Monkeypox is a rare viral disease identified mostly in the rainforest countries of central and west Africa. The virus was originally discovered in laboratory monkeys in 1958. It was later recovered from an African squirrel, which was thought to be the natural host. It may also infect other rodents, such as rats, mice, and rabbits. The first human cases of monkeypox were reported in remote African locations in 1970. In June 2003, there was an outbreak in the United States involving people who had gotten ill following contact with infected prairie dogs.
The monkeypox virus, belonging to the orthopoxvirus group of viruses, causes monkeypox. It's related to variola and cowpox. People can contract monkeypox from an infected animal through a bite or direct contact with the animal's blood, body fluids, or lesions. It's spread person to person via respiratory droplets during direct and prolonged face-to face contact. It's less infectious than smallpox, but it can also be spread through direct contact with an infected person's body fluids or with virus-contaminated objects, such as bedding or clothing.
The signs and symptoms of monkeypox are similar to smallpox, but milder. After an incubation period of about 12 days, the patient may report fever, headache, muscle aches, backache, swollen lymph nodes, and a general feeling of discomfort and exhaustion. A papular rash begins on the face or other area of the body within 1 to 3 days after onset of the fever. The lesions go through several stages before crusting and falling off. The illness’ duration is 2 to 4 weeks.
In Africa, monkeypox is fatal in 10% of those who contract the disease.
Diagnosis is based on history and presenting signs and symptoms. The virus may be isolated from vesicular fluid to aid in diagnosis and differentiation from other rash-producing viruses.
There is no specific treatment for monkeypox, but the smallpox vaccine appears to reduce the risk of contracting the disease. The Centers for Disease Control and Prevention recommends that persons who are investigating monkeypox outbreaks and caring for infected individuals or animals should receive smallpox vaccination. Persons exposed to individuals or animals confirmed to have monkeypox should also receive vaccinations (up to 14 days after exposure).
Vaccinia immune globulin may be considered in some cases, such as in patients who are severely immunocompromised. There is no data available on the effectiveness of cidofovir in the treatment of human monkeypox cases.
❑Notify the local health department immediately if you suspect monkeypox.
❑A combination of standard, contact, and droplet precautions should be applied in all health care settings. Because of the risk of airborne transmission, droplet precautions should be applied whenever possible using a NIOSH-certified N95 (or comparable) filtering disposable respirator that has been fit-tested. Surgical masks may be worn if the respirator is not available. Isolation continues until all lesions are crusted over or until the local or state health department advises that isolation is no longer necessary.
❑Perform scrupulous hand hygiene after contact with an infected patient or contaminated objects. Teach the patient and his family members proper hand hygiene as well.
❑Eye protection should be used if splash or spray of body fluids is possible.
❑Place the patient in a private room. Use a negative pressure room if available.
❑When transporting the patient, place a mask over his nose and mouth, and cover the exposed skin lesions with a sheet or gown. If the patient is to remain at home, he should maintain the same precautions.
Review other book chapters online related to Smallpox:
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X 
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