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Published on: Oct 28, 2020
2 minute read
By: Dr Rajan ( Medical Second Opinion Cell)

Hepatitis C Nobel Prize

Earlier this month the Nobel Prize in Physiology and Medicine was jointly awarded to Harvey J Alter, Michael Houghton and Charles M Rice for the discovery of the Hepatitis C virus. This helped push our understanding of blood-borne hepatitis, a major global health problem that is one of the leading causes of cirrhosis and liver cancer alongside Hepatitis B. It led the way in introducing new tests for chronic hepatitis as well as new treatments that have saved the lives of millions.

HEPATITIS

Hepatitis is the inflammation of your liver, the largest solid organ in your body. Though there are numerous other causes of hepatitis, including alcohol abuse, drugs and toxins (including paracetamol overdose), and autoimmune disorders (such as Wilson’s disease), viral infections are the most common worldwide causes for hepatitis. Hepatitis A was the first to be discovered, transmitted by polluted food and water, and results in a short-term transient hepatitis. Hepatitis B on the other hand is transmitted through blood and is more of an issue as it can lead to chronic cirrhosis and possible liver cancer. It can remain indolent in a person, causing disease long after the initial infection.

Blood borne hepatitis was first discovered in the 1960s, when it was found that some patients would become ill after receiving blood transfusions. Despite this discovery and new tests for Hepatitis B reducing the number of transfusion related hepatitis, a large number of cases remained.

NOT A, NOT B

Harvey Alter, working at the US National Institute of Health, was studying the occurrence of hepatitis in blood transfusion patients. His team showed that blood from these infected patients could transmit the disease to chimpanzees, resulting in hepatitis. This agent had the properties of a virus, one that was “non-A, non B” hepatitis.

Further investigation into the virus would require the input of Michael Houghton, working for Chiron pharmaceutical. His team created a collection of DNA fragments found in the blood of infected chimpanzees. Though the majority of these fragments were from the chimpanzee, enough were from the virus. They were able to utilise this information to identify antibodies against the suspected virus, and ultimately identify it as the flavivirus Hepatitis C.

The final piece of the puzzle was shown by Charles M Rice, a researcher at Washington University, St Louis – could the virus alone cause hepatitis. He studied the RNA of Hepatitis C to identify regions that may be used for replication, and areas that might hinder replication. This was key as the virus can lay dormant for years, replicating at a slow rate before causing damage to the liver. For researchers, this was an issue as it was not feasible to wait years and see if the suspected virus caused hepatitis. By genetically engineering the viral genome, he developed a variant of Hepatitis C that would only multiple rapidly and have no mechanism to inactivate itself for dormancy. This strain caused rapid changes to the livers of infected chimpanzees; the same changes seen in hepatitis patients.

. ;.,hrvxzThe impact was significant. Prior to this, receiving a blood transfusion was like Russian Roulette. You were receiving life saving therapy, but it coZuld also be a hidden death sentence. Now that hepatitis had been discovered, it became possible to screen patients prior to donation, to screen blood transfusion bags, and to start developing treatments for the virus.

The fight is not over yet. There are still over 70 million people who still live with the virus, and it still kills around 400,000 a year. Its only very recently that we have found treatments that can reduce the viral load in patients to levels that they are considered cured. This treatment remains expensive, and we are very far away from eradication itself.

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Monkeypox Virus Symptoms: Early Signs, Disease Progression, and When to Seek Care

Monkeypox, now commonly referred to as mpox, is a viral infection that has gained global attention due to outbreaks beyond traditionally affected regions. Understanding monkeypox virus symptoms is essential for early detection, timely isolation and prevention of further spread.

According to the World Health Organization and Indian public health authorities, awareness of symptom patterns plays a critical role in controlling outbreaks and protecting vulnerable populations.

What Is the Monkeypox Virus?

