 Today I will be going to speak about the recently worried disease transmission that is happening in India that is about the monkeypox. I will talk about its virology, about its epidemiology, about the previous outbreaks and the current outbreak of 2022 and then how long it will be infectious if a person has its incubation period, clinical signs and symptoms and the investigations that can be done and the treatment that is available. Coming to the first one about the virology, the monkeypox virus comes under the name called as orthopox virus which is similar as that of veriola virus or otherwise the smallpox virus. In this monkeypox virus there are mainly three strains are identified and it is called as clad 1, clad 2 and clad 3. The present 2022 outbreak is because of this strain called as clad 3 all over the world. The first monkeypox outbreak has happened in the year 1950 between the animals to animals and mainly in the laboratory monkeys. Later on the outbreak in humans happened in 1970 in Africa a place called as Congo and most cases after 1970 were seen in south as well as the east Africa and in 1970 outbreak in Africa almost around 80 cases were detected of monkeypox and surprisingly about 17 percent mortality was seen in children who are affected with this monkeypox in the 1970 outbreak. In 2022 the WHO declared as monkeypox as the endemic disease a week back WHO declared as the public health emergency of international concern so that is in July 2023 and in 2023 till now all over the world about 18,000 confirmed monkeypox viruses have been detected and in India about 5 to 6 cases of monkeypox virus have been found to be positive. We all need to know how does this monkeypox virus spreads? One is from the animals to human beings so whenever somebody gets exposed to the infected animals and if that infected animal bites the human being then it can transmit or if the infected animal scratches the human being then it can spread to the human being or the infected animals bodily fluids if it can touch the human beings then it can get transmitted that is from animals to animal. The second one is from human being to human being somebody who is infected it can transmit it can get transmitted to the other person by direct contact with the infected source scaps body fluids mucus membrane abrasions and whenever infected person gets in close contact with other person then also it can get transmitted and more so it is also found in homosexual men so where they spend more time with other other infected person. However the indirect contact also can transmit the disease what I mean by indirect contact is a disease person has got fomites that are exposed to the linen or the clothes or the body fluids and the normal person gets exposed to these linen fomites or on the clothes then also this disease can get transmitted. It can also get transmitted through the respiratory secretions also but however one need to have a prolonged exposure to the infected person by face to face and then it can also get transmitted through the respiratory secretions. It is also found it is also found that it can also transmit as a vertical transmission from mother to the and all over the world it has been found that about five cases have been transmitted from the infected mother to the babies also and among five there was a one fetal death was also found and the fetus also had this skin lesions or the rashes. We are all in the covid era where the covid gets transmitted so fast to all the human all the household individuals but however it is found that monkeypox spreading fast reading fast is less likely and the and the steady show may be around nine percent it can spread in the household or transmission coming to the viral shedding and period of infectious infectiousness that means if somebody has got the symptoms starting with the fever body pain myalgia so he will be he will be transmitting this monkeypox virus from the time of symptoms till he develops the rashes till the rashes gets healed till the rashes gets scab and till there is a healthy skin appears so so long he can transmit the virus to the next individual person. So when then what about the incubation period incubation period is nothing but when an uninfected healthy individual gets exposed to the infected person and after from that day after how many days you will start having the symptoms and it is found that it varies from five days to 13 days maximum up to 21 days and in 2022 outbreak it is been found on an average about 8.5 days after he gets exposed we will start having the symptoms and signs so what are the classical symptoms and signs that are seen with monkey or monkeypox virus disease most commonly they will have a fever chills myalgia and they will have a characteristic rashes and the rashes can be present over the skin mainly over the upper limb and the lower limb it can present at the genitalia and rectum and even at the oral cavity also and the prodromal period these rashes will develop generally after a prodromal period of this fever myalgia severe headache fatigue for five days after that they will start having the rashes and the characteristic is also found that they can have a very intense headache and they can develop the lymphadenopathy either it can be a localized or it can be a generalized lymphadenopathy which is commonly not seen with the other chickenpox or the smallpox viruses severe fatigue is also one of the manifestation and lymph nodes also can be present to talk about the characteristic of this rash it generally begins in one to four days after the onset of fever and it continues for two to three weeks and it can present over the face hands soles oral cavity conjunctiva anal area and genital area there are various stages what this rashes progresses to it starts with just a two to five mm of macule then it progresses to progresses to the papule vesicle becomes a pustule and circumscribe deep seated and characteristically it has got an obelication and later on it forms a crust which gets epithelized to the normal tissue over a period of next 7 to 14 days and other characteristic feature of this is generally all these rashes or the lesions begin simultaneously unlikely in the chickenpox or the smallpox where they develop in various stages but however in monkeypox outbreak from 2022 is also formed that it can also present at various stages also so what we are worried is apart from this rashes what other complications the monkeypox virus causes these patients can have a secondary infection they can have a bronchonemonia they can develop into the sepsis they can also have an encephalitis and some patients also had a loss of vision also and when when we do the laboratory test they can have they are found to have increased WBC count decreased platelet count and they will also have a low albumin level so whenever we suspect the possible viral infection so we need to first differentiate is it monkeypox virus or is it a possibility of other rashes that what we commonly seen as in chickenpox are long back what we had seen as the as the smallpox but mainly now we need to differentiate between the rashes due to the monkeypox as well as the chickenpox and as I mentioned previously chickenpox has got at various levels of stages of rashes and generally they do not have the lymphadenopathy coming to the confirmation of these tests the confirmation of these tests can be analyzed by the fluid sent from these rashes fluid sent from the oral cavity or the nasal cavity swabs and the PCR technique will confirm the monkeypox virus as of now in Bangalore there are two centers one is at the Victoria hospital virology center and another one is at the demands where these tests are confirmed so it is important to identify and once we identify know how long it can spread and also keep this patient isolated and the isolation period that is advised is for 21 days that means if somebody is infected he has to be isolated for 21 days if some person has got exposed to this monkey monkeypox virus even he needs to be isolated for 21 days and beyond 21 days if it does not develop any symptoms then he can come out of the isolation with respect to the treatment as in any other viral illness it is the symptomatic treatment for its fever, myalgia, body ache, headache and if they are severely dehydrated these patients may require admission and require IV fluids and certain antiviral drugs also have been tried all over the world so hope this information will help all of you to find out and diagnose investigate and treatment of this monkeypox virus disease thank you