, which has been detected in approximately 100 countries, including Türkiye. To provide clarity on this disease, which has spread globally, Istinye University (ISU) Faculty of Medicine Faculty Member Prof. Dr. Nuriye Taşdelen Fişgın stated, "The virus can be transmitted to humans through close contact with infected animals, infected individuals, or contaminated inanimate objects such as clothing, towels, and sheets."
Originally confined to Africa, the monkeypox disease has rapidly spread worldwide, especially in Europe and the USA, since May 2022, and can lead to severe health complications, including death. As of January 2024, over 15,000 cases have been reported, with 537 fatalities. Prof. Dr. Fişgın emphasized that
Even if a Person Appears Healthy, the Virus Can Still Enter the Body
In discussing the disease, Prof. Dr. Fişgın explained:
"Mpox (formerly known as monkeypox) is not a newly identified disease. First discovered in monkeys, it was initially reported in the Democratic Republic of the Congo in 1970 and has since been recorded in 11 countries in Central and West Africa. The causative agent of the disease, the Mpox virus (Monkeypox Virus), is a DNA virus related to the smallpox virus. There are two different genetic subtypes responsible for the disease. The West African subtype (Lineage 2) is known to cause milder disease compared to the Central African (Congo Basin) subtype (Lineage 1). The more severe Lineage 1 subtype is responsible for the epidemic that began in Congo in 2023 and continues to spread."
Concerns have been raised that this virus variant may have acquired the ability to spread more easily among people due to its mutations. The virus can be transmitted to humans through close contact with infected animals, infected individuals, or contaminated inanimate objects such as clothing, towels, and bedding. Even healthy individuals can become infected if the virus enters the body through small, often invisible cracks or scratches on the skin, mucous membranes (mouth, nose, eyes), or the respiratory system. Transmission from infected animals to humans can occur via bites, scratches, contact with the animal's blood and bodily fluids, or through the consumption of contaminated meat. Additionally, there have been reports of transmission through sexual contact and close interactions within households. In the latest outbreak, cases have also been reported among children and women.
The Virus Has Been Detected in Approximately 100 Countries, Including Türkiye
Regarding the spread of the disease, Fişğın stated:
"Until 2022, it was believed that all cases outside of Africa were linked to individuals traveling from Africa or to rodents imported from the continent. However, since May 2022, Mpox has been identified in individuals without any known contact with Africa or its animals, particularly in Europe and the USA. This has led to a widespread epidemic affecting over 100,000 people worldwide. In 2023, the WHO declared a global public health emergency due to this outbreak, which marked the first significant spread of Mpox outside Africa. By the end of 2023, various countries implemented measures such as enhanced surveillance and vaccination for vulnerable populations, bringing the epidemic under control. Subsequently, in May 2023, the WHO lifted the global emergency status. Nonetheless, Mpox cases continue to be reported globally, albeit at lower numbers. As of 2023, a significant outbreak has emerged in Africa, particularly in Congo, caused by a subtype (1b) of Lineage 1, which is associated with more severe infections. Since January 2024, this outbreak has resulted in over 15,000 illnesses and 537 deaths, with cases spreading to neighboring countries like Rwanda, Burundi, and Uganda. Consequently, the African CDC declared an international public health emergency on August 13, 2024, followed by the WHO's declaration of a similar emergency for the Mpox outbreak on August 14, 2024. The main aim of this declaration is to urge countries to implement necessary measures regarding diagnosis, surveillance, immunization, and treatment, as well as to allocate resources to control the epidemic."
Faculty of Medicine Faculty Member Prof. Dr. Nuriye Taşdelen Fişgın
Will Mpox Lead to a Pandemic Like Covid-19?
Prof. Dr. Nuriye Taşdelen Fişgın, a faculty member at the Faculty of Medicine, addressed the potential for Mpox to evolve into a pandemic akin to COVID-19:
"Considering factors such as the clear signs and symptoms associated with Mpox, the requirement for close and prolonged contact for transmission, and the virus's relative stability (with fewer new variants emerging compared to COVID-19), it is not anticipated that Mpox will lead to a pandemic of the same scale as COVID-19."
Concerns have been raised regarding the ongoing 2023 monkeypox outbreak, which is impacting all demographic groups and is spreading rapidly, leading to a higher mortality rate.
Symptoms Occur on Average 6-13 Days After Contact with the Virus
Fişgın provided information about the symptoms of monkeypox, noting the following:
• The disease can cause fever, headache, fatigue, widespread body aches, swollen lymph nodes, and skin lesions (rashes). Symptoms typically appear 6 to 13 days after exposure to the virus.
• During the first five days of infection, individuals may experience fever, severe headache, swollen lymph nodes, back pain, and extreme weakness.
• Rashes generally develop 1 to 3 days after the onset of fever and are more likely to appear on the face, arms, and legs than on the trunk.
• Lesions may occur on the palms, soles of the feet, inside the mouth, and in the genital area, as well as on the eyes.
• The number of lesions can vary widely, ranging from a few to many.
• Lesions begin as red spots, become raised, and eventually fill with clear fluid, which later turns yellowish.
• These lesions, known as pustules, eventually scab over, and the scabs fall off, leading to the disappearance of the lesions.
• This process typically lasts 2 to 4 weeks and usually resolves spontaneously.
• The disease can be severe in individuals with compromised immune systems and may lead to secondary bacterial infections, pneumonia, sepsis, encephalitis, and vision loss.
There is Currently no Widely Used Medication for Monkeypox
He stated, "The cases reported so far have been managed with antiviral medications such as cidofovir, brinidofovir, tecovirimat (ST-246), and smallpox immunoglobulin; however, their effectiveness has not been conclusively established, and studies are ongoing."
Groups at Risk of the Disease Should be Vaccinated
To prevent the disease, Fişgın highlighted the importance of identifying, isolating, and monitoring individuals who are sick. He recommended that healthcare workers and household members who may come into contact with infected individuals or their belongings use appropriate personal protective equipment, including gloves and masks. Vaccination is also advised for at-risk groups. In the U.S., the FDA approved a vaccine called JYNNEOSTM (also known as Imvamune and Imvanex) in 2019 for use against monkeypox.