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Monkey Pox

Surgical Intensive Care Unit


By S/N Vaishali Lokhande
& S/N Namrata Biswas
Table Of Contents

• What is Monkey Pox? • Complications


• Diagnosis
• Origin
• Treatment
• Regions Infected • What must be done if infected?
• Nursing Care
• Transmission
• Available Vaccines
• Vulnerable to the Virus • Scenario in India
• Signs & Symptoms • Conclusion

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What is Monkey Pox?
• Monkey Pox is a viral Zoonosis(a virus transmitted from animals to humans).
• It has symptoms very similar to those in the past in smallpox patients.
• It is called “Monkey Pox” because it was first identified in Laboratory monkeys.

Double Stranded DNA of the virus


Belongs to the Orthopox Virus Family

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Origin

• Monkey Pox as a disease in humans


was first associated with an illness in
the Democratic Republic of
Congo(formerly Zaire), in the town of
Basankusu, Equateur Province in 1970.
• WHO surveillance recorded 338
confirmed cases and 33 deaths.

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Regions Infected

• 1996- Democratic Republic of Congo


• 2003- U.S.A.
• 2017- Nigeria
• 2018- United Kingdom
• 2021- Singapore
• 2022-Parts of Europe, Asia & Africa

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Regions Infected- Contd.

• Monkey Pox primarily


occurs in Central and West
Africa, often in proximity to
tropical rainforests, and has
been increasing appearing in
urban areas.

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Transmission of the Virus

• Animal to Human(Zoonotic)
transmission can occur from blood,
bodily fluids, or cutaneous or mucosal
lesions of infected animals.
Transmission Hosts
• Human to Human transmission can
result from close contact with
respiratory secretions, skin lesions of
an infected person or recently
contaminated objects.
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Vulnerable to the Virus

• Most Children & Adults with healthy


immune systems are likely to dodge
severe illness, but there are two high
risk groups:-
• Infants younger than six months &
adults below the age of 50 years are
under high risk.

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Signs & Symptoms

• The incubation period for the • Fever


virus is usually 7-14 days but can • Headache
range from 5-21 days. • Muscle Aches
• Backache
• The illness begins with the • Swollen Lymph Nodes
following symptoms:- • Chills
• Exhaustion
• Within 1-3 days(sometimes longer) after the appearance of fever, the patient develops a rash, often beginning on
the face then spreading to other parts of the body.
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Signs & Symptoms-Contd.

• Lesions progress through the following stages before falling off:-

Macules Papules Vesicles Pustules Crusts

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A Photo Gallery

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Complications
• Complications of Monkey Pox
can include secondary
infections, bronchopneumonia,
sepsis, encephalitis, and
infection of the cornea with
ensuing loss of vision. The
extent to which asymptomatic Sepsis
Bronchopneumonia
infection may occur is unknown.

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Encephalitis
Diagnosis

• The clinical differential diagnosis that must be considered are:-


1. Other Rash illnesses like, Chickenpox
2. Measles
3. Scabies
4. Syphilis
5. Medication associated allergies
6. Lymphadenopathy

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Treatment

• Treatment for Monkey Pox is mostly symptomatic, as there is no specific antiviral treatment.
• It is suggested to avoid touching lesions and sores, taking paracetamol & eye drops for relief
and rinsing mouths regularly.
• There are currently 2 antiviral drugs that may be used for monkeypox infections: tecovirimat
and Brin cidofovir. Tecovirimat prevents formation of the viral envelope by inhibiting p37, a
highly conserved protein in all Orth poxviruses.
• Vaccine Immunoglobulin recommended for severe cases.

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What must be done if infected?
A smallpox vaccine can provide protection against monkeypox, but its use is currently
limited to people who work in a lab with the variola (smallpox) virus. Prevention depends
on decreasing human contact with infected animals and limiting person-to-person spread.
Monkey Pox Virus can be prevented by:
•Avoiding contact with infected animals (especially sick or dead animals).
•Avoiding contact with bedding and other materials contaminated with the virus.
•Washing hands with soap and water after coming into contact with an infected animal.
•Thoroughly cooking all foods that contain animal meat or parts.
•Avoiding contact with people who may be infected with the virus.
•Using personal protective equipment (PPE) when caring for people infected with the virus. 18
Nursing Care

Care for a patient with Monkeypox is supportive. A person


can do the following to provide supportive care for the
patient:-
• Place him in a negative-pressure room(preferably) or a private room.
• Inititate contact, droplet, and airborne precautions.
• Use a face-shield or goggles if splashing or spraying of body fluids
might occur.
• Strictly follow infection control protocols for hand hygiene and
disinfection or disposal of equipment and fomites.
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Nursing Care-Contd.

If a patient with monkeypox is recovering at home, he should be isolated in a private


room and minimize contact with others. The following must be done to prevent
infection hazard:-
• Don’t shake bedding, towels, or clothing which may release airborne droplets.
• Launder bedding and clothing with warm water in the washing machine and dryer.
• Don’t share dishes or eating utensils with the patient. Clean the patient’s dishes &
utensils with soap and warm water.
• Clean and disinfect contaminated surfaces with a standard household disinfectant.
• Place soiled dressings and disposable medical equipment in a plastic bag and place it
in another container for disposal with the household trash.
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Available Vaccines

At this time, there are no specific treatments available for monkey pox infection, but the
outbreaks can be controlled. The available vaccines are:-
• Small Pox Vaccine
• Cidofovir & Brin cidofovir(CMX001)
• Tecovirimat(TPOXX, ST-246)
• Vaccinia Immuno Globulin(VIG)

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Smallpox Vaccine
Scenario in India
• As of date, there are no cases of monkeypox in India.
• The Union government has issued instructions to states and Union territories to keep an eye on people
who show symptoms associated with monkeypox and have a history of travelling to the affected
countries.
• The Centre has also state that suspected samples would be sent to the National Institute of Virology,
Pune (NIV) for diagnosis.
• The National Centre for Disease Control (NCDC) has instructed states and Union territories to move
suspected cases to an isolation centers and keep them until all lesions have resolved and a fresh layer of
skin has formed or until the treating physician decides to end isolation.
• Also, if cases continue to increase, the government could start random screening of people arriving
from affected countries.
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Conclusion

Monkeypox virus is a highly contagious orthopoxvirus that is currently causing a global


outbreak. Control of this growing international outbreak will require careful
coordination among public health officials, clinicians, and the community to
disseminate information, obtain appropriate diagnostic testing, implement contact
tracing, and ensure that affected individuals and their contacts have access to medical
care.

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