Fever and headache must be considered a warning sign
Usually, the symptoms of monkeypox are similar to those of viral fever, such as high-grade fever, headache, body ache, and profound weakness. The infection period starts 1 to 2 days before the rashes begin to surface. Once the rashes appear, the infectivity starts, and scabbing takes another 2 days. When skin lesions occur, the patient remains infectious at least until the scabs fall off.According to Dr. Neha Patel Nakshiwala, Consultant Infectious Disease, Bhailal Amin General Hospital, “Mpox, previously known as Monkeypox, begins with a prodromal phase that resembles common viral illnesses. Symptoms in this phase include fever, body aches, fatigue, headache, and sometimes a sore throat. One notable feature is lymphadenopathy, which may manifest in areas such as the cervical, axillary, or inguinal regions. This phase typically lasts for 1 to 4 days.”
The most prominent symptom of Mpox is the development of a rash, which often starts on the face, hands, and legs, spreading inwards. The rash can also appear on mucous membranes such as the tongue and even on private parts. It is important to note that this rash can be extremely painful and may last for an extended period, typically 2 to 4 weeks, making it a key distinguishing feature from other viral rashes, which tend to resolve more quickly.
According to Dr. Shailaja Mane, Head of Department of Paediatric, DPU Super Speciality Hospital Pimpri, Pune, “In monkeypox, what is more prominent is the appearance of lesions that typically start on the face. Patients may have fever with chills, profuse sweating, muscle pain, sore throat, mild cough, and within 2 to 3 days after the fever, the skin lesions or rash begin. These are more painful and may start itching as well. The first lesions may appear on the tongue or mouth and slowly spread. In almost 98% of cases, the face is involved, and then the rash spreads to the palms, soles, oral cavity, mucosa, and genitalia. Sometimes the conjunctiva, or eyes, may also get involved, which is an important feature of monkeypox.”
The rash progresses from an erythematous stage (redness) to raised macules, then papules, and finally fluid-filled vesicles. After that, pustules (pus-filled lesions) form. The entire process may take up to one week. Children are more prone to this infection, as well as immunocompromised individuals, including those undergoing chemotherapy for cancer treatment, immunotherapy for certain diseases, or those with compromised immunity due to malnutrition or other infections. These groups are at a higher risk.
Transmission of Mpox
In terms of transmission, Mpox can spread from animals to humans and from human to human. During the early prodromal phase, when the rash has not yet appeared, it is challenging to identify and diagnose the disease. Once the rash emerges, it becomes easier to recognize. Transmission can occur through direct contact, fomites (e.g., furniture or bedclothes), and even sexual contact, particularly within high-risk populations.
Subtle signs of Mpox to watch for
Lymphadenopathy: The swelling of lymph nodes (in areas like the neck, underarms, and groin) can be an early indicator of Mpox, even before the rash appears. This is a subtle but significant sign that may help in early identification.
Persistent Rash: While viral rashes usually clear up within a few days, the Mpox rash is distinct for its prolonged duration, often lasting 2 to 4 weeks. This prolonged rash duration can serve as an important clue in distinguishing Mpox from other viral illnesses.
Precautionary measures
To minimize the risk of contracting Mpox, individuals should avoid crowded places and refrain from touching contaminated surfaces, especially in regions experiencing a surge in cases. It is important to be cautious about handling objects such as furniture and bed linens in areas with high Mpox prevalence.
Monkeypox infection: When to seek medical help
