Be aware of the transmission of monkeypox infection in pregnancy

Monkeypox virus (MPXV) was discovered in a monkey colony in 1958 and the first case of monkeypox infects humans in 1970 in the Republic of the Congo. Monkeypox virus belongs to the family poxviridae, genus orthopoxvirus.

Until now, sporadic cases of monkeypox have occurred in 10 countries in Africa. Monkeypox is a rare disease that can heal itself. Transmission of monkeypox through direct contact with the virus from animals, humans or objects contaminated with the virus.

Viruses enter the body through :

• Respiratory tract.
• Contact with blood.
• Skin lesions.
• Mucous membrane.
• Eating the meat of animals infected with the virus.

Monkeypox virus reservoirs other than monkeys, including :

• Rat.
• Squirrel.
• Other types of rodents.

Animal-to-human transmission occurs through :

• Bites or scratches.
• Consumption of African wild animal meat. Direct or indirect contact with body fluids or lesions.

Human-to-human transmission occurs via :

• Respiratory droplets.
• Direct or indirect contact with body fluids.
• Contaminated objects.
• Vertical transmission from mother to fetus.

Clinical symptoms.

• The symptoms of monkeypox are almost the same as those of smallpox (variola), but the symptoms are milder.
• The incubation period is between 5-21 days.

Invasion Period 0-5 days :

• Fever.
• Headache.
• Myalgia.
• Back pain.
• Enlarged lymph nodes.
• Asthenia.
• Lymphadenopathy (this is what distinguishes the symptoms of smallpox).

Eruption period (1-3 days after the first day of fever) :

• Rashes of varying degrees (maculopapular, vesicles, pustules and crusts).
• It appears on the face and then spreads to other parts of the body.
• Rash on face, palms and feet.
• The pus-filled lesion then hardens.

Generally, this disease will heal by itself in 2-4 weeks.

Diagnosis.

Diagnosis can be seen from the clinical symptoms and required laboratory tests. Examination of specimens from swabs of skin lesions which are then stored dry in refrigerated sterile tubes.

Complications.

• Pneumonia.
• Breath failure.
• Eye infection.
• Keratitis.
• Corneal ulceration.
• Blindness.
• Sepsis.
• Encephalitis.

Monkeypox infection in pregnancy.

In 2017, 4 cases of monkeypox were found in pregnant women. Pregnancy resulted in miscarriage in the first trimester, fetal death and in living infants there were monkeypox lesions. People with a high risk of contracting monkeypox should be given smallpox immunization regardless of their pregnancy status.

Treatment.

Until now there is still no specific treatment for monkeypox. Treatment is only done according to symptoms. In critical cases of monkeypox, the antiviral cidovfovir was given.

Prevention.

• Live clean and healthy. Always wash your hands with soap.
• Consumption of cooked meat.
• Avoid contact with wild animals and eat wild animal meat.
• Avoid contact with infected animals and people.
• Avoid contact with objects that have been touched by an infected animal or person. 
• Use personal protective equipment when in contact with patients.
• Quarantine infected patients.
• Until now there is no monkeypox vaccine, but the smallpox vaccine is up to 85% effective in preventing monkeypox.
• Vaccinia immune globulin (VIG) is only given if there is a complication of the smallpox vaccine (progressive vaccinia).