Mpox

Clinical description

• Caused by the monkeypox virus (closely related to eradicated smallpox). July 2024: declared public health emergency of international concern. No confirmed cases in Malawi as of October 2024, but risk of import from Central/East Africa.
• Transmission: close physical or sexual contact with skin lesions, body fluids, or contaminated materials. Less commonly by respiratory droplets during prolonged face-to-face contact. Not exclusively an STI.
• Incubation: 5–21 days. Symptoms: fever, headache, muscle aches, swollen lymph nodes, exhaustion. Rash appears after 1–3 days (macules → pustules → scabs), often on face, hands, feet and genital area. May resemble herpes simplex or syphilis.
• Can lead to secondary bacterial infections, pneumonia or encephalitis.

Treatment

Increased vigilance in STI clinics is essential. For patients with compatible symptoms: use gloves, gown, mask; submit swabs from skin lesions for PCR testing by reference lab. Treatment is symptomatic. In severe cases, tecovirimat (TPOXX) may be used (access is limited).

Prevention

• Avoid close contact with infected individuals and contaminated materials.
• Use condoms, though condoms alone may not prevent transmission due to skin contact.
• Smallpox vaccine (ACAM2000 or Jynneos) is effective in preventing mpox.