Monkeypox or chickenpox? How to differentiate between the two

A suspected case of monkeypox admitted to Delhi’s LNJP Hospital last week has tested negative for the infection but was diagnosed with chickenpox. Another Ethiopian citizen in Bengaluru showed symptoms similar to monkeypox but was detected with chickenpox. 

According to health experts, chickenpox cases are largely seen during the rainy season, which has led to confusion among people at a time when monkeypox cases are spreading. Moreover, both lead to skin rashes and fever. However, either way, experts have advised individuals suspected of contracting monkeypox to get in touch with a doctor. 

Doctors have said that there is a difference in the way the symptoms manifest in patients. 

All you need to know about the difference between monkeypox and chickenpox:

1. Monkeypox is a viral zoonosis or a virus transmitted from animals to humans, with symptoms similar to smallpox. However, it is clinically less severe than smallpox. Chickenpox, according to Dr SCL Gupta, medical director of Batra Hospital, is a RNA virus, which is not as severe but leads to rashes on the skin too. He said that the dampness during monsoon leads to rise in temperature, water logging, formation of moisture, wet clothes, which causes the virus. 

He told news agency PTI that there is also a religious aspect attached to the chickenpox, and patients are hence not treated with any sort of medicines, but are kept in isolation to heal.

2. Dr Ramanjit Singh, visiting consultant, dermatology, Medanta Hospital, told the news agency that people are more prone to viral infections during the rainy season, which is when chickenpox cases are largely seen. 

Monkeypox cases usually start with fever, malaise, headache, sometimes sore throat and cough, and lymphadenopathy or swollen lymph nodes. These symptoms appear four days before the skin lesions, rashes and other problems. There are likely to be other symptoms too in case of monkeypox. 

3, Monkeypox lesions are bigger than chickenpox, and these lesions are mostly seem on palms and soles. The chickenpox lesions are self limiting after seven to eight days, unlike in monkeypox. Moreover the chickenpox lesions are vesicular and itchy, but broad vesicular and non-itchy in monkeypox, said Dr Satish Koul, Director, Internal Medicine, Fortis Memorial Research Institute to the news agency. The duration of fever is longer in monkeypox.

4. Dr Gupta said that the main sign of monkeypox virus is that the rashes have liquid inside, leading to viral infection that weakens the body’s resistance. 

"Right now, monkeypox is at its juvenile stage. We do not have a proper treatment. We are just following the method of isolation and treating the suspected patient according to their symptoms. If there is a throat infection, we use the generic medicines that we usually take. So, here it is a case of symptomatic treatment," he said.

5. Dr. Rajinder Kumar Singal, Senior Director & HOD, Internal Medicine, BLK Max Hospital, New Delhi, said both are caused by different viruses, the mode of transmission is different, and previous infection does not ensure any protection against the new one.

To answer whether previous chickenpox infection makes a patient immune to monkeypox, the answer is no. But those who have been vaccinated with the smallpox vaccination have a lesser chance of contracting monkeypox. 

(With PTI inputs)

Also read: Monkeypox in India: Govt issues guidelines; advises 21-day isolation for patients

Also read: Delhi: Suspected monkeypox patient tests negative; discharged from hospital