Monkeypox Infection Specialist Doctor In Mumbai A number of monkeypox cases have been identified recently in European countries like Britain, Italy, Sweden, Portugal, France, Germany and Spain. Similar cases have also been recorded in Canada and United States. It is a viral zoonotic ( transmitted to humans from animals ) infection. The virus was first isolated in the late 1950s from a colony of sick monkeys. It was first identified as a cause of disease in humans in the 1970s in the Democratic Republic of the Congo. Most of the cases have since then occurred in the rain forests of Western and Central Africa among individuals exposed to small forest animals ( eg, rodents, squirrels, and monkeys ). The virus is typically acquired through contact with an infected animal’s bodily fluids, blood, skin or mucosal lesions or through a bite. It is also possible to catch the disease by eating meat from an infected animal that has not been cooked properly. The human to human transmission is thought to occur primarily through large respiratory droplets, direct contact with body fluids, lesions and contaminated materials. According to the US CDC ( Centers for Disease Control and Prevention ), many of the reported cases are occurring within sexual networks. The involvement of sexual mode of transmission has also been raised by the UK health agencies and is being investigated by the World Health Organization. The incubation period ( interval from infection to onset of symptoms ) is usually from 6 to 13 days. The predominant signs and symptoms are rash, fever, lymphadenopathy ( swelling of the lymph nodes ), intense headache, muscle aches and lack of energy. The fever generally precedes the rash by approximately one to three days. The rash is predominantly present on the face and extremities. Chickenpox and smallpox should be included in the differential diagnosis of monkeypox. The role of a specialist is paramount to correctly identify this disease at an early stage.The swelling of lymph nodes is a distinctive feature of monkeypox. The laboratory confirmation is necessary to differentiate this disease. Polymerase chain reaction ( PCR ) based laboratory tests are preferred. It is usually a self – limited disease with symptoms lasting from two to four weeks. Most patients have mild disease and recover without medical intervention. Severe cases occur more commonly among children and are also related to the extent of virus exposure, patient health status and the underlying immune status of the individual patient. An qualified specialist should be sought at the earliest for any suspicious case of monkeypox. For the seriously ill patients, supportive care is necessary until the patient recovers from the infection. The drug named tecovirimat was approved for use in the United States for treatment of smallpox and there is a likey possibility that it may be efficacious against monkeypox infections in humans. The prior smallpox vaccination has a significant protective effect against acquisition of monkeypox virus and may ameliorate the clinical manifestations of this infection. A modified vaccine with limited availability can be used for prevention of both smallpox and monkeypox. The same vaccine may be considered in consultation with public health authorities for certain patients after exposure to monkeypox. The optimal time for monkeypox postexposure vaccination is within four days; however vaccination can be considered for up to 14 days of a close contact. Both contact and airborne precautions should be initiated and close contacts should be isolated and monitored. During the first week of the rash, persons with suspected monkeypox should be considered infectious and be isolated until all scabs separate and results of PCR are negative.