Mpox impacts
Over dinner with my family, I casually asked if they were aware of monkeypox or mpox. They responded in the affirmative and said that they heard it on the news but were not alarmed because they had a fair idea of how it was transmitted. Unfortunately, this does not hold for the majority based on the number and nature of the queries in the past weeks, which were further fueled by false information about an impending lockdown.
It was one of those situations that brought home the importance of providing clarity in health messaging. This has always been a challenge as various factors come into play beyond the complexities of simplifying medical jargon. In shaping key messages, one has to consider the target audience; have an awareness of cultural differences, beliefs, and sensitivities; take into account their level of health literacy; and identify what is the most important information that they would want and need to know. While various infographics have been helpful together with public health advisories from the medical community and the Department of Health, the importance of feedback on how they perceive the information given cannot be overemphasized. I have to be grateful to our two secretaries who made me realize its importance when our coffee break led to a conversation about mpox. The questions they posed have found their way into this piece and hopefully might be of help in providing a better understanding.
Is this virus related to the one causing chickenpox? No it isn’t. While the clinical picture resembles mpox, it is classified as an orthopoxvirus, which is related to the smallpox virus. Chickenpox (Varicella zoster) is a herpes virus.
Is it as contagious as COVID-19? There have been reports of hoarding of face masks.
No it isn’t. The route of transmission needs to be explained. In the multicountry outbreak in 2022, the risk factor identified was exposure to skin lesions or mucous membranes from infected individuals, which implied direct, close, and personal contact. Since then, other routes such as indirect contact from touching objects or materials that have been contaminated with the virus have been mentioned. But whether this is a common mode of spread remains unclear, including the extent to which respiratory secretions may play a role as well as other bodily fluids. While it is not airborne, the Centers for Disease Control and Prevention or CDC recommends the use of masks for those infected and for individuals providing care for patients, which includes other appropriate personal protective equipment.
Locally, to support the fact that currently the virus is not being transmitted through the airborne route, the Philippine Society for Microbiology and Infectious Diseases stated that compulsory mask-wearing is not necessary and is not a cost-effective measure.
Is it deadly? I have been told that there is no available cure. Will acyclovir help?
In general, the disease is self-limiting. Available published data is limited and has shown that those at higher risk for severe or prolonged illness include those who are immunocompromised. Acyclovir does not play a role. The efficacy of antivirals for the treatment of smallpox and the use of other therapeutics remains to be elucidated. In those with complications, consultation with experts is vital.
Who are those who may be in danger of complications? As previously mentioned, those who are immunocompromised, such as those with HIV with low CD4 counts, solid organ recipients, pregnant women, and infants.
If it is self-limiting, how long will a patient need to isolate? The course of the illness may take around two to four weeks on average. Infected individuals are infectious even prior to the onset of symptoms, which could be around one to four days. There has been no evidence so far of asymptomatic individuals spreading the disease. One is no longer infectious when the lesions have totally healed. This is when a fresh layer of skin is noted after the scabs have dried and fallen off.
Can you get reinfection? Reinfection is possible. The length of immunity after a previous infection remains to be a question.
How can we protect ourselves? While there are vaccines available, these are in limited supply and not currently available in our country.
Seek proper and prompt consult if you have a rash and you have been exposed or have a history of significant exposure to mpox. Remember that mpox is contagious and you may be placing individuals with weakened immunity at risk for complications. Isolate until your lesions have been fully healed.
Wash your hands, do not share personal items, and practice good personal hygiene.
Get your facts straight from authorities and credible sources to avoid confusion. If you do not have the answers, do not hesitate to ask those who are armed with the expertise.
It pays to stay properly informed.
