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Monkeypox and the dental team

From Volume 49, Issue 8, September 2022 | Pages 683-687

Authors

Lakshman Samaranayake

DSc, DDS, FRCPath, FHKCPath, FDS RCS(Edin), FRACDS, FDS RCPS

Professor Emeritus, and Immediate-past Dean, Faculty of Dentistry, University of Hong Kong

Articles by Lakshman Samaranayake

Email Lakshman Samaranayake

Sukumaran Anil

BDS, MDS, PhD, FDS RCPS (Glas)

Professor & Senior Consultant, Oral Health Institute, Hamad Medical Corporation, Qatar University, Doha, Qatar

Articles by Sukumaran Anil

Abstract

Monkeypox (MPX), a rare zoonotic disease, endemic to some African countries is now spreading in non-endemic regions, including the UK. So far, it has been reported in 93 countries with over 38,000 global cases, although the signs are that the disease may be plateauing in UK. The outbreak was declared a public health emergency of international concern by the World Health Organization (WHO). Monkeypox virus (MPXV), belongs to the family Orthopoxviridae, the same family as the smallpox (variola) virus. Although some features of MPX resemble smallpox, a disease that has been eradicated, the former is far milder with a very few associated fatalities. Usually, the initial signs of MPX appear during its prodrome, as single or multiple macular lesions on the oral mucosa, accompanied by generalized lymphadenopathy, followed by the characteristic macular, papular vesicular rash on the skin that heals with scarring. The major mode of spread of MPX is generally through direct or indirect contact with body fluids or lesion material. Its transmission in the dental clinic environment is unlikely if the standard infection prevention and control (IPC) precautions recommended in the National IPC Manual (NHS England) are adhered to. These include wearing N95 masks, fluid-resistant attire and eye protection. Here, the virology, clinical manifestations, diagnosis, management and prevention strategies of MPX, with particular reference to dentistry are reviewed.

CPD/Clinical Relevance: To describe the epidemiology of the re-emergent monkeypox outbreak, and discuss the management of dental patients who may present with it.

Article

Monkeypox (MPX), a zoonotic infection, caused by the monkeypox virus (MPXV), which is a DNA virus, is spreading around the world at an alarmingly rapid rate. A re-emergent viral infection, it was first identified in monkeys in a laboratory in Denmark in 1958, but it is typically found in rodents and other animals. The first case of monkeypox in humans was first described in 1970.1

Surprisingly, the original source of the disease is still a mystery. In fact, the World Health Organization (WHO) is planning to rename the MPXV due to the concerns for the stigmatization of monkeys, particularly as the animals have little to do with disease spread. Since the 1960s, the disease has been mainly endemic in the African continent with occasional sporadic outbreaks in western countries. Previous MPX cases in the UK were either imported from such endemic regions or through contacts with documented epidemiological links to the imported cases.

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