21-day surveillance of asymptomatic arrivals from monkeypox-reporting nations

Tribune News Service

Tribune News Service

New Delhi, May 31

With monkeypox cases rising in non-endemic nations, the government on Tuesday issued guidelines to states and UTs for case management asking for asymptomatic arrivals from countries reporting the disease to be observed for 21 days for the development of any potential symptoms. The disease presents itself between six and 21 days.

Samples from symptomatic cases would need to be collected upon arrival and sent to apex lab ICMR- National Institute of Virology Pune for confirmation. India has no reported case of monkeypox so far. The government has, however, asked states to maintain caution and prepare ahead.

WHO has confirmed transmission of monkeypox in non-endemic Europe with no epidemiological links to West or Central Africa where monkeypox is usually found.

Cases are being reported in endemic Cameroon, Central African Republic, Cote d’Ivoire, Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, and Sierra Leone and also non-endemic USA, UK Belgium, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, Australia, Canada, Austria, Canary Islands, Israel and Switzerland.

“Asymptomatic travellers from outbreak, endemic or community transmission region be observed for the development of any signs and symptoms for 21 days post exposure. If signs and symptoms develop, collect specimens,” guidelines to states and UTs say.

A suspected case has been defined as a person of any age having a history of travel to affected countries within the last 21 days presenting with an unexplained acute rash and one or more of the following symptoms — swollen lymph nodes, fever, headache, body aches, profound weakness.

Probable case is a person meeting the case definition for a suspected case, and one who has face-to-face exposure, including healthcare workers without appropriate personal protective equipment; direct physical contact with skin or skin lesions, including sexual contact; or contact with contaminated materials such as clothing, bedding or utensils is suggestive of a strong epidemiological link.

A confirmed case is laboratory confirmed for monkeypox virus by detection of unique sequences of viral DNA either by polymerase chain reaction or sequencing.

Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks.

Severe cases occur more commonly among children. In recent times, the case fatality ratio has been around 3 to 6 pc, guidelines said asking people to avoid contact with any material of the sick person.

About Monkeypox

Monkeypox (MPX) is a viral zoonotic disease with symptoms similar to smallpox, although with less clinical severity. Monkeypox virus primarily occurs in Central and West Africa. In 2003, the first monkeypox outbreak outside of Africa was reported in the US which was linked to contact with infected pet prairie dogs. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country from Ghana. The disease is managed and has no specific treatment.