As monkeypox cases increase, Centre holds meeting of experts

New Delhi, August 4

A meeting of top health experts called by the Centre on the need for revisiting existing guidelines on management of monkeypox is under way here on Thursday amid rising number of cases of the disease in the country. 

India has so far reported nine cases of monkeypox including one death.

“This is a technical meeting to revisit the existing guidelines,” an official said.

The meeting is being chaired by L Swasticharan, director of Emergency Medical Relief, and is being attended by officials from the National AIDS Control Organisation, National Centre for Disease Control and World Health Organisation (WHO) representatives.             

According to existing ‘Guidelines on Management of Monkeypox Disease’ issued by the Centre, any person having a history of travel to affected countries within the last 21 days presenting with an unexplained acute rash and symptoms like swollen lymph nodes, fever, headaches, body aches and profound weakness is to be considered to be a ‘suspected case’.

A ‘probable case’ has to be a person meeting the case definition for a suspected case, clinically compatible illness and has an epidemiological link like face-to-face exposure, including health care workers without appropriate PPE, direct physical contact with skin or skin lesions, including sexual contact, or contact with contaminated material such as clothing, bedding or utensils.

A case is considered laboratory confirmed for monkeypox virus by detection of unique sequences of viral DNA either by polymerase chain reaction (PCR) and/or sequencing. 

Defining contacts, the guidelines stated that a contact is defined as a person who, in the period beginning with the onset of the source case’s first symptoms, and ending when all scabs have fallen off, has had one or more of the exposures–  face-to-face exposure, direct physical contact, including sexual contact, contact with contaminated materials such as clothing or bedding —  with a probable or confirmed case of monkeypox.

Cases can be prompted to identify contacts across household, workplace, school/nursery, sexual contacts, health care, houses of worship, transportation, sports, social gatherings, and any other recalled interactions.

Contacts should be monitored at least daily for the onset of signs/symptoms for a period of 21 days from the last contact with a patient or their contaminated material during the infection period. In case of occurrence of fever clinical/lab evaluation is warranted.

Asymptomatic contacts should not donate blood, cells, tissue, organs or semen while they are under surveillance.

Pre-school children may be excluded from day care, nursery, or other group settings.

The ministry guidelines state that human-to-human transmission occurs primarily through large respiratory droplets generally requiring prolonged close contact.

It can also be transmitted through direct contact with body fluids or lesions, and indirect contact with lesion material such as through contaminated clothing or linen of an infected person. Animal-to-human transmission may occur by bite or scratch of infected animals or through bushmeat preparation.