Monkeypox virus is a viral zoonosis (a virus which is transmitted to humans via animals) having symptoms similar to those seen in the past in patients who suffered from smallpox. Usually viruses are submicroscopic infectious agents that live in the cells of organisms. Viruses are found in almost every ecosystem of the earth. When infected with a host cell they are forced to produce thousands of copies of the original virus. Viruses spread in many ways, one transmission is through disease bearing known as vectors, there are many viruses including Smallpox, chickenpox, spread in the air by coughing and sneezing. Viral infections in animals usually provoke an immune response which eliminates the virus and causes HIV/AIDS, viral hepatitis. Viruses that transmit through the vertical (transmission to offspring of the host)and horizontal transmission (transmission between members that don’t have child-parent relationship). In this topic we will study in detail about its causes, symptoms and its ayurvedic management in detail.
Monkeypox is an illness caused by monkeypox virus, which can spread from animals to humans or can spread from human to human. With the eradication of smallpox in 1980 and cessation of smallpox vaccination, monkeypox virus has emerged as an orthopoxvirus for public health. It is a double stranded DNA virus which is similar to smallpox with a milder form of rash and lower mortality rate. Pregnant people can spread the virus to their fetus through the placenta. It primarily occurs in central and west Africa, in the tropical rainforest, and is recently increasing in the urban area which includes a range of rodents and no human primates. It was first identified in humans in 1970 in democratic Republic of the Congo in a 9 months old boy and hence eliminated in 1968.
- Monkeypox is caused by a virus that is a member of the Orthopoxvirus genus and in the family Poxviridae.
- It is a self limited disease with the symptoms lasting from 2 to 4 weeks, severe cases can also occur, and the fatality ratio has been around 3-6%.
- Monkeypox virus is transmitted to humans through close contact or the material contaminated with the virus.
- Monkeypox typically presents with fever, rashes and swollen lymph nodes which leads to a range of complications.
- An antiviral agent which is developed for the treatment of smallpox has been licensed for the treatment of monkeypox.
This virus can make entry from any route (oropharynx, nasopharynx, intradermal). Monkeypox virus can replicate at the inoculation site which can spread to the local lymph nodes. The incubation period lasts from 7 to 14 days with an upper limit of 21 days. Before lesions appear there are prodromal symptoms of fever and lymphadenopathy for 1 -2 days. First these lesions start over the oropharynx and then on the skin.
It can range from mild symptoms to some serious symptoms which need a health facility. Those at higher risk for severe disease include patients who are pregnant, childrens, and the persons that are immunocompromised.
Main Symptoms are:
- Low energy
- Swollen lymph nodes
- Rashes for 2-3 weeks which can be found on face, palms and soles of feet, genital and anal regions of the body.
- Lesions usually begin flat and then fill up liquid and then crust over and dry up, which falls off with fresh skin underneath.
- Fever, intense headache and myalgia (muscle ache).
- Chills and sweats
- Sore throat and cough
STAGES OF RASHES
- First lesion is seen on the tongue (enanthem)
- Macules starts from face to legs, palms, soles within 24 hours.
- The rash moves from macular, papular, vesicular, pustular. Generally skin rashes can be seen in genitalia which can be a dilemma of STD.
- By the third day it progressed to papules.
- By 4th 5th day the fluid is filled and becomes vesicles.
- By the 6th and 7th day it becomes pustular with opaque fluid filled in it.
- By the end of the 2nd week it becomes crusty and then dries up.
- Scabs remain for a week and then fall off.
- The lesions become hyperpigmented and have atrophic scars and deformity of the facial muscles following ulcerated facial lesions.
COMPLICATIONS OF MONKEYPOX VIRUS
- Secondary infections
- Infection in the cornea with loss of vision
- Hypopigmentation and hyperpigmentation
- Permanent skin scarring
TRANSMISSION OF MONKEYPOX VIRUS
- It can usually spreads from person to person through close contact who has monkeypox rash including face to face, skin to skin and sexual ocntact.
