I- Current status:
The spread of viruses around the world today is influenced by a combination of biological, social and environmental factors.
A thorough understanding of these elements is essential to develop effective prevention and control strategies. After the coronavirus, we are now facing another virus called monkeypox.
It is a disease initially present in animals, particularly rodents in Africa, and which is now circulating in humans; we are therefore talking about an emerging zoonosis, the Center for Disease Control and Prevention, Africa CDC, has declared this disease a public health emergency of continental security.
It presents as a milder form of human smallpox, with less severe symptoms and lower lethality.
When was this virus first isolated to allow researchers to study its mutations:
The Mpox virus was first isolated in 1958 in Denmark, in a colony of monkeys. These monkeys had skin lesions reminiscent of human smallpox. Hence the name monkeypox, attributed to this disease.
Please note that this disease is not transmitted to humans via monkeys, but from rodents, which we will describe in the transmission section.
What are the types of Mpox virus? There are two main types: Clade 1, present in the Congo Basin in Central Africa and Clade 2 present in West Africa.
II – Symptomatology: Transmission occurs either through direct contact with infected animals, through contact with skin lesions or biological fluids, or indirectly through contaminated materials (such as bedding or surfaces). It could also possibly occur through respiratory droplets from an infected person.
III – Epidemiology: This year, 18,737 cases of Mpox and several deaths have been reported in at least 12 African countries according to Africa CDC (as of 08/16/2024).
-DRC: 15,664 potential cases, 548 deaths
-Burundi: 65 suspected cases, 103 confirmed cases
-South Africa: 24 confirmed cases including 3 deaths
-Cameroon: 23 suspected cases, 5 confirmed cases including 2 deaths
-Republic of Congo: 150 suspected cases, 19 confirmed cases including 1 death
-Central African Republic: 223 suspected cases, 45 confirmed cases, 1 death
-Nigeria: 749 suspected cases, 39 confirmed cases
-Liberia: 5 confirmed cases
-Rwanda: 4 confirmed cases
-Ivory Coast: 2 confirmed cases
-Uganda: 2 confirmed cases
-Kenya: 1 confirmed case
IV- Treatment: treatment of simple cases (symptomatic treatment):
- Fever:
- PARACETAMOL: 60 mg/kg/day in 3 or 4 doses, PO for 2 days, continue if fever persists.
- The pain:
- Mild: PARACETAMOL: 60 mg/kg/day in 3 or 4 doses, PO for 2 days, continue if pain persists
- Moderate: TRAMADOL: moderate to severe pain 2 mg/kg in 4 doses
- Skin lesions (basic): macules, papules and vesicles
• Wash with water and antiseptic soap. - Itching:
• Antihistamine: LORATADINE: 10 mg orally once daily.
V- Prevention: Vaccines developed to immunize against smallpox are also 80% effective against MPOX, which could help to overcome the epidemic fairly quickly. Beyond that, we can act to:
- Prevent superinfections: Place the patient under the impregnated mosquito net, which will be cleaned every 3 days; and give ERYTHROMYCIN IV/IM: 30-40 mg/kg/day in 2 doses for 5 days.
-Eye damage: RETINOL PO on D1 and D2
-Prevention of dehydration: Make the patient drink regularly.
– Prevention of malnutrition: Promote breastfeeding, feed the child on demand, split meals every 2-3 hours. Increase intake to promote catch-up growth as soon as appetite returns, foods that are easy to eat and digest, rich in calories and nutrients.
VI- Recommendations: They aim to strengthen local capacities and address the unique challenges of poor countries to better control and prevent viral epidemics.
- Strengthening health infrastructure: Improving health infrastructure, such as hospitals, clinics and laboratories, is crucial.
-Training staff: Training local health workers and educating communities on preventive measures is essential.
-Access to vaccines: Ensuring equitable access to vaccines through the transfer of skills is vital.
-Strengthening surveillance systems: Setting up effective surveillance systems to rapidly detect epidemics and monitor their development enables a rapid and targeted response.
-Improving living conditions: Addressing the social determinants of health, such as access to clean water, sanitation and housing conditions, reduces the risks of spreading infections.
-Prevention and treatment programs: Establishing prevention programs specific to endemic viral diseases and ensuring access to necessary treatments is crucial to controlling epidemics.
-Policies and governance: Strengthen public health policies and improve governance for more effective management of health crises.
VII- Conclusion: The fight against this viral disease is a complex challenge that requires a multidimensional approach. Our country, Guinea, being a border with some countries already affected by this virus (Liberia and Ivory Coast), must maintain continuous vigilance in collaboration with all stakeholders in the health system to ensure effective and appropriate preventive control.
Par M. Karamo Kaba
State Doctor of Pharmacy, Retrovirologist, Specialist in Hospital and Health Services Management, Writer-Author, Health-Media Consultant. Contact: 628 49 78 95
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