MONKEY POX - AN EMERGING PUBLIC HEALTH GLOBAL EMERGENCY

On 23 July 2022, the World Health Organization (WHO) declared the monkeypox outbreak as a Public Health Emergency of International Concern (PHEIC). From May to July 2022, a multi-country outbreak of monkeypox was reported in both endemic and non-endemic regions (almost 35,000 including sexual contact are pivotal in transmission in humans during recent outbreak.4 There could be vertical transmission from mother to fetus or at birth from mother to newborn.3 The cardinal features of monkeypox are high-grade fever, headache, malaise, muscle aches, backache, swollen lymph nodes and a cases in 92 countries with 12 deaths).1 There has general sense of unwellness.4,5    It is pertinent to note been no case reported in Pakistan yet, but there were some rumors of cases identified in a public sector hospital of Lahore, which were later found to be unrelated to monkeypox infection.Monkeypox is a rare zoonotic disease caused by a DNA virus from Orthopoxviridae family of viruses, which also includes viruses such as cowpox,that lymphadenopathy or enlarged lymph nodes are not seen in smallpox patients. After 1-3 days of these symptoms, the infection heralds itself by a vesicular and pustular rash similar to small pox, primarily beginning on the face and then spreading to other parts of the body involving palms and soles as well.5,6 Eventually rash progresses from vesicular stage to vaccinia and variola.2   It is endemic in rainforest crusting of lesions. However all stages of the rash are countries of the central and West Africa, exists in two main strains with variable case fatality: Congo Basin strain having 10% case fatality, and West African strain with 1% mortality among those contracted the visible in same patient. The face is affected in 95% of cases, while palm and soles in 75% cases; oral mucous membranes in 70%, genitalia 30% and conjunctiva and cornea in about 20% or less number disease.1,2     The manifestations of monkeypox are of cases.7 Interestingly the lesions in conjunctivae similar to that of smallpox infection, though less severe than the later. The first case of monkeypox was diagnosed in 1970 in Democratic Republic of Congo, but an evidence of the disease was observed in laboratory held monkeys as early as in 1958.1 Human beings are the incidental hosts, where rodents are identified to be the natural reservoir of this virus.3