Rashes and fever, symptoms common in both monkeypox and chickenpox, have caused confusion among the people although doctors stressed that there is a difference in the way the symptoms of both viral diseases present in patients.
They also advised to consult a doctor to dispel any doubts.
Monkeypox is a zoonotic viral disease (a virus transmitted to humans from animals) with symptoms similar to those seen in the past in patients with smallpox, although clinically less severe.
Dr. Ramanjit Singh, Consultant Dermatologist at Medanta Hospital, said that in the rainy season, people are more susceptible to viral infections and cases of chickenpox mostly appear during this time along with other infections also showing symptoms like rash and nausea.
“Because of this situation, some patients get confused and misinterpret chickenpox with monkeypox. A patient may determine whether or not they have monkeypox by understanding the sequence and onset of symptoms,” said Dr. Ramanjit Singh.
He further explained, that monkeypox usually begins with fever, malaise, headache, sometimes throat and afternoon cough, and lymphadenopathy (enlarged lymph nodes), and all these symptoms appear four days before the skin lesions, rashes and other problems that begin primarily from The hand and eyes are spread over the whole body.
Other experts agree and say that apart from the infection of the skin, there are other symptoms as well in the case of monkeypox, but it is always best to consult a doctor to dispel any doubts.
In two recently reported cases, two suspected cases of monkeypox turned out to be chickenpox.
A suspected case of monkeypox was admitted to Lok Nayak Jai Prakash Narayan Hospital (LNJP) in Delhi last week with fever and lesions, she tested negative for the infection but was diagnosed with chicken pox. Similarly, an Ethiopian national, who had gone to Bengaluru, was tested for chickenpox after showing symptoms, but his report confirmed that he had chickenpox.
India has so far reported four cases of monkeypox – three from Kerala and one from Delhi. Dr. Satish Kaul, director of internal medicine, Fortis Memorial Research Institute, said: “In monkeypox, the lesions are larger than chickenpox. In monkeypox, lesions appear on the palms of the hand and soles of the feet. In chickenpox, the lesions are self-limiting after seven to eight days. But not so in monkeypox. The lesions are vesicular and itchy in chickenpox. In monkeypox the lesions are extensive and non-itchy.” Dr. Satish Kaul also said that the duration of fever is longer in monkeypox and such a patient had enlarged lymph nodes.
Detailing about the virus that causes chickenpox, Dr. SCL Gupta, Medical Director of Batra Hospital said that chickenpox is ribonucleic acid (RNA) virus which is not severe but also leads to rashes on the skin. “This is the season of chickenpox. Usually, during the monsoon, there is this humidity, the high temperature, the water washing, the formation of dampness and wet clothes, all of this leads to the growth of the virus.
He said, “There is a religious aspect associated with the disease. People treat it like ‘gods’ and therefore these patients are not treated with any kind of medicine. They are isolated and given time to heal.”
Speaking about monkeypox, Dr. SCL Gupta explained that such a virus requires an animal host but limits sore throat, fever and normal signs of the virus.
“The main sign of this virus is a rash that contains fluids in the body, and this leads to a viral infection that weakens the body’s resistance, but problems arise due to its complications, and in the event of any bacterial infection, breakouts and blisters occur. This leads to more complications in body.” Currently, monkeypox is in the juvenile stage. We do not have the appropriate treatment. We just follow the method of isolating and treating the suspected patient according to his symptoms. If there is a sore throat, we use the generics that we usually take. So this is a case of symptomatic treatment.”
Doctors also received inquiries about whether a previous infection with chickenpox makes a patient immune to chickenpox, to which the answer was definitely no.
Both are caused by different viruses, the mode of transmission is different, and previous infection does not guarantee any protection against the new virus, said Dr. Rajinder Kumar Singhal, Senior Director and Head of Department of Internal Medicine, BLK Max Hospital in New Delhi. He emphasized that those who received the smallpox vaccination had fewer chances of contracting monkeypox.
“The smallpox vaccine was discontinued after the World Health Organization (WHO) said the disease was completely eradicated around 1979-80. People born before 1980 who took the smallpox vaccine have lower chances of getting monkeypox. Both smallpox and monkeypox are caused by viruses from the same the family “.
Because of this similarity between smallpox and monkeypox, many countries have allowed the administration of “smallpox” vaccines but in India, it is still not allowed. “The virus is in the juvenile stage and doctors are still detecting it,” Dr. SCL Gupta added.
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