Special Episode 10. Monkeypox and Japanese Encephalitis with Dr Alex Tai

In May this year, new cases of the rare infection-Monkey Pox - typically limited to Africa, began spreading within Europe and North America.

More than 780 cases have now been reported across 15 countries with Australia recently reporting 8 cases.

Monkeypox is a viral zoonotic disease, a member of the same family of viruses as smallpox and typically is spread through close physical contact with skin lesions, body fluids, respiratory droplets, and contaminated materials such as bedding and is much less infectious than respiratory illnesses such as Covid 19. Transmission of Monkey pox virus by respiratory droplets would normally require prolonged face-to-face contact, so the apparent rapid spread of the virus may signal a shift in its behaviour and some scientists have questioned if the virus may have mutated to become more transmissible. Two strains have been identified.

The west African strain has a 1-3% mortality and is the strain currently spreading beyond Africa. The Central African strain is more deadly with a 10% mortality rate.

Infection is characterised by: Lymphadenopathy, muscle aches, fever, headache, and a pustular rash developing 1-3 days after the fever and typically starting on the face before spreading to other parts of the body.

It’s estimated that just 3% of close contacts of Monkeypox will become infected however asymptomatic spread is being postulated and another unusual feature of the current outbreak is the detection of cases through sexual health services and amongst same-sex men.

As smallpox was declared eradicated in 1980 the last mass vaccination against smallpox was in the 1970’s and it is speculated that declining herd levels of immunity against smallpox may be leading to the current propensity for transmission.

I thought it may also be interesting to expand the conversation with our guest beyond Monkeypox to discuss the recent spike in cases of Japanese encephalitis reported in Australia, noting that JEV is a mosquito-born presenting with fever, vomiting and headache and linked to piggeries as well as pig handling and abattoirs.

Please welcome Dr Alex Tai Infectious Diseases specialist with a special interest in public health, tropical medicine, multi-drug microbial resistance and travel medicine.

References:

Dr Alex Tai-Infectious Diseases Physician-www.bawbawphysicians.com.au

www1.racgp.org.au -Monkeypox exposure

Monkeypox-Fact sheets-NSW Health-www.health.nsw.gov.au

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.