Monkeypox infection and community transmission have been documented since May 2022 in a number of non-endemic nations worldwide. Initially discovered to be spreading in Europe and North America, the monkeypox virus has now made its way to Asia:

• Singapore’s Ministry of Health said on June 21 that the first confirmed case of monkeypox infection was found in Singapore. The patient is a 42-year-old British man who is a flight attendant.
• On June 22, the Korean Agency for Disease Control reported that the Korean epidemic prevention department confirmed the first case of monkeypox infection on the same day, a Korean who entered South Korea from Germany was diagnosed with monkeypox virus.

The SARS-COV-2 virus, which first appeared in early 2020, differs from the monkeypox virus in terms of transmission and diagnosis. What are the signs of a monkeypox virus infection, how is it spread, and how is it diagnosed?

Droplets can transmit the virus!

The monkeypox virus enters the human body through mucous membranes and broken skin, per the WHO Q&A on the disease. Getting bitten or scratched by an infected animal is another common way for humans to become infected with animals that have the disease.

The major method of human-to-human transmission is close proximity, though it can also spread via droplets. Monkeypox virus infection can also result from direct contact with virus-contaminated objects or from vertical transmission through the placenta. Sexual transmission is a possibility.

Most patients have enlarged lymph nodes in their neck, armpits, and groin when they first present.

Monkeypox takes 5–21 days, usually 6–13 days, to incubate. Chills and fever are symptoms of the disease's early stages. After an infection, the body temperature is typically higher than 38.5 °C, and symptoms including headaches, drowsiness, lethargy, back pain, and myalgia may also be present. Most patients have enlarged lymph nodes in their neck, armpits, and groin when they first present.

After one to three days, a skin rash develops. Typically, the rash starts out on the face and moves down the body, eventually covering the extremities and other areas. More often than the trunk, the face and extremities developed rashes. The number of rashes ranged from dozens to thousands, and they might arise on the palms and soles of the feet, among other places like the oral mucosa, digestive tract, genitalia, conjunctiva, and cornea.

From macules, papules, herpes, pustules, and scabs, the rash progresses. Herpes and pustules typically have a spherical shape, a diameter of 0.5 to 1 cm, are hard to the touch, and may be accompanied by blatant itch and discomfort.

From the time of beginning to the time the scab sheds, it takes roughly 2-4 weeks. After the scab has peeled off, erythema, hyperpigmentation, or even scarring could be left behind; the scarring could endure for years. Some individuals may experience complications, such as sepsis, encephalitis, bronchopneumonia, secondary bacterial infection in the skin lesions, and ocular infection.

Children and others with impaired immune systems frequently experience severe instances.

However, the monkeypox virus can infect large populations. However, people who have previously received a smallpox vaccination have some degree of cross-protection against the monkeypox virus. And the majority of the time, monkeypox has a positive prognosis and a self-limiting course.

Young children and immunocompromised individuals frequently experience severe cases, and the prognosis depends on the viral branch of infection, the level of virus exposure, the patient's prior health, and the severity of sequelae. About 3% of cases in the West African branch and 10% of those in the Congo Basin branch are deadly, respectively.

Nasopharyngeal secretions and other samples can contain monkeypox virus.

The general examination and etiological testing are two laboratory testing procedures for the monkeypox virus.

General assessment

Both the level of platelets and the level of white blood cells are normal or high. Some patients may have hypoproteinemia, high transaminase levels, and low blood urea nitrogen levels.

Etiological investigation and a fast test for monkeypox antigen

1. Detection of nucleic acids
By using the polymerase chain reaction (PCR) method, the nucleic acid of the monkeypox virus can be found in specimens such as rash, blister fluid, crust, oropharyngeal, or nasopharyngeal secretions.

2. Virus culture
The aforementioned samples can be gathered for virus culture in order to isolate the monkeypox virus. A level 3 or above biosafety laboratory should be used for virus culture.

3. Rapid test for monkeypox viral antigen
The aforementioned samples contain monkeypox viral antigen, which can be identified in a manner similar to the nucleic acid detection approach. Although slightly less accurate than nucleic acid detection, monkeypox antigen fast test kits can be crucial in the identification of the virus, particularly in situations where access to PCR or level 3 laboratories is constrained. The SARS-COV-2 antigen quick test kits, which have been widely utilized in the community over the past two years, have a similar operating method to the monkeypox rapid test kits, making them simple to use and familiar to most people.