The method of treatment of monkeypox virus has been announced.

APA reports that this was stated in the clinical protocol prepared by the Center for Public Health and Reforms (ISIM) of the Ministry of Health on the diagnosis and treatment of monkeypox.

The protocol states that patients with a severe disease and a high risk of complications should be treated in an inpatient setting.

Symptomatic treatment is sufficient as monkeypox is mild in most patients.

However, it is advisable to start antiviral treatment for patients with severe disease and high risk of complications (for example, patients with immunodeficiency, children younger than 8 years, pregnant or lactating women, patients with septic complications).

Antiviral treatment for monkeypox infection may also be considered in patients whose rash is not in typical locations (eg, mouth, eyes, genital area).

Tecovirimate is currently considered the most useful for the treatment of monkeypox.

Tekovirimat was approved in the US in 2018 for the treatment of monkeypox.

Oral and intravenous preparations are available.

For adults

Intravenous (v/d):

For patients between 35 and 120 kg: 200 mg

every 12 hours For patients ≥120 kg: 300 mg every 12 hours

Oral:

For patients between 40 and 120 kg: 600 mg

≥ every 12 hours

For patients weighing 120 kg: 600 mg every 8 hours

The treatment period is 14 days.

No dose adjustment is required for the oral form in renal failure.

In IV forms, if the creatinine clearance is over 30 mL/min, no dose adjustment is required.

Use is not recommended if creatinine clearance is below 30 mL/min.

If vomiting occurs within 30 minutes of taking Tecovirimat capsules, another dose may be administered immediately.

If vomiting occurs more than 30 minutes after taking tecovirimat, no additional dose should be given and the drug should be resumed after 12 hours.

Tecovirimat capsules should be taken within 30 minutes of a moderate or high fat meal.

For patients unable to swallow tecovirimat capsules, the capsules may be opened, the contents mixed with approximately 30 mL of liquid (e.g. milk) or soft food (e.g. yogurt) and taken within 30 minutes of a meal.

The most commonly reported side effects are headache, nausea, and abdominal pain.

Local antiviral preparations are used in cases of corneal damage.

Trifluorothymidine is used topically for the ocular form of the cowpox virus, and can be applied for corneal lesions during monkeypox.

Trifluridine eye drops (9 drops per affected eye, daily).

Most patients recover without any medical intervention as the disease is mild.

In case of complaints such as nausea, vomiting, dysphagia, infusion treatment can be performed to maintain fluid balance by hospitalization.

Fever and pain: first-line therapy is paracetamol (500-1000 mg orally, 4-6 times a day if necessary, maximum dose 4000 mg/day).

The use of nonsteroidal anti-inflammatory drugs (including aspirin) should be avoided in patients with high bleeding risk and in patients with nephropathy due to potential nephrotoxicity.

Oral or intravenous antiemetics are recommended for nausea and vomiting.

It should be noted that the risk factors for the severe course of the disease were also disclosed in Procol.

It was noted that severe cases are more common among children, depending on the viral load, the patient's general health and the nature of the complications.

Profound immunodeficiency can lead to more serious consequences.

Also, pregnant women and those with atopic dermatitis, eczema, and other skin conditions may be at higher risk of complications and death.

Healthcare workers are also at higher risk because of longer exposure to the virus.

People vaccinated against smallpox may have some protection against monkeypox.

At the same time, the suspension of natural smallpox vaccination worldwide for more than 40 years justifies the susceptibility of people younger than this age to monkeypox.

The risk group of infection includes people with immunodeficiency and people caring for infected people.

Complications can be secondary infections, bronchopneumonia, sepsis, encephalitis, visual impairment (corneal damage).

The patient should be closely monitored if any of the symptoms of eye pain or nausea, shortness of breath, chest pain, difficulty breathing, loss of consciousness, disorientation, drowsiness, convulsions, decreased urine output, significant decrease in food intake, prolonged fever, arterial hypotension

If you have any of the above-mentioned symptoms, you should consult a doctor without delay.