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    Monkeypox virus problem, UNAIR expert: don’t worry, remain vigilant

    UNIVERSITAS AIRLANGGA NEWS – Recently, the public was shocked by the news about the outbreak of monkeypox in Singapore. The news spread after a man from Nigeria tested positive for contracting the disease. As a response, the local authorities immediately fled him to the isolation room at the National Center for Infectious Diseases (NCID) and put him in quarantine to prevent the spread of the virus.

    Some photos of monkeypox patients are spreading widely in social media, and it is quite disturbing for some Indonesian people as Indonesia is not far from Singapore. However, the Indonesian government has taken preventive measures by installing detectors in ports and airports to detect body temperature of foreign and local citizens coming from other countries, especially Singapore.

    Knowing Monkeypox Virus

    Professor on Virology and Immunology of Faculty of Veterinary Medicine (FKH) Universitas Airlangga — Prof. Dr. drh. Suwarno, Msi., also gave a response to this case. He emphasized that the public should not worry too much but remain vigilant about monkeypox because the health agency has yet not found a presence of the virus-host in Indonesia.

    “Usually, monkeypox patients are healed on their own from 14 to 21 days. But it can be fatal if the patient has a secondary infection or complication, “explained Prof. Soewarno last Thursday, May 23, 2019.

    He said that the percentage of fatality was only one to ten percent. And, most of them occur in the early age group of nine to fifteen years. An outbreak has lead to numerous children deaths in Africa.

    The medical world classifies monkeypox into zoonotic categories or diseases that transmit from animals to humans and vice versa. However, there is a tendency that it spreads between humans. It is classified as a newly emerging disease in 1958 and restricted to Africa until before 2003.

    “Only in 2003 it expanded to America (47 cases), in 2018 to England (3 cases) and Israel (1 case), and 2019 in Singapore,” said the inventor of avian flu spray.

    The monkeypox virus (MPV) is a member of the Orthopoxvirus genus of the Poxviridae family. It is similar to variola (human smallpox), vaccinia (calf virus), cowpox (adult cow virus) and camelpox (camel virus). It is 140-260 nm, 220-450nm long, enveloped, slightly pleomorphic, dumbbell-shaped core with a lateral body, a complex symmetry with linear genome length 196.858bp.

    “Before the monkeypox, the world was shocked by the appearance of smallpox in humans or variola. If it infects the skin, it is deep and will leave a scar in the form of pockmark. But it has been successfully eradicated since the 1970s. So there is also a kind of close relationship between the two, “explained the 1987 FKH UNAIR alumnus.

    There are two MPV clades, known as Congo Basin and West African. However, they are pathogenically, clinically, and epidemiologically different. Infection caused by Congo Basin is more severe than West African. It can also create a higher risk of death.

    Process of Transmission and Symptoms

    Monkeypox can be transmitted from animals to animals or from animals to humans through direct contact with the infected animals, such as from blood, body fluids, and cutaneous lesions. Some information also revealed that eating undercooked meat from affected animals can result in infection.

    “In addition to primates, we must also be aware of animals that act as reservoirs, such as rodents including mice, rabbits, porcupines, anteaters, and squirrels,” explained the man who serves as Vice Dean III of FKH UNAIR.

    The incubation period of monkeypox ranges from six to sixteen days. On the first day of infection, the virus multiplies and causes local inflammation. Then it spread to the blood vessels. The symptom in the first five days is a fever, headache, lymphoglandular swelling, and pain in some parts of the body. After a fever, symptoms are followed by a rash on the skin from the stage of papules, to vesicles, pustules, followed by leprosy within ten days.

    “About 70% of cases occur on the face, 30% in the genital area, the rest in the eye. In other cases, there are those on the back, hands, or thighs. Very varied, “he said.

    Preventive Measures and Role of Educational Institutions

    There are no drugs or vaccines that can prevent monkeypox. However, the smallpox vaccine can reduce the risk of MPV infection in Africa. For treatment, patients will use antiviral cidofovir. Efforts to prevent transmission in endemic areas are to avoid contact with rodents, primates, and patients. Maintaining health and the environment is also vital to prevent the disease.

    More comprehensive prevention is also carried out by Indonesia One Health University Network (Indohun). It is a global organization working with all universities with faculties of medicine, veterinary medicine, nursing, and public health. Indohun has involved around 20 universities and 34 faculties throughout Indonesia, including UNAIR in conducting dissemination and treating zoonosis.

    “In UNAIR, it’s called Airlangga Disease Prevention and Research Center (ADPRC). So this disease will be dealt with by three experts and involve social experts, environmentalists, and cultural experts to get the best handling, “he concluded. (*)