Name : Gusti Izzarul Hasanah

SRN : P07120121020
Class : Keperawatan 2B
Lecturer : Hj. Evi RisaMariana

WHO DECLARED “MONKEYPOX VIRUS” AS AN INTERNATIONAL CONCERN

In the midst of the declining number of COVID-19 sufferers worldwide and in the hope
that this pandemic will pass soon, WHO has again received reports of cases of monkeypox
disease (monkeypox) from non-endemic countries. Monkeypox is now reported to have spread to
12 vulnerable countries in WHO's three regions (Europe, Americas, and Western Pacific).
Currently, the majority of reported cases occur in the WHO European Region. The WHO
Regional Office for Europe remains committed to working with countries and communities to
combat the outbreak with the urgency needed. Not surprisingly, this has made health
policymakers around the world cautious and the general public has started asking questions
about the disease. What exactly is monkeypox? Or what does international monkeypox mean?

Definitions
Monkeypox is a viral zoonotic disease (a virus that can be transmitted from animals to
humans) that resembles the symptoms previously seen in smallpox patients but is clinically less
severe. The name monkeypox comes from the fact that the virus was first discovered in monkeys
in a Danish laboratory in 1958.
The first human case was diagnosed in 1970 in Zaire (now the Democratic Republic of
the Congo, the Democratic Republic of the Congo) in a 9-month-old boy). Outside of Africa, the
first reported case of monkeypox was in 2003, and at the time of this systematic review, the most
recent case was in 2019. Prior to April 2022, few human infections with the monkeypox virus
were reported outside of endemic African regions. There are now cases all over the world.
Transmission, risk factors, clinical manifestations, and sequelae of infection are poorly defined.
Then, on July 23rd, 2022, the WHO Director-General declared the escalating global monkeypox
outbreak a Public Health Emergency of International Concern (PHEIC).
 By definition, a PHEIC means that an outbreak is serious, sudden, unusual, or
unexpected; it’s a public health risk beyond the affected countries’ borders, and it may require an
urgent international response.

The Symptoms of Monkeypox

Monkeypox cases in Indonesia have not been found. However, it never hurts to remain
vigilant to avoid contagion and spread. Monkeypox can cause a variety of signs and symptoms.
Some people have mild symptoms, while others become more severe and require treatment at a
health facility. People at high risk for serious illness and complications include pregnant women,
children, and those with compromised immune systems.
The incubation period (interval from infection to onset of symptoms) of monkeypox is
usually from 6 to 13 days but can range from 5 to 21 days. The infection can be divided into two
periods
 The invasion period (which lasts between 0–5 days) is characterized by fever, intense
headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle
aches), and intense asthenia (lack of energy). Lymphadenopathy is a distinctive feature of
monkeypox compared to other diseases that may initially appear similar (chickenpox,
measles, smallpox)
 The skin eruption usually begins within 1–3 days of the appearance of fever. The rash
tends to be more concentrated on the face and extremities rather than on the trunk. It
affects the face (in 95% of cases), and palms of the hands, and soles of the feet (in 75%
of cases). Also affected are oral mucous membranes (in 70% of cases), genitalia (30%),
conjunctivae (20%), as well as the cornea. The rash evolves sequentially from macules
(lesions with a flat base) to papules (slightly raised firm lesions), vesicles (lesions filled
with clear fluid), pustules (lesions filled with yellowish fluid), and crusts that dry up and
fall off. The number of lesions varies from a few to several thousand. In severe cases,
lesions can coalesce until large sections of skin slough off.

The most common symptoms of monkeypox are fever, headache, muscle weakness Pain,
back pain, lack of energy, and swollen lymph nodes. This is followed by the development of a
rash that can last for 2-3 weeks.
 The rash can be found on the face, palms, soles, eyes, mouth, throat, groin, genitals,
and/or anal area of the body. The number of lesions can range from one to thousands. Lesions
begin flat, then crust and fill with fluid before drying and flaking off, forming a layer of fresh
skin underneath. Resolve spontaneously or with supportive care such as B. Medicines for pain
and fever.
A person remains contagious until all lesions have crusted and the crust falls off, forming
a new layer of skin underneath. Anyone with possible monkeypox symptoms or who has been in
contact with a monkeypox patient should call a healthcare provider or seek medical attention.

