Even one case of monkeypox to be considered an outbreak, says India

• Any person of any age having travel history to affected countries within the last 21 days and developing an unexplained acute rash are suspected to be suffering from monkeypox.
• The patient is advised to isolate themselves in an isolation room of the hospital or at home.
• Airport authorities have also been asked to stay alert and familiarize themselves with the monkeypox symptoms and conduct strict thermal screening.

The Union Health Ministry rolled out guidelines on surveillance, detection and treatment of monkeypox even though India hasn’t reported any cases, as yet.

Any person having a travel history to affected countries within the last 21 days and developing an unexplained acute rash along with any of the symptoms — are suspected to be suffering from monkeypox.

The symptoms to watch out for are — swollen lymph nodes, fever, headache, body aches and profound weakness. An infection can be confirmed only after conducting a PCR test or laboratory test by the ICMR-National Virology, Pune.

If symptoms are observed, the patient is advised to isolate either at a hospital or at home – in a separate room with separate ventilation. Patients are also advised to wear a triple layer mask and cover the skin lesions as much as possible by wearing long sleeves and long pants to minimize contact risk.

The patient should closely monitor for any of the following symptoms during the period of isolation — pain in eye or blurring of vision, shortness of breath or chest pain, difficulty in breathing, altered consciousness or seizure, lethargy. If observed, they should immediately contact a hospital or a doctor.

“Monkeypox is usually a self-limited disease with the symptoms lasting from two to four weeks. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and nature of complications. The extent to which asymptomatic infection occurs is unknown,” said the guidelines report.

Integrated Disease Surveillance Programme (IDSP), which tracks infectious diseases in the country, has been asked to remain alert along with all the healthcare facilities.

“Even one case of monkeypox is to be considered as an outbreak. A detailed investigation by the Rapid Response Teams needs to be initiated through IDSP,” the guidelines said.
Guidelines for travellers
The Health Ministry also advised travellers to avoid close contact with — sick people, including those with skin lesions or genital lesions, dead or live wild animals such as small mammals including rodents (rats, squirrels) and non-human primates (monkeys, apes).

Use of material such as clothing, bedding, or materials used in healthcare settings used by the contaminated patients should be strictly avoided.

Travellers should also avoid eating or preparing meat from wild game (bushmeat) or using products derived from wild animals from Africa (creams, lotions, powders).

Airport authorities have also been asked to stay alert and familiarize themselves with the monkeypox symptoms and conduct strict thermal screening, especially of those people who have a traveler history to affected countries in the last 21 days.

Monkeypox cases have so far been reported in the USA, UK, Belgium, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, Australia, Canada, Austria, Canary Islands, Israel and Switzerland.

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