Rectal pain & penile swelling new symptoms of monkeypox, doctors suggest isolation for 3 weeks, Health News, ET HealthWorld

Rectal pain & penile swelling new symptoms of monkeypox, doctors suggest isolation for 3 weeks

The monkeypox outbreak has left several people worried around the world.

India has reported six monkeypox cases so far – four from Kerala and two from Delhi. The first death due to monkeypox was reported in Kerala on Saturday (July 30), who tested positive in UAE and arrived in India on July 22.

The cases in the national capital reported no recent history of foreign travel.

There have been more than 21,000 cases in nearly 80 countries since May, and 75 suspected deaths in Africa – mostly in Nigeria and Congo – where a more lethal form of monkeypox is spreading than in the West. Spain and Brazil have also reported deaths linked to monkeypox.

Last week, the World Health Organization declared it a global health emergency. The rare medical phenomenon caused by the monkeypox virus comes from the same family of viruses, namely the Variola virus which is also responsible for causing smallpox.

Recently, a new study, published by the British Medical Journal (BMJ), caught a lot of attention for its surprising findings. The research revealed that the new variant of monkeypox has shown never-seen-before symptoms such as rectal pain and penile swelling (oedema) in patients, which are different from those seen in the previous outbreak, according to the study.

To help with the checklist, Dr Subrata Das, Senior Consultant – Internal Medicine and Diabetology at Sakra World Hospital, shared some of the most common symptoms of monkeypox previously reported – acute headache, fever, skin rashes or lesions/blisters on the skin, macules (small non-elevated skin patches) to papules (elevated solid patches), exhaustion, chills and swelling of the lymph gland in the armpit, neck, and groin, muscle aches, backaches.

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Monkeypox can also present with malaise, lymphadenopathy, vesicle, pustules and scab formation. It can affect the face too, and cause palm soles and mucous membranes, which is similar to smallpox but with bigger lesions.

Dr Bindumathi PL, Senior Consultant, Internal Medicine at Aster CMI Hospital, said that the recent outbreak in the UK was mostly seen in people who were immunocompromised due to HIV infections. These patients presented with atypical features like only skin lesions with abscess and tonsillar abscess. There were no deaths reported, but pain and suffering in the genital and peri genital area due to skin lesions were more.

“Patients can visit various specialities like an infectious disease, surgeon, sexual disease clinic, and ENT doctors to receive the appropriate disease management they need,” she advised.

The study included 197 men with confirmed monkeypox cases at an infectious disease centre in London between May and July 2022. Of the total, 196 identified as gay, bisexual, or other men who have sex with men.

Overall, 20 (10 per cent) of the participants were admitted to the hospital for the management of new-found symptoms. The researchers recommend that clinicians consider monkeypox infection in patients presenting with these symptoms.

All patients presented with lesions on their skin or mucosal membranes, most commonly on the genitals or in the perianal area. Most (86 per cent) of patients reported systemic illness (affecting the entire body). The most common systemic symptoms were fever (62 per cent), swollen lymph nodes (58 per cent), and muscle aches and pain (32 per cent).

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And in contrast with existing case reports suggesting that systemic symptoms precede skin lesions, 38 per cent of patients developed systemic symptoms after the onset of mucocutaneous lesions, while 14 per cent presented with lesions without systemic features. A total of 71 patients reported rectal pain, 33 sore throats, and 31 penile oedema, while 27 had oral lesions, 22 had a solitary lesion, and 9 had swollen tonsils.

The researchers also noted that solitary lesions and swollen tonsils were not previously known to be typical features of monkeypox infection, and could be mistaken for other conditions.

Just over a third (36 per cent) of participants also had HIV infection and 32 per cent of those screened for sexually transmitted infections had a sexually transmitted infection. However, no deaths were reported and no patients required intensive hospital care.

Monkeypox can be transmitted through three routes – sexually, skin-to-skin contact and droplet infection.

People with recent travel history to any of the infected countries or contact with travellers from those countries upon developing a fever, myalgia, throat pain or skin lesions should be isolated and evaluated with proper physician care, said Dr Bindumathi. “Threat lies in its potential to become a pandemic due to increase in travel to various countries. Hence, awareness of the disease becomes crucial,” she added.

Dr Das said that patients suffering from monkeypox should be isolated for three weeks as a new person coming in contact with the infected individual can develop the symptoms in five to 21 days. “Two to three weeks of quarantine is necessary,” he stressed.

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Immunocompromised individuals like HIV patients, other immunodeficiency syndromes and neonates should be cautious as they are prone to developing an infection.

Once contracted the disease, the healing procedure of the rash occurs in stages. “It (rashes/legions) would last around two to four weeks before subsiding,” Dr Das added.

People who are taking care of the infected person must maintain good hygiene. “The person taking care of the patient needs to wash their hands regularly and should be PPE-protected and follow the necessary precautions same as Covid-19,” Dr Das shared.

Meanwhile, caretakers should also be careful while touching or handling the utensils, bedding, towels, or clothing of the person affected with monkeypox. The waste disposal and disinfection of the patient’s belongings should be done with care.

Since monkeypox and smallpox viruses are genetically the same, Dr Das suggested that the antiviral medicine for smallpox can be used to prevent and cure monkeypox-affected individuals. Monkeypox can have a serious and fatal impact with about 0.5 per cent to 10 per cent mortality rate.

Hence, it is important to consult the healthcare provider in case of any symptoms of monkeypox.

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