The Union health ministry’s Integrated Disease Surveillance Programme has sent a health advisory to the states, directing them to alert hospitals to quickly identify and isolate cases of monkeypox, a rare viral disease that has surfaced in some non-endemic countries.
A two-page advisory issued on May 21, accessed by Moneycontrol, said health facilities should keep a lookout for people who complain of an unexplained rash and have travelled in the last 21 days to a country that has recently had confirmed or suspected cases of monkeypox.
All suspected monkeypox patients should be isolated at designated healthcare facilities until all lesions have subsided and a fresh layer of skin formed, the advisory said.
All such cases are required to be reported to the district officer of the Integrated Disease Surveillance Programme.
Monkeypox, a viral infection largely limited to some countries in west and central Africa, has been reported from at least 12 countries in Europe and North America as well as Australia. Nearly 100 cases have been confirmed.
The disease is characterised by skin lesions, fever and muscle ache and the World Health Organisation says it has a fatality rate of 1-10 percent.
The communique by the Centre to the states said the disease can be transmitted from animals to humans as well as humans to humans.
Also read: Explained I Why India should worry as monkeypox clusters emerge in Europe and the disease reaches North America
The virus enters the body through broken skin, respiratory tract, or mucous membranes in the eyes, nose and mouth.
Contact tracing
The advisory sent by the Integrated Disease Surveillance Programme said that laboratory samples consisting of fluid from vesicles, blood and sputum should be sent to the National Institute of Virology (NIV), Pune, for monkeypox 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,” it said, and added that all infection control practices should be followed while handling suspected cases.
Officials at NIV, under the Indian Council of Medical Research, said that they are prepared to examine samples from any suspected monkeypox cases which will be handled at India’s only biosafety level 4 (BSL4) facility but added that they had not received any samples so far.
Major spread unlikely
Some biologists say India may struggle initially to quickly deal with monkeypox cases, given the lack of a sufficient number of polymerase chain reaction (PCR) test facilities needed to detect it and lack of awareness among physicians.
Even so, experts downplayed the potential for a large-scale outbreak of monkeypox.
“In the countries where the disease has been reported recently, the cases are limited and not widely spreading among people which means that the reproductive value (the rate at which a disease spreads from one person to others) is fairly low and that’s a relieving sign,” said Dr R R Gangakhedkar, former chief epidemiologist with the ICMR.
He also pointed out that as the disease is marked by a very distinct skin rash, among other symptoms, it is easy to identify and isolate patients.
“We are yet to fully understand its transmission dynamics but initial information suggests that respiratory route does not play a significant role in the disease’s spread,” he said. “Also, the cases, unlike COVID-19, are not rapidly growing in countries whether the cases have been confirmed.”
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