In the past few weeks, the Indonesian health world has been shocked by the case of Monkeypox that occurred in Singapore. According to a press release from the Singapore Ministry of Health on May 9, 2019, there has been one confirmed case of Monkeypox in Singapore. The case is a Nigerian national who visited Singapore on April 28, 2019 and tested positive for the infection. Monkeypox virus (MPX) on May 8, 2019. The case and 23 contacts have been quarantined. In Indonesia alone, there have been no reported cases of Monkeypox However, the Ministry of Health of the Republic of Indonesia has issued a circular letter Number SR.03.04/II/1169/2019 regarding the vigilance of Disease Importation. Monkeypox.

Monkeypox is actually not a new disease. In 1970, a virus genus orthopoxvirus which was not recognized and later called monkeypox virus, was identified for the first time in humans. The first case was found in the Republic of Congo, when a young boy was found suffering from a disease similar to chickenpox (smallpox), which was later confirmed as an infection Monkeypox virus in humans by the WHO. Among the general public, there is a misconception about this disease. Most people refer to the disease as “monkey pox”. Monkeypox and monkey pox are actually different diseases. Monkey pox itself is known in medical terms as the impetigo bullosa which is caused by bacteria. In stark contrast to the disease Monkeypox which are actually caused by viruses despite their similar clinical manifestations.

The disease was initially restricted to the rainforests of West and Central Africa, until a case was reported in 2003 in the Americas. Monkeypox It mostly affects children less than 15 years old and is not affected by race or gender. The spread of the virus is initially zoonotic (animal-borne). Suspected carrier animals are rabbits, squirrels, monkeys and some other rodents.

Transmission is thought to be from direct contact with infected animals during mucosal contact, bites, scratches, blood contact, or processing of undercooked meat from carrier animals. Human-to-human transmission is thought to occur through respiratory secretions or mucosal contact. Risk factors for human-to-human transmission are thought to be due to densely populated environments, hygiene and a lowered immune system.

The incubation period is about 12 days (range 4-20 days). Clinical symptoms include fever accompanied by chills and sweating, severe headache, back and muscle pain, weakness, decreased appetite, swallowing pain, shortness of breath, and cough (with or without phlegm). Lymph node enlargement may occur within 2-3 days post-fever. Most patients will develop a reddish rash (eruption stage) within 1 - 10 days of fever. The rash usually starts on the face and spreads to the rest of the body. The rash then progresses to form vesicle (fluid-filled) blisters and pustules (pus-filled) which eventually form scabs, and undergo desquamation and scar formation. The size of the lesions varies between 3-15 mm. The lesions are more itchy than painful. Complications can include scarring, secondary infection by bacteria, pneumonia, respiratory failure, corneal inflammation, blindness, sepsis, and brain inflammation.

This disease is self-limitting disease (self-limiting without treatment). Resolution occurs within 2-4 weeks. Treatment of severe cases requires hospitalization with isolation. In mild cases, only bed rest dan suportif (simptomatik). Vaksinasi smallpox as prevention is recommended in cases of exposure that are less than 2 weeks after exposure (ideally within 4 days)

Mortality rates vary between 1-10%. High mortality rates have been reported in Africa and mostly in children. Death is usually associated with secondary infection. Uncomplicated cases will improve within 2-4 weeks but leave scars. Prevention of the disease can be done with clean and healthy living behaviors, namely washing hands with soap, avoiding contact with wild animals, rats, or primates, cooking animal meat thoroughly, and immediately reporting to health workers if you find or experience symptoms of the disease. Monkeypox.

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