WHO: Monkeypox not Exclusively Spread through Sexual Interaction

By Mary Hearty

The World Health Organization (WHO) has clarified that the monkeypox virus is not exclusively spread through sexual interaction, instead it is spread through contact which occurs in different forms such as shaking hand, hugs, direct contact with contaminated objects, among others.

Speaking during a virtual meeting hosted by Internews under a theme: “Monkeypox: What Journalists Need to Know”, Dr Patrick Ramadan, Health Emergency Officer, WHO explained that monkeypox transmission is categorized into two: primary infection which arises mostly when humans interact with animals such as rodents as well as wild animals that have been identified to be reservoirs of the virus; contact with contaminated animal products.

Also, he said there is human to human transmission which primarily occurs through close contact with a person who is infected, especially when the rashes are there and fluid is coming from them as well as other body fluids. It can also be transmitted through mother to foetus.

“In Africa for instance, we are seeing two distinct patterns of transmission: sporadic transmission in remote areas due to spill over from the wild through contact or contaminated food; and then slow human to human transmission in countries like Nigeria and Ghana,” Dr Ramadan noted.

He further stated that the more a person with monkey pox has a contact with several other people, the transmission is amplified, and hence many people get infected, adding that humans like being in contact with each other and a lot of fluids are exchanged in the process.

In addition, the health expert said the transmission in Africa mostly happen in the context of household. “You find that one person may get exposed to an animal and get in contact with the wives and children, who would then become the subsequent cases. In addition, we have not seen transmission related to sexual activity, ” he said.

In case someone within the household or community has symptoms of the monkeypox virus, Dr Ramadan advised that there should be minimal contact with the person and the person should be referred to the hospital, but incase of contact with the person, people should wash their hands with soap and water.

For communities that hunt wild animals for food, he recommended that the food should be properly cooked while healthcare workers should use personal protective equipment.

He noted that Nigeria has the highest number of cases having reported at 172 cases, followed by Democratic Republic of Congo (DRC) with 163 cases; then Ghana 47. In the eastern and southern Africa, only South Africa has confirmed 4 cases, with the fourth case has a history of travelling from Spain.

Dr. Ramadan also clarified that the reported monkeypox cases are not predominantly male as it is happening in the other parts of the world like Europe, noting that in such regions, over 90% of the cases are male, but in the African region, 60% of the cases reported are male and 40% are female, and there is also considerable number of young people.

According to the health emergency officer, monkeypox is a viral zoonotic disease that is characterized by fever and rash, with a range of illnesses: from mild asymptomatic disease to severe disease which can result to death.

The disease has an incubation period of 15-21 days and during this period, the person has no symptoms. After the incubation period, the symptoms begin to show in the form of high fever, swelling of the lymphnodes around the neck and also in the armpits, headache, chills, sore throat, fatigue and malaise. This lasts between 1-4 days.

According to Dr Ramadan, this phase is very difficult to differentiate in our setting because many clinical conditions including malaria and typhoid also present in the same form, except with the swelling of the lymphnodes.

The next stage is the rashes which starts occurring from the mouth and face and then spreads to the entire body. We have so many other viruses that presents with rash but the rash of the monkeypox occurs even on the soles of the feet and palm of the hand, which is not common with other viruses.

The rashes are a raised flat swelling and thereafter it is filled with fluids, which then form a purse, then breaks making it very infectious as it contain a lot of virus. After that the person goes on to heal and recover. This phase can take up to 2-4 weeks.

Notably, he pointed out that the world needs to stay vigilant about the monkeypox virus because it does not only occur in the form of rashes but also affects the glassy part of the eye known as the cornea, which can result in the loss of vision.

Secondly, it can cause bacterial infection as the whole body of the infected person becomes full of wounds, so bacteria can enter in and get infected. Other illnesses that can result from the monkeypox disease are pneumonia, abscess and airway obstruction, bacterial infection of the blood, inflammation of the brain, miscarriage and death.

Hence, the need for enhanced vigilance and scaling up capacity to be able to detect and respond.

According to Dr Ramadan, there is still no evidence that the virus has evolved as the transmission dynamics have been favourable.

“The virus was probably introduced through interaction amongst people, and for any organism that passes from person to person, the more contact you have, the higher the chances that the virus will evolve,” he said.