With cases being reported from across the world, monkeypox has caught everyone’s attention. The present outbreak has a toll of over 220 confirmed cases spread across 19 countries. U.K., Spain and Portugal are leading the pack with the highest number of confirmed cases but no deaths reported till date.
The present outbreak has been interesting in many ways. While sporadic outbreaks have occurred in Africa and a few outside of Africa in regions which had recorded travel from areas where outbreaks have occurred, such massive flare-ups spanning multiple countries simultaneously has not happened before. Additionally many of the affected patients did not travel to regions where the disease is considered prevalent and the initial cases were largely, but not exclusively among young individuals who identify themselves as men who have sex with men.
Monkeypox is not a new virus. The virus, belonging to the poxvirus family of viruses, was first identified in monkeys way back in 1958, and therefore the name. The first human case was described in 1970 from the Democratic Republic of Congo and many sporadic outbreaks of animal to human as well as human to human transmission has occurred in Central and West Africa in the past with significant mortality. After the elimination of smallpox, monkeypox has become one of the dominant poxviruses in humans, with cases increasing over years along with a consequent reduction in the age-group affected. Since the transmission occurs only with close contact, the outbreaks have been in many cases self-limiting. Since in the majority of affected people, the incubation period ranges from five to 21 days and is often mild or self-limiting, asymptomatic cases could transmit the disease unknowingly. The outbreaks in Central Africa are thought to have been contributed by close contact with animals in regions adjoining forests. While monkeys are possibly only incidental hosts, the reservoir is not known. It is believed that rodents and non-human primates could be potential reservoirs.