Spread Person to Person

Monkeypox is spread from person to person through close contact with a person with
monkeypox rash, including direct skin-to-skin, mouth-to-mouth, or mouth-to-skin contact,
including sexual contact. It is not yet known how long a monkeypox patient remains contagious,
but generally, it is contagious until all lesions have crusted, the crust falls off, and a new layer of
skin forms underneath.
The monkeypox virus can contaminate the environment when an infected person touches
clothing, bedding, towels, objects, electronic devices, and surfaces. Another person who touches
these objects can become infected. People can also become infected by breathing in skin flakes
or the virus from clothing, bed linen, or towels. This is known as fomite transfer.
Mouth ulcers, lesions, or ulcers can become infected. That is, the virus can be spread by
direct contact with the mouth, respiratory droplets, and possibly short-range aerosols. The
possible mechanisms of airborne transmission of monkeypox are not yet well understood and
studies are underway to learn more. , or can be passed from monkeypox parents to infants or
children through close contact.
Asymptomatic infections have been reported, but it is not clear whether asymptomatic
individuals spread the disease or rough other bodily fluids. Monkeypox virus DNA has been
found in semen, but it is not yet known whether infection can be spread through semen, vaginal
fluid, amniotic fluid, breast milk, or blood. Studies are underway to further examine whether
humans can spread monkeypox by sharing these fluids during and after.
Diagnosis
Clinical differential diagnoses to consider include chickenpox, measles, bacterial skin
infections, scabies, syphilis, and other rash diseases such as drug allergy. Lymphadenopathy in
the prodromal stage of the disease can be a clinical feature to distinguish monkeypox from
chickenpox or smallpox.
If monkeypox is suspected, health care workers must collect an appropriate sample and
transport it safely to an appropriately skilled laboratory. Confirmation of monkeypox depends on
the type and quality of the specimen and the type of laboratory test. Therefore, samples must be
packed and shipped according to national and international requirements. Polymerase chain
reaction (PCR) is the preferred clinical test due to its accuracy and sensitivity. The best
diagnostic samples for monkeypox are skin lesions - roofs or fluid from vesicles and pustules,
and dry crusts. A biopsy is an option if possible. Lesion specimens should be stored in
dry, sterile tubes (without viral transport medium) and kept refrigerated. Due to the short
duration of viremia compared to the time of sampling after the onset of symptoms, PCR blood
tests are usually inconclusive and should not be routinely drawn from patients. Due to the
serological cross-reactivity of orthopoxvirus, antigen and antibody detection methods do not
provide monkeypox-specific confirmation.
Therefore, serology and antigen detection methods are not recommended for diagnosis or
case investigation when resources are limited. In addition, recent or remote vaccination with a
vaccinia-based vaccine (e.g., those who were vaccinated before smallpox was eradicated, or
those who were recently vaccinated for high risks, such as orthopoxvirus researchers). people)
can give false-positive results.
In order to interpret test results, it is important to provide the following patient
information with the specimen: a) date of fever onset, b) date of rash onset, c) date of specimen
collection, and d) current condition. (stage of rash) and e) age of the individual.
Protect Yourself From Monkeypox
Let’s protect ourselves from this virus by avoiding close contact with someone who has
symptoms:
 Avoid skin-to-skin, face-to-face, and mouth-to-skin contact, including sexual contact.
 Clean hands, objects, surfaces, bedding, towels, and clothes regularly.
 Wear a mask if you can’t avoid close contact and when handling bedding, towels, and
clothes.
 Ask people if they have symptoms before you have close contact.
 Keep yourself informed about monkeypox in your area and have open conversations with
those you come into close contact (especially sexual contact) with about any symptoms
you or they may have.

If you think you might have monkeypox, you can act to protect others by seeking medical
advice and isolating yourself from others until have been evaluated and tested. If you have
probable or confirmed monkeypox, you should isolate yourself from others until all of your
lesions have crusted over, the scabs have fallen off and a new layer of skin has formed
underneath. This will stop you from passing on the virus to others.
Get advice from your health worker on whether you should isolate yourself at home or in
a health facility. Until more is understood about transmission through sexual fluids, use condoms
as a precaution whilst having sexual contact for 12 weeks after you have recovered.

References
Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, et al. (2022) The changing
epidemiology of human monkeypox—A potential threat? A systematic review. PLoS Negl
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