Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
The history (especially association with rodents or other animals) and
physical exam (present of pox lesions) is presumptive evidence for a diagnosis
of monkeypox. Caution is advised. Infectious-disease consultants and CDC
personnel should be notified because this infection may represent two additional
problems. First, in the U.S. or other countries, it may likely indicate an
outbreak of monkeypox, and informed health authorities may help to identify the
source of the infection and prevent its spread. The second problem is unlikely
but far more serious; the early symptoms may represent a biological warfare or
terrorist attack with smallpox that is mistakenly identified as monkeypox.
Consequently, definitive diagnosis of this viral disease, outside of Africa, and
especially in developed countries where monkeypox is not endemic, is urged. Most
laboratories do not have the reagents to do this testing, so state labs or the
CDC will need to process the samples to establish a definitive diagnosis. These
tests are based on detecting antigenic structures (usually from skin or pox
samples or occasionally serum) specific to either monkeypox virus or
immunoglobulin that reacts with the virus. PCR (polymerase chain reaction),
ELISA techniques (enzyme-linked immunosorbent assay), or Western blotting tests
(immunoblotting) are the main tests used.
What is the treatment for monkeypox?
The CDC recommends the following:
A smallpox vaccination should be administered within two weeks of
exposure to monkeypox.
Cidofovir (Vistide), an antiviral drug, is suggested for patients
with severe, life-threatening symptoms.
Vaccinia immune globulin may be used,
but efficacy of use has not been documented.
For severe symptoms, supportive measures such as mechanical ventilation may
rarely be needed. Consultation with an infectious-diseases expert and the CDC is
recommended.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Smallpox is a disease caused by the variola virus. Symptoms and signs include a characteristic rash and high fever. Treatment focuses on supporting the patient. Smallpox may be prevented with the ACAM2000 smallpox vaccine.
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