Dream - A year ago, the monkeypox virus (Mpox) was only present in Africa. But now, after more than a year, the virus has arrived in Jakarta. The virus has infected dozens of patients. They are all in Jakarta. The World Health Organization (WHO) paid attention to this disease last year. WHO declared a global health emergency status for the monkeypox outbreak in July 2022. At that time, a total of 87,000 cases and 140 deaths were recorded in 111 countries related to monkeypox transmission.

However, the number of cases continues to decline. So on May 11, 2023, the Director-General of WHO, Tedros Adhanom Ghebreyesus, in Geneva, Switzerland, announced the lifting of the monkeypox emergency status. However, this does not mean that the job is done. Monkeypox continues to pose health challenges to the public. Monkeypox, or monkeypox (Mpox), is a zoonotic virus or a virus transmitted to humans from animals with symptoms similar to those seen in past smallpox patients. This virus can cause death. Recently, the virus has spread from human to human.

Monkeypox in humans was first identified in humans in 1970 in the Democratic Republic of Congo in a 9-year-old boy. Since then, most cases have been reported from rural areas, in rainforest regions of the Congo Basin, particularly in the Democratic Republic of Congo, and human cases are increasingly being reported from across Central and West Africa. Since 1970, monkeypox cases have been reported in humans in 11 African countries: Benin, Cameroon, Central African Republic, Democratic Republic of Congo, Gabon, Ivory Coast, Liberia, Nigeria, Republic of Congo, Sierra Leone, and South Sudan.

The true origin of this monkeypox is unknown. For example, in 1996-1997, an outbreak was reported in the Democratic Republic of Congo with a lower case fatality rate and higher attack rate than usual. Since 2017, Nigeria has experienced a large outbreak, with over 500 suspected cases and over 200 confirmed cases and a case fatality rate of about 3%. Cases have continued to be reported from then until today.

Monkeypox is a disease that is important to global public health because it not only affects countries in West and Central Africa, but now also worldwide. In 2003, the first monkeypox outbreak outside of Africa occurred in the United States and was associated with contact with infected pet prairie dogs. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country from Ghana. This outbreak resulted in over 70 cases of monkeypox in the US.

Monkeypox has also been reported in travelers from Nigeria to Israel in September 2018, to England in September 2018, December 2019, May 2021, and May 2022, to Singapore in May 2019, and to the United States in July and November 2021. In May 2022, many cases of monkeypox have been identified in several non-endemic countries. The World Health Organization or WHO has also declared monkeypox as a public health emergency of international concern. Current studies are being conducted to better understand the epidemiology, sources of infection, and transmission patterns.

Here's what you need to know about monkeypox: Monkeypox Virus Monkeypox virus is an enveloped double-stranded DNA virus that belongs to the Orthopoxvirus genus of the Poxviridae family. There are two distinct genetic clades of monkeypox virus: the Central African (Congo Basin) clade and the West African clade. The Congo Basin clade historically causes more severe disease and is considered more contagious. The geographical divide between the two clades has so far been found in Cameroon, the only country where both clades of the virus have been discovered.

Inang alami virus cacar monyetBerbagai spesies hewan telah diidentifikasi rentan terhadap virus cacar monyet. Ini termasuk tupai tali, tupai pohon, tikus berkantung Gambia, dormice, primata dan spesies lainnya. Masih ada ketidakpastian tentang sejarah alami virus cacar monyet dan penelitian lebih lanjut diperlukan untuk mengidentifikasi reservoir atau inang yang tepat dan bagaimana sirkulasi virus ini bertahan di alam. Translation: The natural host of monkeypox virusVarious animal species have been identified as susceptible to monkeypox virus. These include flying squirrels, tree squirrels, Gambian pouched rats, dormice, primates, and other species. There is still uncertainty about the natural history of monkeypox virus, and further research is needed to identify the exact reservoir or host and how the circulation of this virus persists in nature.

How does monkeypox spread from person to person? Monkeypox spreads from person to person through close contact with someone who has monkeypox rash, including through face-to-face contact, skin-to-skin contact, mouth-to-mouth or mouth-to-skin contact, including sexual contact. WHO is still studying how long people with monkeypox are contagious, but generally they are considered contagious until all their lesions have crusted, scabs have fallen off, and a new layer of skin has formed underneath.

The environment can be contaminated with monkeypox virus, for example when an infected person touches clothes, bedding, towels, objects, electronics, and surfaces. Other people who touch these items can then become infected. It is also possible to become infected by inhaling skin flakes or virus from clothes, bedding, or towels. This is known as fomite transmission.

Boils, lesions, or wounds in the mouth can be contagious, meaning the virus can spread through direct contact with the mouth, respiratory droplets, and possibly through short-range aerosols. The possibility of airborne transmission mechanisms for monkeypox is not well understood, and research is being conducted to learn more. This virus can also spread from a pregnant person to the fetus, after birth through skin-to-skin contact, or from parents with monkeypox to a baby or child during close contact.

DNA fragments from the Mpox virus have been found in semen, but it is not yet known whether the infection can spread through semen, vaginal fluids, amniotic fluid, breast milk, or blood. Research is currently being conducted to further understand whether individuals can transmit monkeypox through the exchange of these fluids during and after symptomatic infection.

