To enhance surveillance and prevention of monkeypox, the Department of Preventive Health, Ministry of Health, has issued Document 551/DP-DT to the Institutes of Hygiene and Epidemiology, Pasteur; and the Departments of Health of provinces and centrally-run cities.
Forecast of Increasing Monkeypox Cases
According to the WHO, during the recent outbreak of monkeypox, since the first case was detected in the UK on May 13, 2022, by May 25, 2022, over 158 cases had been reported worldwide, with 117 suspected cases across 19 countries, and no fatalities recorded.
All detected cases had no travel history from endemic regions, and the countries reporting cases had never previously reported monkeypox outbreaks.
Test sample container for monkeypox virus. (Photo: Reuters)
The identified cases were confirmed to be infected with the West African strain of the monkeypox virus, which shares characteristics with the monkeypox virus that spread from Nigeria to several countries in 2018 and 2019.
WHO predicts that the number of monkeypox cases will continue to rise in the coming period.
Monkeypox was first identified in monkeys in 1958, with the first human case recorded in 1970 in the Democratic Republic of the Congo.
“The disease can be transmitted from person to person through close contact, via wounds, bodily fluids, respiratory droplets, and contact with contaminated items. It tends to be more severe in children, pregnant women, or immunocompromised individuals,” stated the WHO.
The incubation period ranges from 5 to 21 days (usually from 6 to 13 days). Monkeypox symptoms are similar to those of smallpox, but often involve widespread skin lesions and swollen lymph nodes.
Identifying Monkeypox Infection
According to the World Health Organization, the definition of monkeypox cases is as follows:
A suspected case is defined as a person of any age living in a country without monkeypox, who has an acute rash of unknown origin and has one or more of the following signs or symptoms since March 15, 2022: headache, fever (> 38.5oC), lymphadenopathy (swollen lymph nodes), muscle pain, back pain, weakness.
A possible case is a suspected case that has one or more epidemiological factors such as: Direct contact with an infected person; direct physical contact with skin or skin lesions, including sexual contact; contact with contaminated items such as clothing, bedding, or personal items of a confirmed or suspected monkeypox case within 21 days before symptom onset; travel history to countries with monkeypox outbreaks within 21 days prior to symptom onset; having multiple sexual partners within 21 days before symptoms appeared; positive serological test for orthopoxvirus (if not vaccinated against smallpox or not previously exposed to known orthopoxvirus strains); exhibiting symptoms severe enough to require hospitalization.
A confirmed case is a suspected or possible case with a positive Realtime PCR test for the monkeypox virus.
A excluded case is a suspected case with a negative Realtime PCR test for the monkeypox virus.
According to WHO recommendations, all suspected monkeypox cases must be investigated, and if confirmed, they should be isolated until their skin lesions have dried, crusted, and healed completely.
Temporary Prevention and Control Measures
To promptly implement measures to limit the number of cases and deaths, the Department of Preventive Health recommends that health departments focus on enhancing surveillance for suspected cases at border checkpoints, especially for individuals returning from countries with ongoing monkeypox outbreaks (Benin, Cameroon, Central African Republic, Democratic Republic of the Congo, Gabon, Ghana, Ivory Coast, Liberia, Nigeria, Republic of the Congo, Sierra Leone, and South Sudan).
Healthcare facilities should intensify surveillance for suspected cases of monkeypox (as defined by WHO). Upon detection, they should immediately report to the Department of Health to coordinate with the Institutes of Hygiene and Epidemiology, Pasteur for diagnosis and confirmation of cases.
Additionally, public communication should be organized to raise awareness among the population about the monkeypox situation and temporary prevention measures such as:
- Avoid close contact with individuals infected with monkeypox
- Avoid direct contact with wounds, bodily fluids, respiratory droplets, and contaminated items
- Regularly wash hands with soap and standard disinfectants; cover the mouth when coughing or sneezing
Individuals exhibiting symptoms of suspected cases should proactively contact healthcare facilities for timely monitoring and advice.
Those with symptoms of suspected cases should self-isolate and avoid sexual contact; confirmed cases must be medically isolated until fully recovered.
Individuals traveling to countries with monkeypox outbreaks should avoid contact with infected mammals such as rodents, marsupials, and primates (dead or alive) that may harbor the monkeypox virus, and should not consume or handle wild animals, nor eat undercooked meat or products from infected animals.
The Institutes of Hygiene and Epidemiology, Pasteur: are to direct, guide, and support localities in monitoring, surveillance, and management of monkeypox cases.
They should also proactively coordinate with WHO, the U.S. Centers for Disease Control and Prevention (US CDC), and other international organizations to update information on surveillance, case investigation, diagnostic techniques, and propose support for necessary supplies for monitoring and confirming monkeypox cases.
