You can get COVID and monkeypox at the same time; what doctors say
There has been a case in the US where a man contracted both COVID and monkeypox at the same time. This has left many worried
Amid the COVID-19 pandemic, there is another disease – monkeypox – which has been reported from 75 countries. The World Health Organization (WHO) has declared it a public health emergency of international concern.
Globally, over 16,000 cases of monkeypox have been reported from 75 countries, and the virus is “spreading rapidly”, according to WHO.
However, WHO’s assessment is that the “risk of monkeypox is moderate globally and in all regions, except in the European region where we assess the risk as high”.
Around the world, people who were until now worried about getting infected with COVID, are now concerned about monkeypox. There has been a case in the US where a man contracted both COVID and monkeypox at the same time. This has left many worried.
Now, many are asking whether it is possible to get infected with both COVID and monkeypox at the same time.
Monkeypoxvirus vs COVID virus
According to the WHO, Monkeypoxvirus (MPXV) is a double-stranded DNA virus, a member of the orthopoxvirus genus within the Poxviridae family. Poxviruses cause disease in humans and many other animals; infection typically results in the formation of lesions, skin nodules or disseminated rash. Other orthopoxvirus (OPXV) species pathogenic to humans include cowpox virus, and variola virus (causing smallpox, which has been eradicated).
Monkeypox consists of a short febrile prodromal period followed by progressive development of a classic rash with indurated and umbilicated (centrally depressed) lesions, starting on the head or face and progressing to the limbs and trunk.
“Monkeypox virus is transmitted from infected animals to humans via indirect or direct contact. Human-to-human transmission can occur through direct contact with infectious skin or lesions, including face-to-face, skin-to-skin, and respiratory droplets. In the current outbreak countries and amongst the reported monkeypox cases, transmission appears to be occurring primarily through close physical contact, including sexual contact. Transmission can also occur from contaminated materials such as linens, bedding, electronics, clothing, that have infectious skin particles,” explains WHO.
Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the virus will experience mild to moderate respiratory illness.
As per WHO, the virus can spread from an infected person’s mouth or nose in small liquid particles when they cough, sneeze, speak, sing or breathe. These particles range from larger respiratory droplets to smaller aerosols.
According to WHO, “there are still many unknowns about monkeypoxvirus”.
Although monkeypox and COVID spread between people differently, some of the COVID measures applied during social gatherings such as keeping a physical distance and practicing regular handwashing are also effective against the transmission of monkeypox virus; as such, they should be continued; skin-to-skin and face-to-face contact should be discouraged, stated WHO.
Getting COVID and monkeypox at same time
Dr. Dean Winslow, professor of medicine and infectious disease specialist at Stanford, said while it is rare, it is possible for someone to get both monkeypox and COVID-19 at the same time.
“It’s certainly not impossible for that to occur. It’s just incredibly bad luck. They are very different viruses,” he was quoted as saying by nbcbayarea website.
Dr. Sulaiman Ladhani, Consulting Chest Physician MD Chest and Tuberculosis, Masina Hospital, Mumbai said that COVID and monkeypox can definitely co-exist and the combination can be deadly.
“As far as coexistence of Covid-19 and monkeypox goes they are both two different viral infections. Yes they can definitely co-exist and if god forbid they do, it can be really fatal,” Dr. Ladhani was quoted in a Hindustan Times report.
“It can make things more difficult, Covid by itself is quite a devastating disease and if both of these co-exist together the symptoms may turn out to be the same as before, but diagnosis is very important. For Covid, RT-PCR and for monkeypox, clinical symptoms, rash in the body, histopathological diagnosis by microscopy is necessary,” he added.
According to the expert, monkeypox doesn’t spread easily as you require a prolonged body contact or be in touch with body fluids of an infected person, or in contact with infected animal. “Covid on the other hand spreads very easily. At present, the cases are not many, the possibility (of co-existence of two diseases) definitely exist and if they do chances of fatality are very high.”
COVID vs monkeypox testing
Any individual that meets the suspected case definition for monkeypox should be offered testing, says WHO.
The recommended specimen type for diagnostic confirmation of monkeypox in suspected cases is skin lesion material, including swabs of lesion exudate, roofs from more than one lesion, or lesion crusts. Laboratory confirmation of specimens from a suspected case is done using nucleic acid amplification testing (NAAT), such as real-time or conventional polymerase chain reaction (PCR). NAAT can be generic to orthopoxvirus (OPXV) or specific to monkeypoxvirus (MPXV, preferable), it added.
For COVID, as per WHO, in most situations, a molecular test is used to detect SARS-CoV-2 and confirm infection. Polymerase chain reaction (PCR) is the most commonly used molecular test. Samples are collected from the nose and/or throat with a swab. Molecular tests detect virus in the sample by amplifying viral genetic material to detectable levels. For this reason, a molecular test is used to confirm an active infection, usually within a few days of exposure and around the time that symptoms may begin.
Rapid antigen tests (sometimes known as a rapid diagnostic test – RDT) detect viral proteins (known as antigens). Samples are collected from the nose and/or throat with a swab. These tests are cheaper than PCR and will offer results more quickly, although they are generally less accurate. These tests perform best when there is more virus circulating in the community and when sampled from an individual during the time they are most infectious, said WHO.
Isolation vs quarantine
While handling the COVID cases, WHO recommended both isolation and quarantine depending on contacts and symptoms, monkeypox positive individuals have to only isolate themselves.
If someone is suspected or confirmed as having monkeypox, they should isolate, be tested, undergo clinical evaluation to assess for complications, avoid skin-to-skin and face-to-face contact with others and avoid sex. Anyone caring for a person sick with monkeypox should use appropriate personal protective measures like personal protective equipment (PPE) to prevent transmission, said WHO.
“Quarantine is used for anyone who is a contact of someone infected with the SARS-CoV-2 virus, which causes COVID-19, whether the infected person has symptoms or not. Quarantine means that you remain separated from others because you have been exposed to the virus and you may be infected and can take place in a designated facility or at home. For COVID-19, this means staying in the facility or at home for 14 days.
“Isolation is used for people with symptoms or who have tested positive for the virus. Being in isolation means being separated from other people, ideally in a medically facility where you can receive clinical care. If isolation in a medical facility is not possible and you are not in a high risk group of developing severe disease, isolation can take place at home,” explains WHO.
Vaccine for monkeypox
According to WHO, vaccination against smallpox was shown in the past to be cross-protective against monkeypox.
“Today, any continuing immunity from prior smallpox vaccination would in most cases only be present in persons over the age of 42 to 50 years or older, depending on the country, since smallpox vaccination programmes ended worldwide in 1980 after the eradication of smallpox. Protection for those who were vaccinated may have waned over time. The original (first generation) smallpox vaccines from the eradication programme are no longer available to the general public. Smallpox and monkeypox vaccines, where available, are being deployed in a few countries to manage close contacts,” it said.