Monkeypox, currently responsible for an outbreak of global concern, usually causes no serious long-term health conditions. However, research and medical reports have already found that the disease has been associated with complications such as vision problems and encephalitis – inflammation of the brain caused by an infection.
“Cases that can lead to blindness and inoculation of the virus in the eye do not happen in everyone. But, of all the sequelae of monkeypox, it is perhaps the most common”, says Clarissa Damaso, a virologist at UFRJ (Federal University of Rio de Janeiro). de Janeiro) and advisor to the WHO (World Health Organization) committee for smallpox virus research.
Although data are sparse, studies have observed different types of eye complications in people with the disease caused by monkeypox, as the virus is known. One survey found that conjunctivitis, the inflammation of a membrane in the eye, was reported in 23% of patients infected with monkeypox between 2010 and 2013 in Congo.
The researchers observed that most people with conjunctivitis during the infection were children under the age of ten. In addition, the complication was more present in children who had other symptoms, such as nausea, sore throat and sensitivity to light.
“Cases of smallpox in monkeys with conjunctivitis are at risk of scarring, which can lead to blindness,” the researchers state in the survey.
Other research has already looked at cases of blindness resulting from monkeypox. The study analyzed 338 patients in Zaire – as the Democratic Republic of Congo was called – between 1981 and 1986. Of these, 245 were directly infected by animals and 95 had human-to-human transmission.
The survey concluded that more serious sequelae, such as blindness in one or both eyes, were observed in 10% of those infected by animals. For those who had human transmission, the rate was 5%.
Damaso explains that eye problems can occur when a person touches a bodily injury caused by monkeypox and then takes the hand to the eye without first cleaning.
“When the wound dries, it starts to itch. Then the person scratches and forgets after washing their hands”, he summarizes.
This type of complication has also been reported in cases of other viruses in the monkeypox family, such as the pathogen that causes smallpox. The situation means that, in the UFRJ laboratory where Damaso works, a rule has been established: “Do not put your hand in your eye under any circumstances”, says the virologist, recommending that patients diagnosed with monkeypox follow the recommendation.
Encephalitis
Another complication associated with monkeypox in studies is encephalitis, an inflammation of the brain and brain (brain stem) caused by an infection.
In the case of monkeypox, there are very few reports of encephalitis developing through viral infection. One was from a 2003 outbreak in the United States. Researchers looked at the case of a family – two adults and a child – where everyone was infected with monkeypox. Adults developed the most common symptoms, such as skin lesions, but the child’s condition progressed to encephalitis.
More worrying cases of this complication caused by monkeypox are rare and basically affect children, a group already recognized as at risk for developing severe disease. Other people subject to more critical developments are pregnant women, immunosuppressed individuals, individuals with comorbidities and those who have not been vaccinated.
Marzia Puccioni, professor at the Unirio School of Medicine and Surgery and at the UFRJ’s postgraduate program in infectious and parasitic diseases, says it is important to be alert to the signs of encephalitis in children. The picture mainly involves drowsiness, compulsive crisis, mental confusion, motor deficit and very intense headache.
“Parents have to be very attentive,” says Puccioni. She also points to the need for pediatricians to observe more carefully the development of the health problem. According to her, many causes of encephalitis are not properly investigated.
Encephalitis due to monkeypox has not yet been described in this outbreak, says the researcher.
“It’s rare, but we have to be careful. It can happen, as has happened in previous outbreaks”, says Puccioni.
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