PTI
New Delhi, July 31
Rashes and fever, symptoms common to both chickenpox and chickenpox have caused confusion among people, although doctors have stressed that there is a difference in how the symptoms manifest of the two viral diseases in patients.
They have also advised to consult a doctor to dispel any doubts.
Monkeypox is a viral zoonosis (a virus transmitted to humans by animals) with symptoms similar to those seen in the past in patients with smallpox, although it is clinically less severe.
In the rainy season, people are more prone to viral infections and chicken pox cases are largely seen during this time along with other infections that also show symptoms like rashes and nausea, said Dr Ramanjit Singh , visiting consultant, dermatology at Medanta Hospital.
“Because of this situation, some patients get confused and misunderstand chicken pox with chicken pox. The patient can determine whether he has chicken pox or not by understanding the sequence and onset of symptoms,” Singh said.
Explaining further, he said that monkeypox usually starts with fever, general malaise, headache, sometimes sore throat and cough and lymphadenopathy (swollen lymph nodes) and that all these symptoms appear four days before the skin lesions, rashes and other problems that start mainly in the hand and eyes and spread to the whole body.
Other experts agree and say that, apart from the skin damage, there are also other symptoms in the case of monkey pox, but it is always better to consult a doctor to clear any doubts.
In a couple of recently reported cases, two suspected varicella cases turned out to be varicella.
A suspected varicella case was admitted to LNJP Hospital in Delhi last week with fever and lesions, tested negative for infection but was diagnosed with varicella. Similarly, an Ethiopian national, who had gone to Bangalore, was tested for chicken pox after showing symptoms, but his report confirmed that he had chicken pox.
India has so far reported four cases of monkeypox: three from Kerala and one from Delhi.
Dr Satish Koul, Director of Internal Medicine, Fortis Memorial Research Institute, said, “In chicken pox, the lesions are larger than chicken pox. In monkey pox, the lesions are seen on the palms and plants. In varicella, the lesions are self-limiting after seven to eight days, but not in varicella. The lesions are vesicular and itchy in varicella. In monkeypox, the lesions they are broad vesicular and non-itchy.”
Koul also said that the duration of fever is longer in monkeypox and that this patient has enlarged lymph nodes.
Elaborating on the virus that causes chicken pox, Dr SCL Gupta, Medical Director, Batra Hospital said that chicken pox is an RNA virus which is not that serious but also causes skin rashes .
“This is the season of chicken pox. Generally, during the monsoon, there is this humidity, rise in temperature, accumulation of water, formation of moisture and wet clothes, all of which lead to the growth of the virus.
“Also, there is a religious aspect associated with the disease. People treat him as a ‘goddess’ and so these patients are not treated with any kind of medicine. They are kept in isolation and given time to heal,” he said.
Talking about monkeypox, Gupta explained that this virus requires an animal host, but is self-limiting with a sore throat, fever and normal virus signs.
“The main sign of this virus is rashes on the body that contain fluids inside. 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 it gets blisters and leads to blisters which lead to more complications in the body.
“Right now, monkey pox is in its juvenile stage. We don’t have a proper treatment. We are just following the isolation method and treating the suspected patient according to his symptoms. If there is a throat infection, we use the generic drugs that we take regularly. So here it is a case of symptomatic treatment,” he said.
Physicians have also received inquiries as to whether prior chickenpox infection makes a patient immune to varicella, to which the answer is a resounding no.
Dr Rajinder Kumar Singal, Senior Director and HOD, Internal Medicine, BLK Max Hospital, New Delhi, said 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 vaccine are less likely to contract smallpox, he said.
“The smallpox vaccine was discontinued after the World Health Organization said the disease had been completely eradicated around 1979-80. People born before 1980 who have had the smallpox vaccine are less likely to from contracting smallpox. 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 the administration of “smallpox” vaccines, but in India it is still not allowed.
“The virus is in its juvenile stage and doctors are still figuring it out,” Gupta added.