By Fineline Cube China’s National Health Commission (NHC) has formulated and released the “Monkeypox Diagnosis and Treatment Guidelines” (2022 Edition) in response to the recent outbreaks of monkeypox in multiple non-pandemic countries since May this year. The guidelines aim to enhance early clinical identification and standardized diagnosis and treatment, ensuring thorough preparedness against potential community infections.
Disease Overview
Monkeypox is a zoonotic viral disease caused by the monkeypox virus (MPXV), characterized by fever, rash, and lymphadenopathy. It is primarily prevalent in central and West Africa. MPXV belongs to the genus Orthopoxvirus within the Poxviridae family and is one of four orthopoxviruses that cause human disease, alongside smallpox, vaccinia, and cowpox viruses.
Virus Characteristics
The monkeypox virus is resistant to drying and low temperatures, capable of surviving for several months in soil, scabs, and quilts. It can be inactivated by heating to 56°C for 30 minutes or 60°C for 10 minutes. The virus is also sensitive to ultraviolet light, general disinfectants, and specific chemicals such as sodium hypochlorite, chlorodimethylphenol, glutaraldehyde, formaldehyde, and paraformaldehyde.
Transmission and Infection
The primary infection source is rodents infected with the monkeypox virus. Primates, including humans, can also become infection sources. The virus enters the human body through mucous membranes and damaged skin. Transmission occurs primarily through contact with infected animals’ exudates, blood, or other body fluids, or through bites or scratches. Human-to-human transmission is mainly via close contact, droplet transmission, and contact with virus-contaminated items. Vertical transmission through the placenta is also possible, and sexual transmission cannot be ruled out.
Clinical Manifestations
Monkeypox is generally a self-limited disease with a good prognosis. Severe cases are more common in young children and immunocompromised individuals. The incubation period ranges from 5 to 21 days, typically 6 to 13 days. Symptoms may include chills, fever (above 38.5°C), headache, drowsiness, fatigue, back pain, and myalgia. Most patients experience swollen lymph nodes in the neck, armpit, and groin. A rash typically appears 1-3 days after onset, starting on the face and spreading to the limbs and trunk, with centrifugal distribution.
Diagnosis and Differentiation
Monkeypox virus nucleic acid can be detected in skin rashes, blister fluids, scabs, and oropharyngeal or nasopharyngeal secretions using nucleic acid amplification. The disease should be distinguished from chickenpox, herpes zoster, herpes simplex, measles, dengue fever, and other febrile and eruptive diseases, as well as skin bacterial infections, scabies, syphilis, and allergic reactions.
Treatment
Currently, there are no specific anti-monkeypox drugs in China. Treatment primarily focuses on symptomatic support and management of complications.-Fineline Info & Tech