Monkeypox virus outbreak: a brief timeline

To Editor,

Monkeypox virus is a specie of large double-stranded DNA viruses from the genus Orthopoxvirus family of Poxviridae. Monkeypox is a disease caused by the monkeypox virus. It is the causative agent of the zoonotic disease monkeypox, which was first identified as a human pathogen in the DRC, formerly Zaire, in 1970. In the 50 years since human cases of the Monkeypox virus were identified in 11 African countries, it is considered endemic in the Democratic Republic of Congo [1]. The timeline of the Monkeypox virus from discovery to human infection is shown in Fig. 1. Based on serological data, the Monkeypox virus is evidenced to be kept by various mammalian species in endemic areas. Monkeypox is an infectious viral disease that can occur in both humans and some other animals. Initial symptoms of monkeypox virus infection include fever, headache, muscle pains, shivering, backache, and feeling extremely tired. Typically, there are swollen lymph nodes behind the ear, below the jaw, in the neck, or the groin. Follows a rash that forms blisters and crusts over, most frequently in the mouth, on the face, hands and feet, genitals, and eyes [2]. The time from exposure to onset of symptoms is, on average, 12 days though it ranges from 5 to 21 days. The duration of symptoms is typically two to six weeks, and Cases may be severe, particularly in children and pregnant women or people with suppressed immune systems [2]. According to WHO, it is closely related to smallpox; therefore, vaccines against smallpox can provide protection against Monkeypox. Similarly, one vaccine has also been approved for Monkeypox. The symptoms lasting from 2 to 6 weeks, and the case fatality rate is about 3–6%.

Fig. 1.

Timeline of Monkeypox virus infection.

The current outbreak of Monkeypox was confirmed on May 7, 2022, beginning with a British resident who, after traveling to Nigeria, where the disease is widespread, presented symptoms consistent with Monkeypox on April 29, 2022. The resident returned to the United Kingdom on May 4, creating the country's index case of the outbreak. The origin of various cases of Monkeypox in the United Kingdom is unknown. Some monitors saw community transmission in the London area as of mid-May [3].

According to World Health Organization, on June 13, 2022, more than 780 cases were reported in 27 countries of the world, and more than 50 patients were hospitalized globally. The highest number of cases were reported in the United Kingdom (207), followed by Spain (156), Portugal (138), Canada (58), and Germany (57) [2].

In Pakistan, the news was circulated on print and social media that Pakistan has detected two cases of the rare infection of Monkeypox Virus on May 23, 2022. However, the Ministry of National Health Services Regulations and Coordination, Government of Pakistan dismissed the report of the cases in the country on May 30, 2022 [4]. Recently in Pakistan, on May 29, 2022, the first suspected Monkeypox virus case was reported at the Civil hospital district Sukkur Karachi. As per the details, a 13-year-old young boy is a resident of Shikarpur Karachi. The patient was brought to the Civil Hospital Sukkur, and due to fear that the boy might have caught the monkeypox virus, he was shifted to the CLF ward. The report was sent for further medical analysis. However, no confirmation of Monkeypox from the health authorities. The health authorities monitor the current situation, and the federal govt-issued special instructions to all health authorities, including national and international, to remain on high alert for any confirmed or suspected cases [4,5]. The efforts of Pakistan were appreciated by WHO for the management, diagnosis, and treatment of the Coronavirus disease 2019. However, the emergence of the Monkeypox virus will be a new challenge to the healthcare system of Pakistan. Because currently, no diagnostic facilities for the Monkeypox virus are available in Pakistan. However, the health ministry reported that we are trying to procure diagnostic kits for the National Institute of Health Pakistan. Currently, there is a need for awareness of the population, establishing isolation hospitals and centers, and giving proper attention to the outbreak. It will help combat the new viral outbreak and will eliminate the disease.

Funding

NA.

Authors’ contribution

FA and AW contributed equally.

Conflict of interest

None.