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Friday, February 3, 2023

Threat of Monkeypox looms large in Kerala: Dr Purohit

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Threat of monkeypox looms large as health authorities of Kerala have reported India’s second positive case of monkeypox in Kannur, Dr Naresh Purohit, visiting Professor at the Thrissur-based Kerala University of Health Sciences, said on Tuesday.

The first case in the country was recorded in the state’s Kollam on July 14, after a man who arrived from the UAE tested positive.

Voicing his concern on this issue noted Epidemiologist Dr Purohit told UNl that monkeypox is a largely self-limiting disease which means it will resolve itself on its own, and will leave no long-term harmful effects on a patient’s health.

Most children and adults with healthy immune systems will not, even if they are infected, come down with severe illness.

Dr Purohit, who is also Advisor for National Communicable Disease Control Programme, averred that since early May, monkeypox has been spreading rapidly around the world, mainly among gay and bisexual men, who often present with rashes in the genital and anal area that medics may confuse with herpes or syphilis.

According to WHO a multi-country outbreak is currently underway, including in places where the disease has not been typically found before — in Europe, the Americas, Africa, the Western Pacific, and countries of the Eastern Mediterranean.

Even in those parts of Africa where cases have been previously reported — Nigeria, Democratic Republic of the Congo, Central African Republic — the incidence of infection in 2022 has been higher than usual.

The renowned physician revealed that “the smallpox vaccine, with which older Indians have been immunised over the past decades, works against monkeypox, and provides long-lasting immunity. Smallpox was eradicated in India in 1977.”

He cautioned that the high risk group comprises children, pregnant women and immune- compromised patients, including those who have diabetes. They can have more severe consequences compared to others.

He pointed that human-to-human transmission is known to occur primarily through large respiratory droplets. As such, transmission generally requires prolonged close contact with an infected individual.

He said that monkeypox can also be transmitted through direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linen.

“However, monkeypox is primarily a zoonosis, that is, a disease that is transmitted from infected animals to humans. Animal-to-human transmission is the primary way in which the disease has spread in Africa, but the conditions for such transmission would be rare in India.” he added

According to Health Ministry, Government of India , animal-to-human transmission can happen through the bite or scratch of infected animals like small mammals including rodents — rats, squirrels and non-human primates like monkeys and apes, or through bush meat preparation.

He stated that the monkeypox virus is an orthopoxvirus, which is a genus of viruses that also includes the variola virus, which causes smallpox, and vaccinia virus, which was used in the smallpox vaccine.

He pointed that monkeypox causes symptoms similar to smallpox, although they are less severe.

“Symptoms last between two and four weeks. During the first, prodrome phase (0-5 days), patients can experience one of five symptoms: fever; headache, muscle aches; exhaustion; chills and/ or sweats; and sore throat and cough” he added.

He stated that the patients experience rashes: this usually begins within 1-3 days of the onset of fever, and lasts for around 2-4 weeks. “Lesions are often described as painful until the healing phase when they become itchy,” he added

He pointed that the case fatality ratio of monkeypox has historically ranged from 0 to 11% in the general population and has been higher among young children.

He averred that there is no proven treatment for monkeypox yet. The WHO recommends supportive treatment depending on the symptoms. Those infected are advised to isolate immediately.

According to the Ministry of Health guidelines on supportive management of monkeypox, skin rashes should be cleaned with simple antiseptic, and covered with light dressing in case of extensive lesions. Oral ulcers should be managed with warm saline gargles.

Infectious disease expert urged individuals to not panic and most importantly, not confuse monkeypox with another common viral infection.

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