Interim Advisory from NCDC (MoHFW)* in view of Monkeypox cases reported from a few Countries
Key points about the Monkeypox
- Viral zoonotic disease that occurs primarily in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions.
- The clinical presentation resembles that of smallpox, a related orthopoxvirus infection which was declared eradicated worldwide in 1980. Monkeypox is less contagious than smallpox and causes less severe illness.
- Presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications.
- Usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. (Severe cases can occur. Case fatality rate may vary from 1-10%)
- Can be transmitted from Animal to Humans as well as from human to human.
- The virus enters the body through broken skin (even if not visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth).
- Animal-to-human transmission may occur by bite or scratch, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding.
- Human-to-human transmission is thought to occur primarily through large respiratory droplets generally requiring a 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.
- Incubation period is usually 7-14 days but can range from 5-21 days and the person is usually not contagious during this period.
- An infected person may transmit the disease from 1-2 days before appearance of the rash and remain contagious till all the scabs fall off.
Current Scenario: Indian context
- Monkey pox has not been reported in India, but with new cases being detected from various countries chances of this disease occurring in India cannot be ruled out
- The cases that have been reported worldwide are both due to local transmission and also due to travel to African countries.
- As a proactive approach NCDC, MoHFW has identified several public health actions to be initiated in event of suspected cases being reported from India.
Recommended Public Health Actions
- Health facilities to keep heightened suspicion in people who:
- Present with an otherwise unexplained rash and
- Who have travelled, in the last 21 days, to a country that has recently had confirmed or suspected cases of monkeypox or
- Report contact with a person or people with confirmed or suspected monkey pox
- All suspected cases to be isolated at designated healthcare facilities until all lesions have resolved and a fresh layer of skin has formed OR until the treating physician decides to end isolation.
- All such patients to be reported to the District Surveillance Officer of Integrated Disease Surveillance Programme.
- All infection control practices to be followed while treating such patient.
- Laboratory samples consisting of fluid from vesicles, blood, sputum etc. to be sent to NIV Pune for Monkey pox testing in case of suspicion.
- In case a positive case is detected, contact tracing has to be initiated immediately to identify the contacts of the patient in the last 21 days
For more information on Monkeypox and the latest updates, please refer to the National Centre for Disease Control (NCDC) and the Ministry of Health and Family Welfare (MoHFW)* websites.
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