- It can be contaminated if an infectious person touches clothes, objects or can be transmitted through flakes or virus in clothes towels known as fomite transmission.
- Pieces of DNA from the monkeypox virus have been seen in the semen or can spread through fluids during and after symptomatic infections.
- It can easily spread to people when they come in contact with infected animals, hosts like rodents and primates. Close contact with animals can also spread monkeypox virus so it should be avoided to keep close contact with animals.
DIFFERENTIAL DIAGNOSIS OF MONKEYPOX VIRUS
- Varicella (chicken pox)
- Hand foot mouth disease
- Secondary syphilis
- Molluscum contagiosum
PROGNOSIS OF MONKEYPOX VIRUS
- There are 2 distinct clades seen in monkeypox virus, The west african clade is more favorable and has less fatality rate 1% but in central basin clade is more lethal and has fatality more than 11% commonly seen in unvaccinated childrens.
- There is potential scarring and discoloration of the skin which can fully recover within four weeks of symptoms.
DIAGNOSIS OF MONKEYPOX VIRUS
If monkeypox is suspected the appropriate sample must be taken and sent for laboratory purposes. PCR (polymerase chain reaction) is a confirmatory test for its accuracy and sensitivity. When the lesions are feasible, biopsy is the option to detect the monkeypox virus.
MANAGEMENT OF MONKEYPOX VIRUS
Principles of management
- Patients isolation – The patient must be in a closed room with separate ventilations and must have a triple mask and must be covered to the extent possible to minimize the risk of contact.
- The patient should be monitored closely if the patient is suffering from lethargy, poor oral intake, seizures.
- Reduce the risk of human to human transmission.
PRECAUTIONS OF MONKEYPOX VIRUS
- PPE should be used before entry to patient rooms, where the patient is admitted.
- Proper hand hygiene should be followed after in contact with infected persons.
- Proper care should be taken of soiled laundry to avoid lesion arteries.
- Patients should be in a separate room and area from other family members.
- Patients who suffer from respiratory disease should wear surgical mask.
- Laundry must be washed with warm water and detergent.
- Pets should be excluded from the area where the patient is living.
AYURVEDIC MANAGEMENT FOR MONKEYPOX VIRUS
Monkeypox virus is Aaguntaja vyadhi which is due to external factors which are new to the human body and produces diseases by entering and affecting it. Any organisms like bacteria, viruses which are not a part of the human body enter the body and create diseases. This is usually due to an imbalance of tridoshas, which get lodged in the eternal pathway and give rise to different types of ulcers in the body.
SYMPTOMS ACCORDING TO DIFFERENT DOSHAS
- Vattaja vrana –
- Scant discharge
- Pricking type of pain
- Bluish black discoloration
- Hard in touch
- Pittaja vrana –
- Sloughing out of tissues
- Foul smelling pus coming out from the ulcer
- Kaphaja vrana –
- Excessive slime pus
- For long duration
- Mild pain
METHODS OF EXAMINATION
- Darshana (inspection) – Can be done according to age, color, sense organs.
- Prashna (interrogation) – Can be examined on the nature of pain, agni bala.
- Samsparsha (palpation) – It is done according to stiffness, hardness, heat or coldness in the ulcerated part of the body.
MANAGEMENT OF MONKEYPOX VIRUS
- In Vataja vrana –
- Oleation therapy
- Application of ointments
- Intake of medicated ghee
- Purgation therapy with herbs who have a cooling, sweet and bitter nature
- Fasting (langhana)
- Affusion is prepared with drugs which are kashaya (astringent), katu (pungent) and ushana (hot) nature
HERBS USEFUL FOR MONKEYPOX VIRUS
- TULSI – Tulsi (Ocimum sanctum) has katu (pungent), tikta (bitter) taste, and has ushana potency. It usually balances vata and kapha doshas, so it is helpful to relieve excess sputum. Tulsi has antimicrobial properties so it is the best antiviral herb, increases digestion strength and acts as a cardiac tonic which is helpful in respiratory and relieving cholesterol deposition in the blood vessels. Tulsi can be given in skin diseases and has anti toxic properties.
