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On July 29, the Ministry of Health just released the “Guidelines for Diagnosis, Treatment and Prevention of Human Monkeypox”. Therefore, monkeypox is an acute infectious disease caused by monkeypox virus that can spread epidemically.
The disease originated in Africa and is spread from animals to humans through contact with skin lesions, body fluids, sexual contact, respiratory droplets, and infected human objects, and is spread from person to person and from mother to child.
The main symptoms are fever, vesicular rash and swollen lymph nodes. It can cause serious complications and lead to death.
Stages of Monkey Season Disease
Incubation period: 6-13 days (ranging from 5-21 days): At this time, the infected person has no symptoms and is not contagious.
Stage of disease: 1 – 5 days, the main symptoms are fever and swollen lymph nodes all over the body. Patients may experience headache, fatigue, chills, sore throat and muscle pain. At this stage, the virus can be spread to other people.
Fully mature stage:
A rash may appear on the skin 1-3 days after the onset of fever, with the following characteristics:
– Location: The rash is centrifugal and is most common on the face, palms, and soles of the feet. It may also occur in the mouth, eyes, and genitals.
– The rash progresses: from macules (lesions with a flat base) to papules (firm, slightly raised lesions). Then it becomes blisters (lesions filled with clear fluid), pustules (lesions filled with yellow fluid), dry crusts, peeling, and may even leave scars.
– The average size of the lesions is 0.5 – 1 cm.
– Human skin lesions can range from a few spots to densely packed masses. In severe cases, the lesions may coalesce into large patches on the skin.
Recovery phase: Symptoms of the disease last for 2 to 4 weeks and then disappear on their own. The patient has no clinical symptoms, but scars are left on the skin that affect appearance. Once cured, there is no longer a risk of infecting others.
Monkeypox variants
Asymptomatic: People infected with monkeypox virus do not have any clinical symptoms.
Mild: Symptoms usually disappear after 2 to 4 weeks and do not require any special treatment.
Severe type: often occurs in high-risk groups (pregnant women, the elderly, children, people with underlying diseases, immunocompromised people…). People infected with this virus are usually at risk of death from the second week of illness.
Patients may develop a skin infection with symptoms including prolonged fever and cloudy fluid from the blisters or ruptured blisters that leak cloudy fluid.
At this stage, some people may develop pneumonia (cough, chest tightness, difficulty breathing), encephalitis (decreased consciousness, convulsions, confusion, coma), and sepsis (prolonged fever, brain damage).
Symptoms confirming monkeypox cases
1. The case has one or more of the following epidemiological factors:
– Contact with a confirmed or suspected case through direct physical contact with the skin or skin lesions (including sexual contact) or contact with contaminated objects such as clothing, bedding and personal belongings of a sick person within 21 days before symptom onset.
– People who have travelled to monkeypox-endemic countries within 21 days before the onset of symptoms.
Secondly, the clinical manifestations were suspicious for monkeypox.
The molecular biological test results of monkeypox virus in these cases were positive. When symptoms such as fever, rash, and swollen lymph nodes occur, monkeypox needs to be differentiated from smallpox, chickenpox, disseminated herpes, and hand, foot and mouth disease.
Monkeypox treatment regulations
The Ministry of Health has made it clear that monitoring and isolating suspected/confirmed cases;
– Mainly symptomatic treatment;
– Need to ensure nutrition, electrolyte balance and psychological support;
– Use specific therapeutic drugs in severe cases and special circumstances (newborns, elderly, immunocompromised people, etc.) as recommended by the World Health Organization and other Vietnamese health authorities.
– Monitor, detect and promptly treat serious conditions and complications of the disease.
For mild cases, the following symptoms are mainly treated:
– Use fever reducers and pain relievers.
– Take care of damaged skin, eyes, mouth.
– Ensure nutritional and electrolyte balance.
– It is necessary to monitor and detect complications (if any) early: pneumonia, skin infection, sepsis, encephalitis… Treated in the isolation room of the rehabilitation department.
——Prevent and control infection in accordance with regulations.
For severe cases:
– Requires admission to an isolation room in the resuscitation department and treatment of complications, if any, according to approved protocols
– Specific therapeutic drugs are needed in the following cases:
+ People with severe complications (sepsis, pneumonia, encephalitis…).
+ People with immunodeficiency (HIV, cancer, being treated with immunosuppressive drugs or high-dose corticosteroids…).
+ Children, especially those under 8 years old.
+ Pregnant or breastfeeding women.
+ People with progressive acute illness.
– Use treatment drugs according to the recommendations of the World Health Organization
The Ministry of Health also divides treatment levels according to the type of disease:
Township, district and zone health institutions admit asymptomatic infections and mild cases with common symptoms.
The provincial and central levels will receive severe cases or those at risk of worsening condition (newborns, immunocompromised people, the elderly, those with underlying diseases, pregnant women) as well as cases with serious complications.
Monitor for danger signs of disease and consider referral for treatment:
– Decreased vision.
– Decreased consciousness, coma, convulsions.
– respiratory failure.
– Bleeding, decreased urine output.
– Signs of sepsis and septic shock.
About discharge criteria:
– The patient was isolated for at least 14 days and fully recovered.
– The patient is clinically asymptomatic (no new lesions have appeared for at least 48 hours and old lesions have crusted over).
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