Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.

There are many different types of CVD. 4 of the main types are described on this page.

1. Coronary heart disease, Coronary heart disease occurs when the flow of oxygen-rich blood to the heart muscle is blocked or reduced.
2. Strokes and TIAs, A stroke is where the blood supply to part of the brain is cut off, which can cause brain damage and possibly death.
3. Peripheral arterial disease, Peripheral arterial disease occurs when there’s a blockage in the arteries to the limbs, usually the legs.
4. Aortic disease, Aortic diseases are a group of conditions affecting the aorta. This is the largest blood vessel in the body, which carries blood from the heart to the rest of the body.

The exact cause of CVD isn’t clear, but there are lots of things that can increase your risk of getting it. These are called “risk factors”.

This include; High blood pressure, Smoking, High cholesterol, Diabetes, Inactivity, Being overweight or obese, Family history of CVD, Ethnic background, Other risk factors.

The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of heart attack, stroke, heart failure and other complications.

Heart Failure

This term can be scary. It doesn’t mean your heart has “failed,” or stopped working. It means your heart doesn’t pump as strongly as it should. This will cause your body to hold in salt and water, which will give you swelling and shortness of breath.

Your valves sit at the exit of each of your four heart chambers. They keep blood flowing through your heart.

Sometimes, there are problems with these valves. Examples of heart valve problems include:

Aortic stenosis. Your aortic valve narrows. It slows blood flow from your heart to the rest of your body.

Mitral valve insufficiency. Your mitral valve doesn’t close tightly enough. This causes blood to leak backward, leading to fluid backup in the lungs.

Mitral valve prolapse. The valve between your left upper and left lower chambers doesn’t close right.

A healthy lifestyle can lower your risk of CVD. If you already have CVD, staying as healthy as possible can reduce the chances of it getting worse. The key to cardiovascular disease reduction lies in the inclusion of cardiovascular disease management interventions in universal health coverage packages, although in a high number of countries health systems require significant investment and reorientation to effectively manage CVDs

Basic medicines that should be available include: Aspirin,beta-blockers, angiotensin-converting enzyme inhibitors; and statins.

Medical devices are required to treat some CVDs. Such devices include pacemakers, prosthetic valves, and patches for closing holes in the heart.

Human monkeypox was first identified in humans in 1970 in the Democratic Republic of the Congo in a 9-year-old boy in a region where smallpox had been eliminated in 1968.

Monkeypox is a disease of global public health importance as it not only affects countries in west and central Africa, but the rest of the world. In 2003, the first monkeypox outbreak outside of Africa was in the United States of America and was linked to contact with infected pet prairie dogs. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country from Ghana. This outbreak led to over 70 cases of monkeypox in the U.S. Monkeypox has also been reported in travelers from Nigeria to Israel in September 2018, to the United Kingdom in September 2018, December 2019, May 2021 and May 2022, and to the United States of America in July and November 2021. In May 2022, multiple cases of monkeypox were identified in several non-endemic countries. Studies are currently underway to further understand the epidemiology, sources of infection, and transmission patterns.  

 Signs and Symptoms

In humans, the symptoms of monkeypox are similar to but milder than the symptoms of smallpox. Monkeypox begins with fever, headache, muscle aches, and exhaustion. The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not. The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days.

The illness begins with:

• Fever, Headache, Muscle aches, Backache, Swollen lymph nodes, Chills, Exhaustion

Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a rash, often beginning on the face then spreading to other parts of the body.

Lesions progress through the following stages before falling off:

• Macules, Papules, Vesicles, Pustules, Scabs

The illness typically lasts for 2−4 weeks. In Africa, monkeypox has been shown to cause death in as many as 1 in 10 persons who contract the disease.

Vaccination

Vaccination against smallpox was demonstrated through several observational studies to be about 85% effective in preventing monkeypox. Thus, prior smallpox vaccination may result in milder illness. At the present time, the original (first-generation) smallpox vaccines are no longer available to the general public.

JYNNEOS^TM  (also known as Imvamune or Imvanex) is an attenuated live virus vaccine which has been approved by the U.S. Food and Drug Administration for the prevention of monkeypox. The Advisory Committee on Immunization Practices (ACIP) is currently evaluating JYNNEOS^TM for the protection of people at risk of occupational exposure to orthopoxviruses such as smallpox and monkeypox in a pre-event setting.

Description of the outbreak

As of 21 May, 13:00, 92 laboratory confirmed cases, and 28 suspected cases of monkeypox with investigations ongoing, have been reported to WHO from 12 Member States that are not endemic for monkeypox virus, across three WHO regions (Table 1). No associated deaths have been reported to date.

Table 1.Cases of monkeypox in non-endemic countries reported to WHO between 13 to 21 May 2022 as at 13:00.

Country	Confirmed	Suspected
Australia	1-5	–
Belgium	1-5	1-5
Canada	1-5	11-20
France	1-5	1-5
Germany	1-5	–
Italy	1-5	–
Netherlans	1-5	–
Portugal	21-30	–
Spain	21-30	6-10
Sweden	1-5	–
United kingdom	21-30	–
United States of America	1-5	–
Total	92	28

To date, all cases whose samples were confirmed by PCR have been identified as being infected with the West African clade. Genome sequence from a swab sample from a confirmed case in Portugal, indicated a close match of the monkeypox virus causing the current outbreak, to exported cases from Nigeria to the United Kingdom, Israel and Singapore in 2018 and 2019.

The identification of confirmed and suspected cases of monkeypox with no direct travel links to an endemic area represents a highly unusual event. Surveillance to date in non-endemic areas has been limited, but is now expanding. Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic.

Prevention

There are number of measures that can be taken to prevent infection with monkeypox virus:

• Avoid contact with animals that could harbor the virus (including animals that are sick or that have been found dead in areas where monkeypox occurs).
• Avoid contact with any materials, such as bedding, that has been in contact with a sick animal.
• Isolate infected patients from others who could be at risk for infection.
• Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer.
• Use Personal Protective Equipment (PPE) when caring for patients.

Resource

https://www.who.int/news-room/monkeypox

https://www.cdc.gov/poxvirus/monkeypox