- HARIDRA – Turmeric (Curcuma longa) is useful for retarding facial growth and delaying the growth. It is a helpful herb useful in patients dealing with diabetes. Haridra helps to remove the accumulated kapha and medha doshas from the blood vessels and provides cleansing properties. Due to its antioxidant property it helps to remove the contaminated pitta and kapha so enables the free movements.
- GUGGUL – Guggul (Commiphora mukul) has the unique property of decreasing cholesterol level and helpful in joint inflammation, helps to strengthen the bone so useful in fractures and dislocations. Has an anti-aging property which improves strength and improves digestion. Guggul has an inflammatory property so it helps to heal the wound and ulcers quickly.
HERBAL REMEDIES BY PLANET AYURVEDA FOR MONKEYPOX VIRUS
Planet ayurveda is an ayurvedic manufacturing company that helps to treat the disease with natural extract form of plant products. It has various branches all over, the products made are 100% pure without any additives and preservatives.To treat monkeypox virus, Planet Ayurveda in handling viral infections formulated herbal remedies which are effective in this disease without causing any side effects and helps in maintaining tridoshas.
- CURCUMIN CAPSULES
- SEPTRIN TABLETS
- MAHA SUDARSHAN KWATH
- GANDHAK RASAYAN
1. Curcumin Capsules
They are single herbal capsules prepared by planet Ayurveda using standardized extract of Haridra (Curcuma longa). These capsules help to maintain tridoshas in the body and maintain a healthy immune system in the body. It helps to improve the intestinal flora which strengthens digestion and is a good tonic for skin and blood. It helps to promote the healthy function of the liver and maintain the mechanism of detoxification.
Dosage: 1-2 capsules twice daily with plain water after meals.
2. Septrin Tablets
These are herbal tablets formulations prepared by Planet Ayurveda using ingredients such as Guggul (Commiphora mukul), Sonth (Zingiber officinale), Pippali (Piper longum) and many more. These tablets help to relieve upper respiratory tract disorders and infections, usually maintaining tridoshas in the body. Septrin tablets help to strengthen the reduced immunity and are helpful in diabetic patients who suffer from high blood glucose levels. It helps to melt down the accumulated kapha which is accumulated during plaque formation and tartar.
Dosage: 1-2 tablets once or twice daily.
3. Maha Sudarshan Kwath
Maha Sudarshan Kwath is classical ayurvedic preparation which is formulated by planet ayurveda using ingredients such as Badi Harad (Terminalia chebula), Haldi (Curcuma longa), Kachoor (Curcuma zedoaria), Javasa (Alhagi cameleorum) and many more. It has antipyretic properties which helps to improve appetite, and maintain strength during fever. Maha Sudarshan Kwath helps to unblock the microchannels which further induce sweating and lower down the fever and fight against infections.
Dosage: 2-2 tsp once or twice daily after meals.
4. Gandhak Rasayan
Gandhak Rasayan are herbal tablets formulated by planet Ayurveda using a single extract of Shuddha Gandhak (Sulfur). It helps to maintain tridoshas in the body and has antiviral, antibacterial properties which are used in the treatment of skin diseases, urinary tract disorders. Gandhak Rasayan helps to enhance the immunity of the body and fight against infections, beneficial in malabsorption syndrome which improves nutrients and strengthens the digestive power.
Dosage: 1-2 tablets twice or thrice daily with lukewarm water.
Monkeypox virus is a viral zoonosis (a virus which is transmitted to humans via animals) having symptoms similar to those seen in the past in patients who suffered from smallpox. Monkeypox virus is Aaguntaja vyadhi which is due to external factors which are new to the human body and produces diseases by entering and affecting it. Here we studied how different doshas affect the vrana and many herbal remedies formulated by Planet Ayurveda which provides great relief to patients without causing any side effects.