Monkeypox can cause neurological damage, including brain inflammation: study

monkeypoxSkin effects such as disfiguring rashes and flu-like symptoms are well documented, but few have investigated the neurological and psychiatric problems the virus can cause. .

There are historical reports of neurological complications in people infected with the related smallpox virus and in people vaccinated against smallpox, including the related vaccinia virus. So my colleague and I wanted to know if monkeypox causes similar problems.

We examined all evidence from before the current monkeypox pandemic of neurological or psychiatric problems in monkeypox-infected people.The results are published in the journal eClinicalMedicine.

Read more | New substrain of monkeypox virus emerges

A small but significant proportion (2% to 3%) of monkeypox patients become very ill and develop serious neurological problems such as seizures and encephalitis (inflammation of the brain that can lead to long-term disability). I developed a problem. We also found that a similar number of people caused confusion. However, it’s important to note that these numbers are based on several studies with a small number of participants.

We found evidence in a broader group of monkeypox patients with more common neurological symptoms such as headaches, muscle aches and fatigue, in addition to serious and rare brain problems.

Looking at the studies, it was unclear how severe these symptoms were and how long they lasted. It was unknown because there were few Among them, depressed mood was frequently reported.

It is not known what factors are causing these neuropsychiatric problems in monkeypox patients. We would like to know whether the strain of the monkeypox virus and the severity of the infection affect these problems. , was not reported consistently in studies, so we were unable to properly examine this.

Although we have found that monkeypox-infected individuals can present with neuropsychiatric symptoms, the research in our paper does not allow us to definitively say that it is the virus that is causing these problems. Future studies to investigate should follow up people without neuropsychiatric disorders before contracting monkeypox.

If it is a virus that is causing these problems, the underlying biological processes are unknown and may involve viruses directly entering the nervous system, reactions by the immune system, or something else entirely. Also, the stigma and disfigurement caused by skin rashes from monkeypox infection can lead to depression and other emotional distress.

Our study focused on evidence prior to the current monkeypox pandemic. Most of the data came from West Africa and were of people hospitalized with infections, but the current pandemic is primarily affecting North America and Western Europe. It is unknown to what extent it reflects the symptoms

Support from other recent studies

After we finished writing the paper, an important study was published. A study in the New England Journal of Medicine found that the current outbreak involved more than 500 monkeypox patients in 16 countries. No cases of encephalitis or seizures have been reported, but more than one in four of those infected with monkeypox had headaches and fatigue, and up to one in ten had depression. was seen

However, two cases of monkeypox-confirmed encephalitis have recently been reported in Spain. Further monitoring is needed to determine the true extent of more serious problems such as encephalitis and seizures.

Monkeypox outbreaks remain a global concern and require continued public health measures, including improving access to vaccination.

Monkeypox primarily causes flu-like symptoms and skin problems, but our latest research (and subsequent studies) show that neuropsychiatric symptoms are not uncommon. Although we do not believe that it will occur one after another, a small percentage of people may develop complications such as encephalitis or seizures. Further research is needed to find out whether these symptoms persist for long periods of time and whether monkeypox is the cause.

(James Blanton Badenoch, Academic Foundation Doctor, For The Conversation, Queen Mary University, London)