High alert as Delhi reports monkeypox

India’s fourth case has no history of foreign travel

July 24, 2022 11:49 am | Updated July 28, 2022 02:19 pm IST - New Delhi

Photo used for representation purpose only.

Photo used for representation purpose only. | Photo Credit: Reuters

Delhi confirmed its first case of monkeypox on July 24, 2022, a day after it was declared a Public Health Emergency of International Concern by the World Health Organisation.

The Health Ministry confirmed that a 34-year-old male resident of Delhi was isolated at Lok Nayak Hospital as a suspected case of monkeypox.

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“A confirmation of the diagnosis has been done by National Institute of Virology (NIV), Pune. The case is presently recovering at the designated isolation centre at Lok Nayak Hospital,” the Ministry said.

The close contacts of the case have been identified and they are under quarantine in accordance with the guidelines of the Ministry of Health and Family Welfare (MoHFW). Further public health interventions such as the identification of the source of the infection, enhanced contact tracing, testing sensitisation of private practitioners, etc., are being carried out.

The patient has no travel history and was admitted some days ago with fever and skin lesions.

A high-level review meeting of the situation was organised by Director General of Health Services (DGHS) on Sunday. Following the meeting, the National Centre for Disease Control (NCDC) has been directed to carry out a detailed epidemiological investigation of the positive cases while the National AIDS Control Organisation (NACO) has been instructed to create awareness on preventive measures against the virus.

Health facilities have been told to look for patients with unexplained rash and a history of travel in the last 21 days to a country that has recently confirmed cases of, or has suspected cases of, monkeypox.

Additionally, the ‘Guidelines on Management of Monkeypox Disease’ issued by the Centre states the transmission of the monkeypox virus happens primarily through large respiratory droplets, generally requiring prolonged close contact.

The incubation period of the virus is usually from six to 13 days and symptoms include lesions, which usually begin to appear 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.

Delhi Chief Minister Arvind Kejriwal tweeted that the first case of monkeypox has been detected in Delhi. The patient is stable and recovering.

“There’s no need to panic. The situation is under control. We have made a separate isolation ward at LNJP [Lok Nayak Jai Prakash Narayan Hospital]. Our best team is on the case to prevent the spread and protect Delhiites,” Mr. Kejriwal said.

Meanwhile the World Health Organization (WHO) on Sunday called on countries in South-East Asia Region to strengthen surveillance and public health measures for monkeypox, with the disease being declared a public health emergency of international concern.

“Monkeypox has been spreading rapidly and to many countries that have not seen it before, which is a matter of great concern. However, with cases concentrated among men who have sex with men, it is possible to curtail further spread of the disease with focused efforts among at-risk population,” Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region, said.

Globally, over 16,000 cases of monkeypox have been reported from 75 countries. In the WHO South-East Asia Region, four cases of monkeypox have been reported, three from India and one from Thailand. The cases in India are among nationals who returned home from the Middle East, while in Thailand, a foreign national living in the country has tested positive for monkeypox.

Watch | What is the monkeypox virus?

The Regional Director said, “Importantly, our focused efforts and measures should be sensitive, devoid of stigma or discrimination.”

The decision to term monkeypox a public health emergency of international concern (PHEIC) was announced by Tedros Ghebreyesus, Director-General, WHO, on July 23, 2022, a day after he convened yet another meeting of the International Health Regulations (IHR) emergency committee to review the multi-country outbreak.

“Though the risk of monkeypox globally and in the region is moderate, the potential of its further international spread is real. Also, there are still many unknowns about the virus. We need to stay alert and prepared to roll out intense response to curtail further spread of monkeypox,” Dr. Khetrapal Singh said.

Since the start of the outbreak, the WHO has been supporting countries in assessing risk, and initiating public health measures, while also building and facilitating testing capacities in the region.

Engaging and protecting the affected communities; intensifying surveillance and public health measures; strengthening clinical management and infection prevention and control in hospitals and clinics; and accelerating research into the use of vaccines, therapeutics and other tools, are among the key measures that need to be scaled-up, the Regional Director said.

Monkeypox virus is transmitted from infected animals to humans via indirect or direct contact. Human-to-human transmission can occur through direct contact with infectious skin or lesions, including face-to-face, skin-to-skin, and via respiratory droplets. In the current outbreak across countries and amongst the reported monkeypox cases, transmission appears to be occurring primarily through close physical contact, including sexual contact. Transmission can also occur from contaminated materials such as linen, bedding, electronics, and clothing that have infectious skin particles.

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