Monkeypox and the dental team

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.