Mpox has finally infiltrated India, but how worried should we be about the viral disease?

Having been declared a global health emergency by WHO just a few weeks ago, the dreaded Mpox (formerly monkeypox) has slowly been closing in on India. And now, days after our neighbour Pakistan confirmed its second Mpox case this month, India has also reported its first one this season. While feeling uncertain is understandable, the situation is far from dire just yet.

On Monday, September 9, 2024, the Health Ministry confirmed that a previously suspected case of Mpox was a travel-related infection. The patient, a young male, recently returned from a country experiencing ongoing Mpox transmission. Laboratory tests confirmed the presence of the West African clade 2 of the Mpox virus, which is distinct from the more dangerous clade 1 currently under a public health emergency.

In its statement, the Ministry emphasised that this case is isolated and in line with the 30 previous Mpox cases reported in India since July 2022. The Ministry clarified that this case does not contribute to the WHO-declared public health emergency associated with clade 1 of Mpox, which has spread primarily in parts of Africa.

Patient condition and response measures

The infected individual is isolated at a designated tertiary care isolation facility. The Ministry reports that the patient is clinically stable, with no systemic illness or pre-existing conditions. Public health authorities have initiated contact tracing and monitoring to ensure the infection remains contained, stating that no widespread public health risk exists at this time.

Mode of transmission and symptoms

The global Mpox outbreak has primarily affected young males, with a median age of 34. The main mode of transmission has been sexual contact, followed by non-sexual person-to-person contact. The most commonly reported symptom is a rash, which can manifest either systemically or in the genital region, followed by fever.

WHO data shared by the Ministry indicates that approximately 51.9% of Mpox cases involve individuals living with HIV. This underscores the need for targeted healthcare and awareness, especially in high-risk populations.

Increased vigilance and preparedness

Following the confirmation of this case, the Health Ministry has issued directives to all states and union territories, urging healthcare workers, particularly those in skin/STD clinics and NACO (National AIDS Control Organisation) clinics, to stay alert to the signs and symptoms of Mpox. These clinics must be prepared for immediate isolation, clinical management, and treatment of complications, adhering to established protocols.

The Ministry has also advised enhanced screening and testing of suspected Mpox cases, especially at airports and other points of entry, to prevent further transmission.

Awareness and risk communication

The Ministry has issued guidelines to state AIDS control societies, urging them to be vigilant in identifying suspect cases, especially among vulnerable populations such as female sex workers (FSW) and men who have sex with men (MSM). Communities must be made aware of the disease’s transmission and symptoms, as well as the importance of timely reporting.

Clear risk communication, particularly to healthcare workers and intervention sites such as skin and paediatric clinics, is crucial to prevent the spread of the virus. While the Ministry advocates for robust preventive measures, it also stresses the importance of avoiding undue panic among the general public.

For now, the Ministry’s actions aim to ensure that India remains well-prepared to handle isolated Mpox cases, while working to prevent any major outbreak in the country.