Monkeypox

Sir, recent reports of infection with the Monkeypox virus via community transmission in the United Kingdom (UK) have prompted me to question the impact this could potentially have on dentistry.¹ According to the Centers for Disease Control and Prevention (CDC), Monkeypox is a rare virus belonging to the Orthopoxvirus genus.²Since first being discovered in humans in 1970, the virus has been reported in central and western African countries, the United States, Israel, Singapore and the UK. Currently, the natural reservoir of Monkeypox is unknown.

Monkeypox virus enters the body through broken skin, the respiratory tract or through the mucous membranes of the eyes, nose, or mouth. Human-to-human transmission primarily occurs through respiratory droplets during periods of prolonged face-to-face contact and via indirect contact with lesion material through contaminated clothing.

Those infected with Monkeypox initially experience fever, headache, muscle aches, lymphadenopathy and exhaustion. Within three days, a spreading bodily rash develops, often beginning on the face. Incubation period of the virus can range from 5-21 days. Awareness of the signs and symptoms amongst the dental profession needs to be reinforced. Given the nature of our work, we are in a position to remain vigilant to the early signs of a facial rash amongst patients. The large volume of aerosol generated procedures we undertake in dentistry places us at higher risk of becoming infected with the virus due to the mode of transmission. In recent weeks, guidelines around the use of personal protective equipment (PPE) and social distancing have changed in relation to the COVID-19 pandemic. However, the CDC state that prevention of Monkeypox virus transmission is aided by self-isolation, meticulous hand hygiene and the use of PPE. Due consideration needs to be given to the fact that if reported cases increase, re-implementation of these protective measures may be necessary amongst healthcare staff.

Currently, Monkeypox may not be a cause for major concern but it is imperative we remain vigilant as the lessons we learned from the COVID-19 pandemic cannot be forgotten.