What is monkeypox?
Officially, the virus is called monkeypox virus or MPV for short. Even though few monkeypox cases have been reported in Europe so far the situation is evolving and organisations like the WHO and the ECDC are closely monitoring the outbreak in order to keep an eye on the development of the virus and assess the risks to the population.
According to current studies, the pathogen is a DNA virus with an envelope membrane, which, with a size of 200 to 400 nm, is one of the largest viruses known to date. It is very similar to the variola virus (a.k.a. smallpox) commonly found in Europe, but usually leads to a milder course of disease in infected persons. Nevertheless, isolation of infected persons is currently considered to be one of the most significant infection protection measures against the pathogen.
Common symptoms of infection with the disease include fever, chills and swollen lymph nodes, as well as muscle aches, headache, fatigue, joint pain and back pain. In addition, suspect cutaneous maculopapular to vesiculopustular lesions and oral, rectal or genital enanthema should also be examined more closely.
However, in addition to the symptoms, a patient's medical history must also be taken into account. If a patient has been in close contact with an infected person within 21 days prior to the onset of symptoms, has had sexual contact, especially with several partners, or has been in a known endemic area with possible animal contact, a thorough testing for the disease is recommended.
Transmission of Monkeypox
In endemic areas, animal-to-human transmission is the primary cause of spread. Human-to-human transmission is considered rare and is only possible in the case of close and direct contact, for example through body fluids, skin lesions or sexual activity.
Skin lesions in particular show a particularly high virus concentration of virus, but infection through excreted respiratory secretions is also possible with non-specific symptoms such as fever, headache and aching limbs. In addition, transmission is possible via contaminated surfaces and textiles that have touched body fluids or sores. Further spread via aerosols, however, is unlikely.
But how does the virus enter the human body? The smallest skin lesions and all mucous membranes are considered perfect entry points for the virus. All patients are considered contagious for as long as symptoms are present. This can last between two and four weeks. All people who have close physical contact with infected persons are at higher risk.
To obtain laboratory diagnostic evidence of the presence of a monkeypox case, both electron microscopy and nucleic acid detection, e.g. using the PCR method or genome sequencing, are available. In the case of nucleic acid detection, it should be considered whether this is specific for monkeypox or whether only orthopox has been detected. It is considered safer to perform a detection that is specific to monkeypox.
Preventive Measures Against the Virus
According to current knowledge, vaccination against human smallpox virus offers a high level of protection against monkeypox virus. Vaccinated persons have milder symptoms of infection and the vaccine can also be used to treat acute infections. There is currently no targeted monkeypox vaccine.
Hygiene measures for healthcare professionals:
- Hand hygiene according to official health authority guidelines
- Personal protective equipment (gown, gloves, eye protection and surgical cap)
- FFP2 mask for direct patient care according to occupational health and safety guidelines
- In the case of in-patient care a single-person room with own bathroom is recommended
Effective Disinfectants for Surfaces, Skin & Instruments
To minimise the risk of contamination and transmission in clinical areas, disinfection with an agent of proven virucidal efficacy, at least for enveloped viruses, is recommended. These also inactivate enveloped viruses, such as the monkeypox virus. Strict adherence to the exposure times must also be ensured. If these are not adhered to, the virus may not be completely inactivated. All rooms in medical facilities should be cleaned and disinfected in such a way as to avoid stirring up infectious particles.