Who is at risk of getting monkeypox? Individuals who live with or have close contact (including sexual contact) with someone who is suffering from monkeypox, or who have regular contact with animals that can be infected, are at the highest risk. Health workers must follow infection prevention and control measures to protect themselves while caring for monkeypox patients.

Newborn babies, young children, and individuals with underlying immunodeficiencies may be at risk of experiencing more severe symptoms, and in rare cases, death due to monkeypox. People who have been vaccinated against smallpox may have some protection against monkeypox. However, younger individuals are unlikely to have been vaccinated against smallpox as smallpox vaccination was discontinued in most parts of the world after successful eradication in 1980. People who have been vaccinated against smallpox should continue to take preventive measures to protect themselves and others.

Signs and symptoms The incubation period or interval from infection to the onset of symptoms of monkeypox usually lasts from 6 to 13 days, but can also range from 5 to 21 days. Infection can be divided into two periods: - Invasion period (lasting between 0-5 days) characterized by fever, severe headache, lymphadenopathy (swollen lymph nodes), back pain, myalgia (muscle pain), and extreme fatigue. Lymphadenopathy is a characteristic feature of monkeypox compared to other diseases that may initially appear similar (chickenpox, measles, smallpox).

-Eruptions of skin rashes usually begin within 1-3 days after fever. The rash tends to be more concentrated on the face and extremities than on the body. It affects the face (in 95% of cases), and the palms and soles of the feet (in 75% of cases). Also affected are the mucous membranes of the mouth (in 70% of cases), genitals (30%), and conjunctiva (20%), as well as the cornea.

Rashes develop sequentially from macules (flat-based lesions) to papules (slightly raised hard lesions), vesicles (clear fluid-filled lesions), pustules (yellowish fluid-filled lesions), and crusts that dry up and fall off. The number of lesions varies from a few to several thousand. In severe cases, the lesions can merge and cause extensive peeling of the skin. Monkeypox is usually a self-limiting disease with symptoms lasting from 2 to 4 weeks. Severe cases are more common in children and are associated with the level of virus exposure, the patient's health status, and the nature of complications. Underlying immunodeficiency can lead to worse outcomes.

Although vaccination against smallpox in the past was protective, currently people aged between 40 and 50 years old (depending on the country) may be more susceptible to monkeypox due to the global cessation of smallpox vaccination campaigns after the successful eradication of the disease. The historical fatality rate of monkeypox cases ranges from 0 to 11% in the general population and is higher among children. Recently, the death rate has been around 3-6%.

The following is the translation of the given 'Bahasa' text to 'English' while preserving any html tags: "Clinical therapy for Mpox should be fully optimized to alleviate symptoms, manage complications, and prevent long-term residual symptoms. Patients should be offered fluids and food to maintain adequate nutritional status. Secondary bacterial infections should be treated as indicated. An antiviral agent known as tecovirimat, developed for smallpox, was licensed by the European Medicines Agency (EMA) for monkeypox in 2022 based on data from animal and human studies. It is not yet widely available."

If used for patient care, tecovirimat ideally should be monitored in the context of clinical research with prospective data collection. Vaccination Vaccination against smallpox, as shown through several observational studies, is approximately 85% effective in preventing monkeypox. Therefore, previous smallpox vaccination can cause a milder disease. Evidence of previous smallpox vaccination can usually be found as a scar on the upper arm. Currently, the original smallpox vaccine (first generation) is no longer available to the general public.

Some laboratory workers or healthcare workers may have received a newer smallpox vaccine to protect them if they are exposed to the virus at work. The newer vaccine is based on a modified weakened vaccinia virus strain (Ankara strain) and was approved for prevention of monkeypox in 2019. This is a two-dose vaccine and its availability is still limited. Smallpox and monkeypox vaccines are developed using formulations based on the vaccinia virus due to the cross-protection it provides for the immune response against orthopoxviruses.

Is a man who has sex with another man at higher risk of getting monkeypox? The risk of monkeypox is not limited to sexually active individuals or men who have sex with men. Anyone who has close contact with an infected person is at risk of symptoms. Many cases reported in this outbreak have been identified among men who have sex with men.

Given that the virus is currently transmitted from person to person through this social network, men who have sex with men may currently be at a higher risk of exposure if they have close contact with someone who is infected. Several cases of monkeypox have been identified in sexual health clinics. One reason why the WHO is currently hearing more reports of monkeypox cases in the community of men who have sex with men may be due to positive health-seeking behaviors within this population group.

The following 'Bahasa' text translated to 'English' while preserving any html tags is: "Rashes from monkeypox can resemble several sexually transmitted diseases, including herpes and syphilis, which partly explains why these cases are handled at sexual health clinics. As the WHO investigates further, they may identify more cases within the broader community. Involving the gay, bisexual, and other men who have sex with men communities is crucial to raise awareness and protect those at highest risk. If you are a man who has sex with men, know your risks and take steps to protect yourself and others."

Anyone who has symptoms of monkeypox should immediately seek advice from a healthcare provider to be tested and access treatment. In other words, monkeypox should not be underestimated. (eha)Source: WHO, CDC, UN News