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How to Diagnose Monkeypox?

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In 1970, the first-ever human monkeypox case was discovered in the Democratic Republic of the Congo. Retrospectively, monkeypox was first discovered at a research facility in 1958. This viral infection caused by the monkeypox virus is very rarely seen outside of Africa, where it is considered endemic. It is similar to another pox-like viral illness called smallpox which makes its diagnosis a little tricky. However, unlike smallpox, monkeypox is a milder disease with a low mortality rate. Continue reading this article to learn more about this disease and how it is diagnosed.

How to Diagnose Monkeypox?

When it comes to clinical diagnosis, there are a few steps that can help doctors figure out the cause of the problem. They can be broadly classified into 3 – medical history, physical examination, and clinical tests. We will explore each section in relation to monkeypox.

  1. Medical History

There are many pox-like illnesses besides monkeypox, such as chickenpox, measles, scabies, and bacterial skin infections. That is why a complete medical history is the most important aspect to help narrow down the cause of your illness. Your doctor may ask you questions regarding your symptoms and any other related medical history such as your comorbidities and drug history while also looking for possible risk factors.

Symptoms for monkeypox include :

  • Fever (temperature between 38.5-40.5℃)
  • Chills
  • Excessive sweating
  • Intense headache
  • Back pain
  • Lethargy
  • Myalgia
  • Skin rash

Risk factors for monkeypox infection are :

  • Recent travel to Africa
  • Eating undercooked meat
  • Contact with ill animals from Western Africa such as prairie dogs, squirrels, rabbits, mice, monkeys, porcupines, and gazelles
  • Recent animal bites or scratches
  • Contact with a known infected person
  1. Physical Examination

The most distinguishing factor in monkeypox infection is the presence of lymphadenopathy. Your doctor will proceed to examine your lymph nodes specifically the submental, submandibular, cervical, and inguinal lymph nodes to look for any enlargement. Your doctor will also examine the rash which progresses sequentially from macules to papules, vesicles, pustules, and lastly crusts before they fall off. In addition to these examinations, your doctor may also perform a respiratory examination to look for possible signs of complications like bronchopneumonia and respiratory distress. An eye examination is also included if skin lesions involve the eyes to rule out keratitis and corneal ulceration.

  1. Clinical tests

Once your doctor suspects monkeypox infection, a PCR (Polymerase chain reaction) test is done by taking a sample from the skin lesions or a nasopharyngeal swab. The PCR test is highly accurate and is, therefore, the gold standard in diagnosing monkeypox. A skin biopsy specimen may also be collected if possible. Serological tests for antigen and antibody levels are not recommended as they are not specific to monkeypox infection.

How is Monkeypox treated?

Monkeypox is a self-limiting infectious disease that is usually resolved within 2-4 weeks. Treatment for monkeypox is supportive, which includes sufficient bed rest and painkillers for symptomatic relief. Patients should be kept isolated until the lesions have crusted and dropped off. Death from monkeypox infection is not commonly seen, but it can happen in patients with complications or who have pre-existing comorbidities. A higher mortality rate is also seen in young children infected with the monkeypox virus.

Is there a vaccine for Monkeypox?

Studies have shown that the vaccinia vaccine used in smallpox infection is 85% effective in preventing monkeypox. Plus, those who were previously vaccinated against smallpox developed a milder form of illness when infected with monkeypox. In 2019, a new version of the vaccinia vaccine is approved for the prevention of smallpox and monkeypox virus but this vaccine is yet to be available to the public.

It’s advisable to take Covid19 Vaccine.