(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
WE CONTINUE to share information on monkeypox as a matter of public health service.
The matter is important since the World Health Organization has declared the disease a “global public health importance.”
It affects not just west and central Africa, but the rest of the world as well, the United Nations health agency declared on May 19.
Monkeypox is caused by monkeypox virus. It is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3 percent to 6 percent.
Monkeypox is a viral zoonosis – a virus transmitted to humans from animals.
Monkeypox is transmitted to humans through close contact with an infected, or a material contaminated with the virus.
It may be transmitted from person to person by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.
Uncertainty remains on the natural history of monkeypox virus and further studies are needed to identify the exact reservoir/s and how virus circulation is maintained in nature.
In 2003, the first monkeypox outbreak outside of Africa was in the United States.
Monkeypox has also been reported in travelers from Nigeria to Israel in September 2018, to the United Kingdom in September 2018, December 2019, May 2021 and May 2022, to Singapore in May 2019, and to the United States in July and November 2021.
In May 2022, multiple cases of monkeypox were identified in several non-endemic countries. Studies are currently underway to further understand the epidemiology, sources of infection, and transmission patterns.
In Africa, evidence of monkeypox virus infection has been found in many animals including rope squirrels, tree squirrels, Gambian poached rats, dormice, different species of monkeys and others.
The natural reservoir of monkeypox has not yet been identified, though rodents are the most likely.
Eating inadequately cooked meat and other animal products of infected animals is a possible risk factor. All foods containing animal meat or parts must be thoroughly cooked before eating.
People living in or near forested areas may have indirect or low-level exposure to infected animals.
Raising awareness of risk factors and educating people about the measures they can take to reduce exposure to the virus is the main prevention strategy for monkeypox.
Scientific studies are now underway to assess the feasibility and appropriateness of vaccination for the prevention and control of monkeypox.
Some countries have, or are developing, policies to offer vaccine to persons who may be at risk such as laboratory personnel, rapid response teams and health workers.
Surveillance and rapid identification of new cases is critical for outbreak containment.
During human monkeypox outbreaks, close contact with infected persons is the most significant risk factor for monkeypox virus infection.
Health workers and household members are at a greater risk of infection. Health workers caring for patients with suspected or confirmed monkeypox virus infection, or handling specimens from them, should implement standard infection control precautions. If possible, persons previously vaccinated against smallpox should be selected to care for the patient.
Over time, most human infections have resulted from a primary, animal-to-human transmission. Unprotected contact with wild animals, especially those that are sick or dead, including their meat, blood and other parts must be avoided.
Some countries have put in place regulations restricting importation of rodents and non-human primates. Captive animals that are potentially infected with monkeypox should be isolated from other animals and placed into immediate quarantine.
Any animals that might have come into contact with an infected animal should be quarantined, handled with standard precautions and observed for monkeypox symptoms for 30 days.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
