How can telemedicine aid the monkeypox health emergency
This file handout picture made available by the UK Health Security Agency on June 22, 2022 shows a collage of monkeypox rash lesions at an undisclosed date and location. The Word Health Organization called on July 1, 2022 for 'urgent' action to prevent the spread of monkeypox in Europe, noting that cases had tripled there over the past two weeks.

ON July 24, 2022, Jamaica confirmed its second case of monkeypox after the first case was announced a few days earlier on July 6. The second confirmation comes one day after the World Health Organization (WHO) declared monkeypox a "public health emergency of international concern".

What this means is, WHO has determined monkeypox to be an "extraordinary event" that poses a serious public health risk. This is significantly different from declaring it a pandemic, such as the novel coronavirus pandemic, which is determined by high infection rates, high death rates, and an overall disruption of daily life causing hardship globally. Thankfully, monkeypox has not reached the level of a pandemic, however, as it is an international health concern, it's important that you understand the risks and what to look out for to protect yourself from being infected and infecting others.

Signs and symptoms of monkeypox

If you are infected with monkeypox, it usually takes five to 21 days for the first symptoms to emerge.

Symptoms of monkeypox include:

• High temperature

• Headache

• Muscle aches

• Backaches

• Swollen lymph nodes

•Shivering

•Exhaustion

What most people know about monkeypox is the rash that accompanies it. Usually, a rash will appear one to five days after the first sign of the symptoms listed above. The rash often begins on the face and then spreads to other parts of the body including the palms of the hands, soles of the feet and even the genitals and anus.

The monkeypox rash is characterised as raised spots which then turn into small blisters filled with fluid. These blisters eventually turn into scabs which later fall off. Until the scab falls off and the blisters are completely healed, it is best to assume that these sores are still infectious. The blisters may be very itchy and painful, particularly if rubbed against surfaces, including your clothing.

These symptoms will typically last from two to four weeks and as long as you are still experiencing symptoms you are still able to pass on the virus to others. Although usually mild, severe cases and death have been recorded in monkeypox cases.

How is monkeypox spread?

The following are the ways it is understood that monkeypox can be spread:

• Through direct or indirect contact with the rash, bodily fluids (for example, pus or blood from sores) and blisters or scabs which are infectious. Contact may also include kissing and/or sexual contact.

• A person with monkeypox coughing or sneezing while close to you.

• Coming in contact with clothing, bedding, towels or eating utensils that may be contaminated by an infected person's fluids.

Diagnosis and treatment of monkeypox

It is important that if you do have any symptoms of monkeypox, particularly a rash, you get tested to confirm. Testing includes lesion swabs which take samples directly from lesions (rashes, growths or sores) present on the skin that are potentially contagious. Doctors will carefully swab a lesion to collect DNA from it. This swab will then be sent in a sterile container for testing at a lab. Any other method of testing may give you a false result and lead to improper treatment and possible further spread of the virus. Lesion swabs are currently the most accurate type of testing to confirm a monkeypox diagnosis and it is unlikely that you will be able to get an accurate result through testing before you have lesions on your skin. This may change as the world learns more about the virus.

Some labs may not conduct tests for monkeypox as they may not feel they have the resources to tend to this health crisis. MDLink, however, offers safe and convenient drive-thru and walk-in testing which includes lesion swabs for monkeypox. With the sensitive nature of this virus, if you do think you are infected or have come in close contact with someone who has been confirmed with the virus, drive-thru testing is a great option. You will be able to stay within the confines of your vehicle and be administered the test by health-care professionals who will then confirm if you have the virus or not. If you do, taking this route would ensure that you do not come into close contact with anyone in doctor waiting rooms or other in-person interactions that may happen during traditional testing.

Monkeypox is usually a mild illness and traditionally it can clear up on its own without any treatment. In January 2022, an antiviral treatment that was previously developed to treat smallpox was approved for the treatment of monkeypox. This treatment has proven to be effective because monkeypox and smallpox belong to the same family of viruses. Health officials have confirmed that not only does the vaccine help to protect against the virus before exposure, but it aids in making the disease less severe after being exposed. There may be other treatment methods your doctor may administer to help you relieve any discomfort some individual symptoms you may be experiencing. If you find that your symptoms are not mild, hospitalisation may be necessary.

Telemedicine as a useful tool in the monkeypox health crisis

Telemedicine platforms such as MDLink are useful tools in fighting the spread of viruses such as monkeypox. Telemedicine allows you to speak to a doctor remotely through voice, video and text. These consultations with your doctor are done anywhere you are. However, because of the contagious nature of monkeypox, if you do suspect you have been infected it is crucial that you go into self-isolation until it's confirmed that you don't have it or you are no longer infected. Telemedicine allows you to be treated by a doctor without leaving your self-isolation location, such as your home.

Telemedicine will give you the opportunity to send photos of any rash or blisters you feel concerned about as well as discuss any of the other symptoms you may be facing. You may be recommended to get tested for monkeypox and MDLink offers distanced testing at their drive-thru in Kingston. Additionally, if your doctor thinks you need medication to treat your symptoms, they can send your prescription to the pharmacy after your virtual consultation.

Additionally, if you are not sick and just feel like you need to connect with a doctor to discuss what monkeypox is, how you can protect yourself and any other information you may be curious to know, telemedicine allows you to do so without the hassle of actually going into a doctor's office when you aren't sick.

The convenience and effectiveness of telemedicine during times such as these cannot be understated. Using technology to aid in assessment, treatment and knowledge transfer are key ways taking advantage of the technological space in health care can aid in tackling existing health emergencies and limiting new health emergencies from occurring both locally and globally.

Dr Ché Bowen, a digital health entrepreneur and family physician, is the CEO & founder of MDLink, a digital health company that provides telemedicine options. Check out the company's website at www.theMDLink.com. You can also contact him at drchebowen@themdlink.com.

Dr Ché Bowen

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