PTI
New Delhi, July 31
Skin rashes and fever, the common symptoms of both monkeypox and chickenpox, have caused confusion among people, although doctors have emphasized that there is a difference in the way the symptoms of the two viral diseases manifest in patients.
They have also advised to consult a doctor to clear any doubts.
Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms similar to those seen in the past in patients with smallpox, although it is clinically milder.
During the rainy season, people are more prone to viral infections and cases of chicken pox are largely seen during this time along with other infections that also show symptoms like rashes and nausea, said Dr Ramanjit Singh, visiting consultant, dermatologist, hospital Medanta.
“Because of this situation, some patients get confused and misinterpret chickenpox as monkeypox. A patient can determine whether he has monkeypox or not by understanding the sequence and onset of symptoms,” said Singh.
Explaining further, he said that monkeypox usually starts with fever, malaise, headache, sometimes sore throat and cough and lymphadenopathy (swollen lymph nodes) and all these symptoms appear four days before skin lesions, rashes and other problems that mostly start from the hands and eyes and spreads throughout the body.
Other experts agree and say that apart from skin involvement, there are other symptoms in case of monkeypox, but it is always better to consult a doctor to clear any doubts.
In several cases reported recently, two suspected cases of monkeypox turned out to be chicken pox.
A suspected case of monkeypox, admitted to LNJP Hospital in Delhi last week with fever and lesions, tested negative for the infection but was diagnosed with varicella. Similarly, an Ethiopian national who had gone to Bengaluru was tested for monekipox after showing symptoms, but his report confirmed he had chicken pox.
India has so far reported four cases of monkeypox – three from Kerala and one from Delhi.
Dr. Satish Kaul, Director of Internal Medicine, Fortis Memorial Research Institute said, “In monkeypox, the lesions are larger than chicken pox. In monkeypox, the lesions are seen on the palms and soles. In chickenpox, the lesions are self-limiting after seven to eight days, but not in monkeypox. The lesions are vesicular and pruritic in varicella. In monkeypox, the lesions are broad vesicular and do not itch.
Koul also said that the duration of fever is longer in monkeypox and such a patient has enlarged lymph nodes.
Elaborating on the virus that causes chicken pox, Dr SCL Gupta, Medical Director of Batra Hospital, said chicken pox is an RNA virus which is not as severe but also causes skin rashes.
“Tis the season for chicken pox. Usually during monsoon there is this moisture, rise in temperature, irrigation, formation of moisture and wet clothes, all this leads to growth of the virus.
“Also, there is a religious aspect to the disease. People treat it as a ‘goddess’ and therefore such patients are not treated with any medicine. They are kept in isolation and given time to heal,” he said.
Talking about monkeypox, Gupta explained that such a virus requires an animal host but is self-limiting with a sore throat, fever and normal signs of the virus.
“The main symptom of this virus is rashes on the body that contain fluid. This leads to a viral infection that weakens the body’s resistance. But the problems arise because of its complication. In case, any bacterial infection and gets pus and leads to blisters, which leads to additional complications in the body.
“Monkeypox is currently in its juvenile stage. We have no proper treatment. We simply follow the method of isolation and treat the suspected patient according to his symptoms. If there is a throat infection, we use the generic drugs that we usually take. So this is about symptomatic treatment,” he said.
Doctors have also received inquiries as to whether a previous infection with chicken pox makes a patient immune to monekipox, to which the answer is a resounding no.
Dr Rajinder Kumar Singhal, Senior Director and HOD, Internal Medicine, BLK Max Hospital, New Delhi, said that both are caused by different viruses, the mode of transmission is different and the previous infection does not guarantee any protection against the new one.
But those who have received the smallpox vaccination have a lower chance of contracting monkeypox, he claims.
“The smallpox vaccine was discontinued after the World Health Organization declared that the disease had been completely eradicated around 1979-80. People born before 1980 who were vaccinated against smallpox have a lower chance of getting infected with monkeypox. Both smallpox and monkeypox are caused by viruses from the same family,” Singhal added.
Because of this similarity between smallpox and monkeypox, many countries have allowed smallpox vaccines to be administered, but in India it is not yet allowed.
“The virus is in its juvenile stage and doctors are still discovering it,” Gupta added.
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