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SHORT COMMUNICATION
Year : 2022  |  Volume : 7  |  Issue : 2  |  Page : 61-63

2022 Monkeypox outbreaks in endemic and nonendemic nations and the vulnerability of children


1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission06-Jun-2022
Date of Decision09-Jun-2022
Date of Acceptance10-Jun-2022
Date of Web Publication30-Jun-2022

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ed.ed_13_22

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  Abstract 


The 2022 monkeypox outbreak in nonendemic nations has emerged as a cause of concern for the public health authorities and international welfare agencies. The outbreaks of monkeypox in the endemic nations of the African region have been reported on a regular basis. However, the outbreak, which started on May 13, 2022, as a single case in the United Kingdom has become a cause of global concern. Moreover, the sudden detection of cases that has been distributed worldwide indicates undetected transmission for quite some time, and this is a cause of concern for public health professionals. It has been identified that children possess a higher risk to develop severe symptoms when compared with population groups of adolescents or adults. To conclude, the monkeypox outbreak in 2022 has been reported in both endemic and nonendemic nations. The outbreak in nonendemic nations has been quite atypical, with variable clinical presentation, and the absence of a history of travel to endemic nations. The need of the hour is to take prompt steps to spread awareness about the disease and interrupt the chain of transmission through the implementation of preventive measures.

Keywords: Children, monkeypox, outbreak


How to cite this article:
Shrivastava SR, Shrivastava PS. 2022 Monkeypox outbreaks in endemic and nonendemic nations and the vulnerability of children. Environ Dis 2022;7:61-3

How to cite this URL:
Shrivastava SR, Shrivastava PS. 2022 Monkeypox outbreaks in endemic and nonendemic nations and the vulnerability of children. Environ Dis [serial online] 2022 [cited 2022 Aug 20];7:61-3. Available from: http://www.environmentmed.org/text.asp?2022/7/2/61/349538




  Introduction Top


The 2022 monkeypox outbreak in nonendemic nations has emerged as a cause of concern for the public health authorities and international welfare agencies.[1] Monkeypox infection is a viral disease that initially had a zoonotic origin in 1958, and subsequently, the infection has also been transmitted from human to human through close contact.[1] This viral infection was endemic in the regions of central and west Africa, and generally, cases in nonendemic regions were reported by means of travelers who visited endemic nations.[2] The infection is transmitted through close physical contact with the infected person, and usually, the caregivers, including the health-care professionals are at risk of acquiring the infection.[1],[2]


  2022 Monkeypox Outbreak in The African Region Top


The outbreaks of monkeypox in the endemic nations of the African region have been reported on a regular basis.[1] The available estimates suggest that between January 1 and June 1, 2022, a total of 1,408 suspected cases, 44 confirmed cases, and 66 deaths have been reported as a whole.[3],[4] These figures have been reported from seven nations in the African region, with the maximum confirmed cases reported from Nigeria, while the highest number of deaths have been reported in the Democratic Republic of the Congo.[4] It is important to acknowledge that the disease has been in existence among humans since 1970, and considering that the infection is self-limiting in nature, it is a major cause of concern that still people are losing lives due to the disease-associated complications.[4],[5]


  2022 Monkeypox Outbreak in Nonendemic Nations Top


The outbreak, which started on May 13, 2022, as a single case in the United Kingdom has become a cause of global concern.[6] The available reports depict that as of June 2, 2022, 780 confirmed cases of the infection were reported in 27 nations, all of which are nonendemic.[4] The most affected region is the European region bearing the maximum caseload, but the good thing is that no deaths have been attributed to the infection.[4],[6],[7] The epidemiological investigation has suggested that most of the confirmed cases gave a positive history of travel to nations in the European and North American regions. This is unlike the usual sporadic cases that were reported in the past, as they had a positive history of travel to endemic nations.[2],[4]

