July 25, 2024
Monkeypox Treatment

Monkeypox Treatment: Understanding the Options

Monkeypox has recently emerged as a global health concern, with cases being reported in countries where it is not normally found. While the overall risk to the general public still remains low, it is important to understand the treatment options available for monkeypox.

Symptoms and Stages of Infection

Monkeypox commonly presents with flu-like symptoms like fever, headache, muscle aches, and swollen lymph nodes. Within 1-3 days of the onset of fever, a rash usually develops which starts from the face and spreads to other parts of the body. The rash starts as flat or raised spots which fill up with fluid before forming scabs. It is usually most concentrated on the face, palms of the hands, and soles of the feet.

The illness is generally divided into 2 periods – the invasion period with acute symptoms like fever and the rash period which lasts around 2-4 weeks. The rash is usually most abundant during the first week and starts resolving within 2-3 weeks.

Supportive Treatment for Monkeypox

For most cases of monkeypox treatment, supportive care is usually sufficient for recovery. This involves staying hydrated, taking pain and fever medications like paracetamol to relieve symptoms, and applying calamine lotion or anti-itch creams to soothe the rash. It is also important to rest and avoid scratching the lesions to prevent bacterial infections of the skin. Isolating oneself from others until all scabs have fallen off is advised to curb further spread.

Antivirals for Monkeypox Treatment

Beyond supportive care, antiviral medications may be prescribed in some cases, especially for those with severe symptoms or at high risk for complications. Tecovirimat, an oral drug approved recently, directly targets Monkeypox virus. It inhibits the spread of the virus in the body. Studies show it can reduce the duration of illness if given early in the disease course.

Another antiviral called Cidofovir can also be used intravenously but has more side effects including potential kidney damage. It works by interfering with the virus DNA replication inside infected cells. For both these antivirals, the treatment duration is around 2-3 weeks.

Vaccination After Exposure

Post-exposure vaccination with the smallpox vaccine, also effective against monkeypox, within 4 days of contact with a confirmed case may help prevent onset of the disease or reduce symptoms severity. This is recommended for high-risk contacts. The older generation smallpox vaccine, called Dryvax, involves multiple scarifications of the skin using a needle dipped in vaccine solution. The newer non-replicating smallpox vaccine called Jynneos is administered subcutaneously in two doses.

Specific Treatment for Infections

Scratching the rash can potentially allow bacterial entry and cause secondary skin infections. Monitoring for any signs of pus, increased swelling or redness is necessary. These secondary infections are treated with oral antibiotics like doxycycline or topical ones based on the culture and sensitivity report. Intravenous antibiotics may be started for severe cases with systemic symptoms or immunocompromised individuals.

Managing Complications

Rare complications from monkeypox include encephalitis, eye infections, and pneumonia if the virus disseminates. Pregnant women and young children are also at higher risk. Encephalitis may require antiviral therapy and hospitalization. Eye infections generally improves with topical antibiotic eye drops. Pneumonia associated with monkeypox warrants additional testing to rule out coinfection and monitoring symptoms along with supportive care. Overall recovery is the norm with timely treatment.

Prevention is Key

Currently there are no approved treatments specifically for monkeypox. Supportive care remains the mainstay along with antivirals and vaccination post-exposure in some circumstances. Preventing transmission by isolation especially during the active rash phase and practicing good hand hygiene is of utmost importance given the self-limiting nature of the infection. With prompt identification of cases and contact tracing, outbreaks can be curtailed. Further research is ongoing to develop newer antivirals and vaccines against monkeypox.

*Note:

  1. Source: Coherent Market Insights, Public sources, Desk research
  2. We have leveraged AI tools to mine information and compile it