THE monkey pox , in most cases, progresses without complications, with signs and symptoms that last from two to four weeks. In general, clinical manifestations include skin lesions in the form of blisters or sores that can appear on different parts of the body, such as the face, hands, feet, eyes, mouth or genitals.
However, the disease caused by monkeypox virus it can also cause neurological complications in rarer cases. This is what a study published in the scientific journal JAMA points out this Tuesday (20). As of September 4, 52,996 laboratory-confirmed cases and 18 deaths have been reported to the World Health Organization (WHO) in 102 countries.
According to the survey, few neurological complications monkeypox have been described to date, with headache (or headache) being a common manifestation of the infection. Mood disorders, including depression and anxiety, and chronic (neuropathic) pain are also common.
Skin lesions can cause painful sores and, depending on the site involved, can cause difficulty swallowing (dysphagia), rectal pain, and anal fissures. Conjunctivitis occurred in approximately 20% of patients in a recent outbreak in the Democratic Republic of Congo, which can lead to decreased vision. The problem can also be a potential site for a viral infection in the central nervous system.
According to the study, monkeypox rarely causes inflammation of the brain — or encephalitis. The name of the disease comes from the initial discovery of the virus in monkeys in a Danish laboratory in 1958. The first human case was identified in a child in the Democratic Republic of Congo in 1970. Since then, most cases have been reported in Central and Africa. West, until this year when outbreaks of the disease began to affect multiple countries.
An unvaccinated 3-year-old girl, during the monkeypox outbreak in Zaire, Africa, from 1980 to 1985, developed encephalitis, fell into a coma, and died two days after admission to hospital.
During a short outbreak in the Midwest of the United States in 2003, spread by a pet prairie dog, another 6-year-old girl presented with symptoms prior to the onset of the disease, including headache, fever and malaise, with skin rash two days later. However, seven days after the initial symptoms, she developed decreased responsiveness, stiffness, dilated pupils, optic swelling, and Babinski’s signs, which involve reflexes in her toes.
The patient underwent an MRI scan, which revealed impacts to the nervous system and swelling involving parts of the brain, such as the cortex, thalamus and brainstem. With supportive care, the patient improved and was discharged two weeks after admission, and after one month, she had no neurological deficits.
Studies in Nigeria found three cases of brain inflammation (encephalitis) with seizures in a group of 40 monkeypox cases, including two patients (a 28-day-old child and a 43-year-old man with HIV, who later died.
During the current outbreak, three cases of encephalitis were reported in two Spanish and one Indian patients, all men, who did not resist the infection and died. In the two Spanish patients, the DNA of the virus was detected in the cerebrospinal fluid – cerebrospinal fluid, from a molecular diagnostic test (RT PCR).
The researchers argue that many aspects of the disease still remain unknown, which highlights the need for in-depth studies into the possible impacts of the monkeypox virus on the brain.
“Based on the known neurological complications of orthopoxviruses, we must be prepared for the possibility of viral encephalitis, myelitis, acute disseminated encephalomyelitis (ADEM), Guillain-Barré syndrome, neuropathic pain, and others, and treat them accordingly. Special attention should be given to patients with immunocompromised conditions, such as HIV/AIDS, as it can facilitate viral neuroinvasion”, say the experts in the article.
Most common symptoms of the disease
In the most common documented form of monkeypox, symptoms may appear from the seventh day onwards with a sudden and intense fever. Signs such as headache, nausea, exhaustion, tiredness and especially the appearance of swollen glands are common, which can happen both in the neck and in the axillary region as well as in the genital part.
The manifestation on the skin occurs between one and three days after the initial symptoms. The signs go through different stages: macula (small spots), papule (small pimple-like sores), vesicle (small blisters), pustule (bubble with the presence of pus) and crust (which are healing scabs).
The Ministry of Health recommends avoiding close contact with people suspected or diagnosed with the disease, in addition to washing hands with soap and water or with alcohol gel before eating or touching the face as a preventive measure.
Faced with any suspicious symptoms, people should seek medical attention at Basic Health Units (UBSs) or Emergency Care Unit (UPA) for evaluation.
During the consultation, it is important to inform if there has been close contact with someone with suspected or confirmed disease. Based on these records collected during the consultation, the specialist will be able to order a diagnostic test.
Source: CNN Brasil
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