Dear Editor,

We would like to share ideas on the publication “Monkeypox 2022: A Primer and Identify-Isolate-Inform (3I) Tool for Emergency Medical Services Professionals” in this journal. ^{Reference Koenig, Beÿ and Marty1} According to Koenig, et al, prehospital personnel are essential in preventing the spread of infectious diseases, and the monkeypox 2022 3I Tool contains knowledge that is crucial for all doctors, as well as particular data to help direct crucial prehospital actions. ^{Reference Koenig, Beÿ and Marty1}

The current outbreak and those in Africa are very different from one another. However, other elements, including as the environment and the human host, also have a crucial impact in addition to genetics and evolution. Typically, the patient has a cutaneous lesion in addition to a fever. The presence of neither a fever nor a skin lesion, however, occurs commonly. ^{Reference Wiwanitkit and Wiwanitkit2} Some people may just have strange symptoms, such as neurological and digestive issues. ^{Reference Mungmunpuntipantip and Wiwanitkit3–Reference Mungmunpuntipantip and Wiwanitkit6} It is possible for certain circumstances to occasionally result in skin lesions that are unusual in some way. Hemorrhagic vesicles may also develop. ^{Reference Wiwanitkit and Wiwanitkit2} We both concur that the monkeypox 2022 3I Tool is helpful, but it is important to be aware of the potential for unusual presentations.

At the moment, all professionals working in this developing industry are required to improve their education. Atypical illness symptoms must be taken into account. The concept of universal prevention is one of the major barriers to overcoming this new public health issue. As was already indicated, the illness can manifest clinically in a variety of ways, some of which may be modest and go undiagnosed. It may be substantially responsible for the disease’s eventual spread. Restoration of infection control is necessary, as we have just done during the COVID-19 epidemic.