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1. Monkeypox
Ahmad Thanin

2. Introduction
• A virus transmitted to humans from
animals
• With symptoms similar to those seen
in the past in smallpox patients,
although it is clinically less severe.
Monkeypox is a viral zoonosis

3. Monkeypox
Monkeypox is a rare skin disease that affects a person as a result of a
viral infection.
• It is similar to the well-known smallpox, except that it is less transmissible, and causes
milder and less lethal symptoms.
• Smallpox was declared eradicated in 1980.
There are two known types of monkeypox,
• one so fatal that it kills up to 10% of infected people,
• the second type (currently reported in England) that is milder, with a mortality rate of less
than 1%.

4. Natural host of monkeypox virus
• Various animal species have been identified as susceptible to
monkeypox virus, This includes
• Rope Squirrels,
• Tree Squirrels,
• Gambian Pouched Rats,
• Dormice,
• non-human primates and other species.
• Uncertainty remains on the natural history of monkeypox virus and
further studies are needed to identify the exact reservoir(s) and how
virus circulation is maintained in nature.

5. Rope
Squirrels
Tree Squirrels
Gambian
Pouched
Rats,
Dormice
non-human
primates and
other species

6. Routes of Transmission
• Monkeypox is not easily spread among people.
• Person-to-person transmission occurs
• Through close contact with infectious material,
• Coming from skin lesions of an infected person,
• Through air droplets in the case of prolonged face-to-face contact, and
• through fomites.
• So far, diagnosed cases suggest that transmission can occur through Sexual Intercourse
• The incubation period is 5-21 days, and patients are symptomatic for 2-4 weeks.

7. Transmission
Animal-to-Human (Zoonotic)
• Animal-to-Human (Zoonotic) transmission can occur from direct contact with
• The blood
• Bodily fluids, or
• Cutaneous or Mucosal lesions of infected animals.
• Eating inadequately cooked meat and other animal products of infected animals is a
possible risk factor.
• People living in or near forested areas may have indirect or low-level exposure to
infected animals.

8. Transmission
Human-to-Human Transmission
• Human-to-human transmission can result from close contact with
• respiratory secretions
• skin lesions of an infected person or
• recently contaminated objects.
• Transmission via droplet respiratory particles usually requires prolonged face-to-face
contact, which puts health workers, household members and other close contacts of
active cases at greater risk.
• Transmission can also occur
• via the placenta from mother to fetus (which can lead to congenital monkeypox) or
• during close contact during and after birth.

9. Clinical Course
The disease initially presents
with
• Fever,
• Myalgia,
• Fatigue,
• Headache.
• Backpain
• Swollen lymph nodes
• Chills
Within 3 days of the onset of
the prodromal symptoms,
• A centrifugal
maculopapular rash
appears on the site of
primary infection and
rapidly spreads to other
parts of the body.
• The palms of the hands
and bottoms of the feet
are involved in cases
where the rash has spread.
Usually within 12 days,
• The lesions progress,
• Simultaneously changing
from macules to papules,
• Blisters,
• Pustules, and scabs before
falling off.
• The lesions may have a
central depression and be
extremely itchy.

10. The illness typically lasts for 2−4
weeks. In Africa, monkeypox has
been shown to cause death in as
many as 1 in 10 persons who
contract the disease.

12. Examples

14. Clinical Course
If the patient scratches them,
• A secondary bacterial infection may take hold (for which treatment with oral antihistamines
is indicated).
Lesions may also be present in the oral or ocular mucous membrane.
• Either before or at the same time as onset of the rash,
Patients may experience swelling of the lymph nodes
• Usually is not seen with smallpox or chickenpox.
The onset of the rash is considered the start of the infectious period;
• People with prodromal symptoms may also transmit the virus.

15. Most cases in people present with mild or moderate symptoms.
Complications seen in endemic countries include
• Encephalitis,
• Secondary Bacterial skin infections,
• Dehydration,
• Conjunctivitis,
• Keratitis,
• Pneumonia.
The death rate ranges from 0% to 11% in endemic areas, with fatalities from
the disease mostly occurring in younger children.

16. How is Monkeypox diagnosed?
• Monkeypox is diagnosed through special laboratory tests on
samples taken from people or animals suspected of having
monkeypox.

17. Recent Developments
From May 15 to May 23, 2022
• in eight European Union (EU) member states (Belgium, France, Germany, Italy, the Netherlands, Portugal, Spain,
and Sweden) a total of 85 cases of monkeypox were reported;
• they were acquired through autochthonous transmission.
Current diagnosed cases of monkeypox have mainly been recorded in men who have
sexual relations with other men,
suggesting that transmission may occur during
• sexual intercourse,
• through infectious material coming into contact with mucosa or damaged skin,
• or via large respiratory droplets during prolonged face-to-face contact.

18. Recent Developments
Most current cases have presented with mild symptoms of
the disease, and for the general population, the chance of
diffusion is very low.
However, the likelihood of a further spread of the virus
through close contact, for example during sexual activities
among people with multiple sexual partners, is
considerably increased."

20. Treatment
Treatment for monkeypox is mainly supportive.
• The illness is usually mild and most of those infected will recover within a few weeks
without treatment.
Smallpox vaccine, cidofovir, and tecovirimat can be used to control
outbreaks of monkeypox.
Vaccination against smallpox can be used for both pre and post-
exposure and is up to 85% effective in preventing monkeypox.
• People vaccinated against smallpox in childhood may experience a milder disease.

21. Prevention
contact with animals that could harbor the virus (including animals that
are sick or that have been found dead in areas where monkeypox occurs).
Avoid
contact with any materials, such as bedding, that has been in contact with
a sick animal.
Avoid
infected patients from others who could be at risk for infection.
Isolate

22. Prevention
• monitor the development of their symptoms until 21 days have passed from their most
recent exposure to the virus.
Close contacts for cases of monkeypox should
• Hand Hygiene
• wear appropriate PPE (gloves, water-resistant gowns, FFP2 masks) during screening for
suspected cases or when working with confirmed cases.
• Laboratory staff should also take precautions to avoid exposure in the workplace.
Healthcare workers should
• donate blood, organs, or bone marrow for at least 21 days from the last day of exposure.
Close contacts of an infected person should not

23. Things you can do to avoid getting monkeypox
while travelling
• wash your hands with soap and water regularly or use an alcohol-based hand
sanitizer
• only eat meat that has been cooked thoroughly.
Do:
• Go near wild or stray animals, including dead animals
• go near any animals that appear unwell
• eat or touch meat from wild animals (bush meat)
• share bedding or towels with people who are unwell and may have monkeypox
• have close contact with people who are unwell and may have monkeypox
Don’t

24. Is Monkeypox related to COVID?
Monkeypox is
completely
different and
not related to
COVID.
Monkeypox is
related to
smallpox.
It is not related
to chickenpox.

25. Thank You