Uptick in patients confusing chickenpox, shingles for monkeypox

So far, nine cases of monkeypox have been reported in the country — four from Delhi and five from Kerala.

With more cases of monkeypox being reported in the national capital, outpatient departments (OPDs) of hospitals across the city are seeing an uptick in patients mistaking symptoms of diseases such as chickenpox and herpes zoster for monkeypox, doctors from various hospitals have said.

Monkeypox, usually a self-limiting zoonotic viral disease, manifests itself with fever, rash and swollen lymph nodes and may lead to a range of medical complications. The symptoms last for two to four weeks, doctors said. (Sunil Ghosh/HT)

So far, nine cases of monkeypox have been reported in the country -- four from Delhi and five from Kerala. The latest to test positive in the Capital is a 31-year-old Nigerian woman, who is undergoing treatment at Lok Nayak (LN) Hospital. Two other monkeypox patients, also Nigerians, are being treated at the facility, which is Delhi’s nodal hospital for people diagnosed with the infection. The first patient was discharged after treatment on Monday.

Dr Suresh Kumar, medical director at Delhi’s Lok Nayak Hospital, said it is relatively easy for a common person to mistake the symptoms of diseases such as chickenpox, shingles, herpes zoster, hand-foot-and-mouth disease or even a normal fungal infection for monkeypox, considering that currently there is a lot of fear surrounding the disease.

“The initial symptoms of many viral diseases are similar, so there could be some confusion. People should seek medical care rather than self-diagnosing,” said Dr Kumar.

After Delhi reported its first case of monkeypox, that of a 34-year-old west Delhi resident on July 15, a second suspected case from Ghaziabad was admitted to Lok Nayak Hospital with skin eruptions and fever. His reports, however, returned negative for monkeypox and he was later diagnosed with chickenpox.

Monkeypox, usually a self-limiting zoonotic viral disease, manifests itself with fever, rash and swollen lymph nodes and may lead to a range of medical complications. The symptoms last for two to four weeks, doctors said.

The infection, unlike Covid-19, is not easily airborne and spreads through close contact with the bodily fluids or clothes or bed linen of an infected person.

Dr Satish Koul, director (internal medicine) at the Fortis Memorial Research Institute, explained that in monkeypox, a patient gets skin eruptions that are bigger in size as compared to those in chickenpox.

In the case of monkeypox, the eruptions may also manifest on the palms and soles of the feet, which is not the case in chickenpox, Koul said.

“Both chickenpox and monkeypox are self-limiting viral diseases. The duration of infection in monkeypox is three to four weeks and, in chickenpox, it is two weeks,” Koul said.

In the guidelines issued by the Union health ministry on May 31, the government listed chickenpox, disseminated herpes zoster, disseminated herpes simplex, measles, chancroid, secondary syphilis, hand-foot-and-mouth disease, infectious mononucleosis and molluscum contagiosum as differential diagnosis for monkeypox.

“We have conducted training sessions in all our hospitals and have also released public awareness pamphlets to educate healthcare professionals and the public on what symptoms to look out for. Districts administrations have started awareness campaigns in residential localities so that false information is not spread and people do not panic,” said a senior Delhi health department official, asking not to be named.