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In the wake of the rising cases of Monkeypox in the country, Union Health
Ministry released guidelines to prevent the spread of Monkeypox disease.
What is Monkeypox?
Monkeypox (MPX) is a viral zoonotic disease with symptoms similar to smallpox,
although with less clinical severity. MPX was first discovered in 1958 in
colonies of monkeys kept for research, hence the name 'Monkeypox.'
The first human case of Monkeypox was reported in the Democratic Republic of the
Congo (DRC) in 1970. The Monkeypox Virus primarily occurs in Central and West
Africa. In 2003, the first Monkeypox outbreak outside of Africa was reported in
the United States of America, which 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.
Monkeypox is usually a self-limited disease with symptoms lasting from 2 to 4
weeks. Severe cases occur more commonly among children and are related to the
extent of virus exposure, patient health status and nature of complications.
Mode of Transmission
Human-to-human transmission is known to occur primarily through large
respiratory droplets generally requiring prolonged close contact. It can also be
transmitted through direct contact with body fluids or lesion material, and
indirect contact with lesion material, such as through contaminated clothing or
linens of an infected person.
Animal-to-human transmission may occur by a bite or scratch of infected animals
like small mammals including rodents (rats, squirrels) and non-human primates
(monkeys, apes) or through bush meat preparation.
Suspected case
A person of any age having history of travel to affected countries within the
last 21 days presenting with an unexplained acute rash and one or more of the
following signs or symptoms
- Swollen lymph nodes
- Fever
- Headache
- Body aches
- Profound weakness
Common symptoms and signs
Prodrome (0-5 days)
a. Fever
b. Lymphadenopathy
Typically occurs with fever onset
Periauricular, axillary, cervical or inguinal
Unilateral or bilateral
c. Headache, muscle aches, exhaustion
d. Chills and/or sweats
e. Sore throat and cough
Skin involvement (rash)
a. Usually begins within 1-3 days of fever onset, lasting for around 2-4 weeks
b. Deep-seated, well-circumscribed and often develop umbilication
c. Lesions are often described as painful until the healing phase when they
become itchy (in the crust stage)
The Ministry further laid down guidelines for proper monitoring of those
who came in contact with the infected person.
a) Contacts should be monitored at least daily for the onset of signs/symptoms
for a period of 21 days (as per case definition above) from the last contact
with a patient or their contaminated materials during the infectious period. In
case of occurrence of fever clinical/lab evaluation is warranted.
b) Asymptomatic contacts should not donate blood, cells, tissue, organs or semen
while they are under surveillance.
c) Pre-school children may be excluded from day care, nursery, or other group
settings.
d) Health workers who have unprotected exposures to patients with monkeypox or
possibly contaminated materials do not need to be excluded from work duty if
asymptomatic, but should undergo active surveillance for symptoms for 21 days.
Measures to prevent infection with monkeypox virus
1. Avoid contact with any materials, such as bedding, that has been in contact
with a sick person.
2. Isolate infected patients from others.
3. 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.
4. Use appropriate personal protective equipment (PPE) when caring for patients.
5. Surveillance and rapid identification of new cases is critical for outbreak
containment. During human Monkeypox outbreaks, close contact with infected
persons is the most significant risk factor for monkeypox virus infection.
Health workers and household members are at a greater risk of infection.
6. Health workers caring for patients with suspected or confirmed monkeypox
virus infection, or handling specimens from them, should implement standard
infection control precautions. Samples taken from people and animals with
suspected monkeypox virus infection should be handled by trained staff working
in suitably equipped laboratories. Patient specimens must be safely prepared for
transport with triple packaging in accordance with WHO guidance for transport of
infectious substances.
Infection Prevention and Control (IPC)
A combination of standard, contact, and droplet precautions should be applied in
all healthcare settings when a patient presents with fever and
vesicular/pustular rash. In addition, because of the theoretical risk of
airborne transmission of Monkeypox virus, airborne precautions should be applied
as per risk assessment.
In the wake of the rising cases of Monkeypox in the country, Union Health
Minister Mansukh Mandaviya on Tuesday assured citizens not to panic and said
that an awareness campaign is being run in collaboration with the state
governments to prevent the spread of the infection.
Speaking in Rajya Sabha on Tuesday during the ongoing Monsoon session of the
Parliament, the Union Minister said, "There is no need to be afraid of
Monkeypox, an awareness campaign is being run in collaboration with the state
governments: Public awareness is very necessary in the context of Monkeypox. We
have also formed a task force under the chairmanship of a member of NITI Aayog
on behalf of the Government of India."
"On the basis of the observations of the task force, we will assess and study
the further action to be taken. If the state government of Kerala needs any kind
of help from the Central government, it will be given. Also, an expert team of
the Central government is guiding the state government from time to time," he
said.
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