Transmission occurs through large respiratory droplets
Irfan Tramboo
SRINAGAR, May 22: While the cases of Monkeypox, a zoonotic virus, are reported across Europe and a few other countries around the globe, the J&K Health Authorities today issued necessary advisory even as the SOPs, too, have been issued for handling of the suspected cases.
In a letter which has been written to all Chief Medical Officers of Jammu division by Dr. Harjeet Rai Epidemiologist/SSO IDSP Jammu, it has been stated that there has been a recent outbreak of Monkeypox cases in Europe as well as in United States and Australia.
“This is a Zoonotic disease, first identified in monkeys and it is also spread by rodents. The clinical presentation of Monkeypox resembles that of Smallpox,” reads the advisory, adding that on May 20, 2022, the Ministry of Health & Family Welfare (MoHFW) GoI issued an interim Health Advisory regarding the Monkeypox.
“This office has prepared a Powerpoint presentation in detail on the subject. You are requested to kindly disseminate the advisory among all health care workers of your district for their sensitization and further necessary action,” the letter said.
The key points about the disease, the advisory stated, include that Monkeypox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions.
The communication said that the Monkeypox typically presents clinically with fever, rash, and swollen lymph nodes and may lead to a range of medical complications it is 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%.
“Monkeypox can be transmitted from Animal to human as well as human to human. The virus enters the body through broken skin (even if not visible), respiratory tract, or mucous membranes (eyes, nose, or mouth). animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding,” the letter stated.
The Health Department in Kashmir, however, has not issued such an advisory for Kashmir Division and said that they are also going to issue a similar advisory soon so that an effective response is ensured in case of any suspected case.
On the transmission, the advisory said that the Human-to-human transmission is thought to occur primarily through large respiratory droplets generally requiring a prolonged close contact “and 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.”
Similarly, it said, the clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection that was declared eradicated worldwide in 1980.
Regarding the incubation period, it said that the same is usually 7-14 days but can range from 5-21 days and the person is usually not contagious during this period “and an infected person may transmit the disease from 1-2 days before the appearance of the rash and remain contagious till all the scabs fall off.”
The recommended public health actions, advisory underlined, include that health facilities to keep heightened suspicion in people who present with an otherwise unexplained rash and who have traveled, 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 monkeypox.
“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 and all such patients to be reported to the District Surveillance Officer of Integrated Disease Surveillance Programme,”
It directed that all infection control practices be followed while treating such patients, laboratory samples consisting of fluid from vesicles, blood, sputum, etc to be sent to NIV Pune for Monkeypox testing in case of suspicion and 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.
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