The isolated virus among the reported cases has been from the west African clade.[4] However, the sudden detection of cases that have been distributed worldwide indicates undetected transmission for quite some time, and this is a cause of concern for public health professionals.[8],[9],[10] In the ongoing outbreak in nonendemic nations, a major proportion of the reported cases are among those who came to health facilities to avail sexual health.[4] Thus, patients presented with genital, perianal lesions, and anogenital rash, along with the usual complaints of fever, swollen lymph nodes, and odynophagia. Further, reports of hospitalization have also come and patients are admitted for pain management and to manage secondary infections.[4]


  Vulnerability of Children Top


Children, individuals with immune deficiency, and those who have a simultaneous presence of other chronic illnesses are found to be more vulnerable to developing complications.[1] In- fact, a case fatality rate of 3%–6% has been reported among these high-risk population groups in the recent past, especially in endemic nations.[11] The fetus can acquire infection from the pregnant woman through the placenta, while newborns are at the potential risk to get the infection through close physical contact during breastfeeding or through infected parents.[1],[11] It has been identified that children possess a higher risk to develop severe symptoms when compared with population groups of adolescents or adults.[4]


  Prevention Strategies Top


Primary prevention is the cornerstone to containing the infection, wherein health promotion in terms of creating awareness about the infection, modes of transmission, and symptoms of the disease has to be given utmost importance.[11] As the emergence of the disease in most nonendemic nations is a first-time event, it is essential that people should be informed about the same and should be encouraged to adhere to the standard preventive measures.[1],[9] In terms of secondary prevention, it is important to diagnose the illness at the earliest, isolate the patient, and provide symptomatic treatment to prevent the progression of the infection.[5],[7] In this regard, it is crucial that measures are taken to avoid stigmatization of some specific population groups, as they will be reluctant to avail health care.[11] Tertiary prevention in terms of rehabilitation can be offered to those people who have landed into complications or have been hospitalized for secondary infections.[4] In addition, depending on how the outbreak unfolds, the authorities have to decide about the administration of the available vaccines.


  Conclusion Top


The monkeypox outbreak in 2022 has been reported in both endemic and nonendemic nations. The outbreak in nonendemic nations has been quite atypical, with variable clinical presentation, and the absence of a history of travel to endemic nations. The need of the hour is to take prompt steps to spread awareness about the disease and interrupt the chain of transmission through the implementation of preventive measures.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Monkeypox – Key Facts; 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/monkeypox. [Last accessed on 2022 Jun 09].  Back to cited text no. 1
    
2.
Mauldin MR, McCollum AM, Nakazawa YJ, Mandra A, Whitehouse ER, Davidson W, et al. Exportation of monkeypox virus from the African continent. J Infect Dis 2022;225:1367-76.  Back to cited text no. 2
    
3.
Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, et al. The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis 2022;16:e0010141.  Back to cited text no. 3
    
4.
World Health Organization. Multi-Country Monkeypox Outbreak: Situation Update; 2022. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON390. [Last accessed on 2022 Jun 06].  Back to cited text no. 4
    
5.
Dye C, Kraemer MU. Investigating the monkeypox outbreak. BMJ 2022;377:o1314.  Back to cited text no. 5
    
6.
Mahase E. Seven monkeypox cases are confirmed in England. BMJ 2022;377:o1239.  Back to cited text no. 6
    
7.
Nakoune E, Olliaro P. Waking up to monkeypox. BMJ 2022;377:o1321.  Back to cited text no. 7
    
8.
Mahase E. Monkeypox: What do we know about the outbreaks in Europe and North America? BMJ 2022;377:o1274.  Back to cited text no. 8
    
9.
Kozlov M. Monkeypox goes global: Why scientists are on alert. Nature 2022;606:15-6.  Back to cited text no. 9
    
10.
Cohen J. Monkeypox outbreak questions intensify as cases soar. Science 2022;376:902-3.  Back to cited text no. 10
    
11.
World Health Organization. Monkeypox – Q&A; 2022. Available from: https://www.who.int/news-room/questions-and-answers/item/monkeypox. [Last accessed on 2022 Jun 06].  Back to cited text no. 11
    




 

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Abstract
Introduction
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Vulnerability of...
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