The monekypox is a highly transmittable disease and anyone can catch the virus if one had prolonged or repeated contact with an infected person. The first and foremost protocol the Ministry has advised is isolation of the infected person from others so that the disease does not spread. The Ministry has also advised use of hand sanitisers, or washing hands with soap and water, covering mouth with masks and hands with disposable gloves when close to a patient, and using disinfectants to sanitise the environment around.
To prevent the spread, the Ministry has advised people to avoid sharing linen, beddings, clothes, towels, among others, with people who have tested positive for the infection. The Ministry advised not to wash soiled linen or laundry of patients and those of non-infected persons together, and avoid public events even if you only exhibit symptoms of the disease.
“Do not stigmatise people who have contracted the virus, and suspected patients as well. Also, do not believe any rumour or misinformation,” the Ministry advisory said.
The ‘Guidelines on Management of Monkeypox Disease’ issued by the Centre stated that any person of any age having a history of travel to affected countries within the last 21 days presenting with an unexplained acute rash and symptoms like swollen lymph nodes, fever, headaches, body aches and profound weakness is to be considered a ‘suspected case’.
A ‘probable case’ has to be a person meeting the case definition for a suspected case, clinically compatible illness and has an epidemiological link like face-to-face exposure, including healthcare workers without appropriate PPE, direct physical contact with skin or skin lesions, including sexual contact, or contact with contaminated materials such as clothing, bedding or utensils, is suggestive of a strong epidemiological link.
A case is considered laboratory confirmed for monkeypox virus (by detection of unique sequences of viral DNA either by polymerase chain reaction or PCR and/or sequencing).
Defining contacts, the guidelines stated that a contact is defined as a person who, in the period beginning with the onset of the source case’s first symptoms, and ending when all scabs have fallen off, has had one or more of the exposures — face-to-face exposure, direct physical contact, including sexual contact, contact with contaminated materials such as clothing or bedding — with a probable or confirmed case of monkey pox.
Cases can be prompted to identify contacts across household, workplace, school/nursery, sexual contacts, healthcare, houses of worship, transportation, sports, social gatherings, and any other recalled interactions.
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.
Asymptomatic contacts should not donate blood, cells, tissue, organs or semen while they are under surveillance. Pre-school children may be excluded from day care, nursery, or other group settings.
Meanwhile, a task force on monkeypox has been constituted to closely monitor the emerging situation in the country and decide on response initiatives to tackle the spread of the disease.
It will also provide guidance to the government on expansion of diagnostic facilities in the country and explore emerging trends related to vaccination for the disease.
The health ministry guidelines stated that human-to-human transmission occurs primarily through large respiratory droplets generally requiring prolonged close contact. It can also be transmitted through direct contact with body fluids or lesions, and indirect contact with lesion material such as through contaminated clothing or linen of an infected person. Animal-to-human transmission may occur by bite or scratch of infected animals or through bushmeat preparation.
The incubation period is usually from six to 13 days and the case fatality rate of monkeypox has historically ranged up to 11 per cent in the general population and higher among children. In recent times, the case fatality rate has been around 3 to 6 per cent.
The symptoms include lesions which usually begin within one to three days from the onset of fever, lasting for around two to four weeks and are often described as painful until the healing phase when they become itchy.
A notable predilection for palm and soles is characteristic of monkeypox, the guidelines stated. The World Health Organisation (WHO) had recently declared monkeypox a global public health emergency of international concern.
According to WHO, monkeypox is a viral zoonosis — a virus transmitted to humans from animals — with symptoms similar to smallpox although clinically less severe.
Monkeypox typically manifests itself with fever, rash and swollen lymph nodes and may lead to a range of medical complications. It is usually a self-limited disease with symptoms lasting for two to four weeks.
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