Journalism of Courage
With over 300 suspected or confirmed cases of monkeypox detected even in non-endemic countries, the Union health ministry Tuesday released detailed guidelines on surveillance, identification, confirmation, and treatment of the viral infection in the country. So far, no cases of monkeypox have been detected in India.
The monkeypox virus is a slow-mutating DNA virus that is spread through large respiratory droplets and requires prolonged close contact with a patient for transmission. It can also spread through bodily fluids, material from within the skin lesions, and contaminated clothes and linens of an infected person. It can take anywhere between five to 21 days after infection for the symptoms to show up, with the person becoming infectious – having the ability to spread the virus – one to two days before the skin rashes develop till after they fall off.
The guidelines released by the health ministry state that for a person to be suspected to have the infection, they must have a history of travel to the affected countries in the last 21 days, an unexplained rash and one of the other symptoms such as swollen lymph nodes, fever, headache, body ache, and profound weakness. The case will be confirmed only after conducting a PCR test (like the one done for Covid-19) or sequencing the genetic material by sending the patient sample to the National Institute of Virology-Pune.
The Integrated Disease Surveillance Programme (IDSP) – a network that tracks infectious diseases in the country – has been asked to remain alert about the cases along with health facilities, especially skin clinics, clinics for sexually transmitted diseases, medicine clinics, and paediatrics clinics.
“Even one case of monkeypox is to be considered as an outbreak. A detailed investigation by the Rapid Response Teams needs to be initiated through IDSP,” the guidelines state.
The guidelines mention that the network has to keep an eye on travellers from the affected countries for 21 days to see whether they develop symptoms. If they do, their sample would be collected.
The guidelines also give details on treating skin lesions, dehydration, and alleviating symptoms such as fever, itching, nausea, vomiting, headache, and malaise. It states that during the time of isolation, the patients have to monitor for signs such as pain in eye and blurry vision, shortness of breath and chest pain, altered consciousness, seizures, decreased urine output, poor food intake, and lethargy.
The guidelines also state that the contacts of any confirmed case will be monitored for 21 days, with samples being collected in case of any symptoms. Asymptomatic contacts have been asked not to donate blood, cells, tissue, organs, or semen during the period of isolation. Any pre-school student who is a contact may be excluded from daycare, nursery, or other group settings, according to the guidelines.
International travellers to countries reporting cases of monkeypox have been advised to not come in close contact with sick persons and dead or live wild animals. They have also been asked not to consume meat of wild animals or use creams, lotions or powder made of it.
The airport health authorities have also been asked to familiarize themselves with symptoms of monkeypox and conduct strict thermal screening and history of travel.
Monkeypox cases have now been reported from the USA, United Kingdom, Belgium, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, Australia, Canada, Austria, Israel and Switzerland, among others. This is in addition to countries such as Cameroon, Central African Republic, Congo, Gabon, Liberia, Nigeria, and Sierra Leone, where the disease is endemic.