Monkeypox is caused by the monkeypox virus, a member of the Orthopoxvirus family, which also includes smallpox. While generally less severe than smallpox, monkeypox can still cause significant illness and discomfort.

The virus spreads primarily through close physical contact.

Incubation Period of Monkeypox

After exposure, symptoms typically appear within:

5 to 21 days
most commonly 6 to 13 days

Individuals may feel well during this period but can become infectious once symptoms begin.

Early Monkeypox Virus Symptoms

Fever

Fever is usually the first symptom and may be:

sudden in onset
moderate to high grade
accompanied by chills

Fever signals the start of systemic infection.

Headache and Body Aches

Patients often experience:

severe headache
muscle aches
back pain

These symptoms resemble many viral illnesses.

Fatigue and Weakness

Marked tiredness and low energy levels are common and may limit daily activities.

Swollen Lymph Nodes

Swollen lymph nodes are a distinguishing feature of monkeypox.

Common sites include:

neck
armpits
groin

This helps differentiate monkeypox from chickenpox or smallpox.

Development of Monkeypox Rash

The skin rash usually appears:

1 to 3 days after fever onset

It may begin on the face or genital area and spread to other parts of the body.

Stages of Monkeypox Rash

The rash progresses through well-defined stages:

Macules

Flat red spots on the skin.

Papules

Raised, firm bumps.

Vesicles

Fluid-filled blisters.

Pustules

Pus-filled lesions that are painful.

Scabs

Lesions crust over and eventually fall off.

Complete healing occurs once scabs detach.

Distribution of Rash

Rash commonly affects:

face
hands and feet
mouth
genital and anal areas

The number of lesions can vary widely.

Pain and Discomfort

Rash lesions may be:

painful
itchy during healing

Pain severity differs between individuals.

Other Possible Symptoms

Additional symptoms may include:

sore throat
cough
nasal congestion

These reflect upper respiratory involvement.

Duration of Illness

Monkeypox symptoms typically last:

2 to 4 weeks

Recovery occurs gradually as lesions heal.

Who Is at Higher Risk of Severe Illness?

Higher risk groups include:

children
pregnant women
individuals with weakened immunity
people with chronic illness

Early care is crucial in these groups.

Complications of Monkeypox

Though uncommon, complications may include:

secondary bacterial skin infections
dehydration
pneumonia
eye involvement

Prompt medical guidance reduces risk.

How Monkeypox Is Transmitted

Transmission occurs through:

direct skin-to-skin contact
contact with lesions or bodily fluids
respiratory droplets during close contact
contaminated clothing or bedding

Understanding transmission helps prevent spread.

When to Seek Medical Care

Seek medical evaluation if:

fever is followed by rash
lymph nodes become swollen
rash appears in genital or facial areas

Early diagnosis supports isolation and care.

Diagnosis and Testing

Diagnosis may involve:

clinical examination
laboratory testing of lesion samples

Public health authorities guide testing protocols.

Prevention and Control Measures

Preventive steps include:

avoiding close contact with infected individuals
maintaining good hand hygiene
isolating during illness
following public health guidance

Vaccination may be recommended for high-risk groups.

Role of Public Awareness

Awareness of symptoms:

enables early detection
reduces stigma
supports timely care

WHO emphasises community education in outbreak control.

Conclusion

Monkeypox virus symptoms typically begin with fever, body aches and swollen lymph nodes, followed by a characteristic rash that progresses through defined stages. While most cases are self-limiting, early recognition, medical evaluation and isolation are essential to prevent complications and reduce transmission. Staying informed and acting promptly protects both individual and public health.

References

World Health Organization (WHO) – Mpox (Monkeypox) Clinical and Public Health Guidance
Indian Council of Medical Research (ICMR) – Emerging Viral Infections Reports
National Centre for Disease Control (NCDC), India – Monkeypox Advisories
Lancet – Clinical Features and Outcomes of Mpox
NITI Aayog – Public Health Preparedness and Infectious Disease Control

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