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

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The monkeypox outbreak has alarmed several people around the world.

Since May, more than 21,000 cases have been reported in nearly 80 countries and 75 suspected deaths in Africa, mostly in Nigeria and the Congo, where a more deadly form of monkeypox is spreading than in the West. Spain and Brazil have also reported deaths related 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, variola virus, which also causes smallpox.

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

To help with the checklist,
Dr. Subrata Das, Senior Consultant, Internal Medicine and Diabetology, Sakra World Hospitalthey shared some of the most common monkeypox symptoms previously reported: severe headache, fever, skin rash or skin lesions/blisters, macules (small non-raised skin patches) to papules (raised hard patches), emaciation, chills and swelling. lymph nodes in the armpit, neck and groin, muscle pain, back pain.

Monkeypox can also present with malaise, lymphadenopathy, vesicles, pustules, and scabs. It can also affect the face and cause lesions on the soles of the hands and mucous membranes, similar to smallpox but with larger lesions.

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Once you’ve contracted an illness, the rash heals in stages.

Dr Bindumathi PL, Senior Consultant Internal Medicine at Aster Hospital, said the recent outbreak in the UK has mostly been in people who are immunocompromised due to HIV infection. These patients had atypical features such as only skin lesions with abscess and tonsil abscess. No deaths were reported, but pain and suffering in the genital area and perigenital area due to skin lesions was greater.

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“Patients can visit various specialties, such as an infectious disease specialist, a surgeon, a clinic for sexual diseases and ENT doctors, to receive the necessary treatment for the disease,” she advised.

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

Overall, 20 (10%) participants were hospitalized for treatment of newly discovered symptoms. The researchers recommend that clinicians consider contracting monkeypox in patients with these symptoms.

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All patients had lesions on the skin or mucous membranes, most often on the genitals or in the perianal region. The majority (86%) of patients reported systemic disease (affecting the whole body). The most common systemic symptoms were fever (62%), swollen lymph nodes (58%), muscle aches and pains (32%).

Graphics from Times Of India

Graphics from The Times Of India

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And in contrast to existing case reports suggesting that systemic symptoms precede skin lesions, 38% of patients developed systemic symptoms after the onset of mucocutaneous lesions, and 14% had lesions without systemic signs. A total of 71 patients reported rectal pain, 33 sore throat and 31 penile edema, while 27 had oral lesions, 22 solitary lesions and 9 tonsil edema.

The researchers also noted that it had not previously been known that solitary lesions and swollen tonsils were typical signs of monkeypox infection and could be mistaken for other conditions.

Just over a third (36 percent) of participants were also infected with HIV, and 32 percent of those screened for sexually transmitted infections had sexually transmitted infections. However, no deaths were reported and no patient required intensive hospital care.

Monkeypox can be transmitted in three ways: sexual contact, skin contact, and airborne droplets.

Dr. Subrata Das of Sakra World Hospital and Dr. Bindumathi PL of Aster CMI HospitalAgencies

Dr. Subrata Das (left) from Sakra World Hospital and Dr. Bindumathi PL from Aster CMI Hospital

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People who have recently traveled to or come into contact with travelers from those countries who have developed fever, myalgia, sore throat or skin lesions should be isolated and evaluated with proper medical care, Dr. Bindumati said. “The threat is that it could become a pandemic due to increased travel to different countries. Therefore, awareness of the disease becomes crucial,” she added.

Dr. Das said monkeypox patients should be isolated for three weeks because a new person who comes into contact with an infected person may develop symptoms in 5 to 21 days. “Two to three weeks of quarantine are necessary,” he stressed.

Immunocompromised people, such as patients with HIV, other immunodeficiency syndromes, and newborns, should be careful as they are prone to infection.

Once you’ve contracted an illness, the rash heals in stages. “They (rashes/legions) will last two to four weeks before they disappear,” added Dr. Das.

People who care for an infected person must practice good hygiene. “The caregiver should wash their hands regularly and be protected by personal protective equipment and take the necessary precautions, the same as for Covid-19,” said Dr. Das.

Meanwhile, caregivers should also be careful when touching or handling utensils, linens, towels, or clothing of a person affected by monkeypox. Disposal of waste and disinfection of patient belongings should be carried out with care.

Because monkeypox and smallpox viruses are genetically the same, Dr. Das suggested that an antiviral medicine for smallpox could be used to prevent and treat monkeypox. Monkeypox can be serious and fatal, with a mortality rate of 0.5 to 10 percent.

Therefore, it is important to consult your health care provider in case of any symptoms of monkeypox.

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