The risk of Monkeypox declaring itself arrived in Kashmir must not be higher than other parts of the country. We are but a small place, with a decent healthcare infrastructure. However, what escalates our concerns for any outbreak is the high inflow of people from across India and many parts of the World.
In times like this, when pandemics and disease outbreaks of unknown, unheard of nature seem unrelenting, surveillance is the only way to delay and slow down spread.
What is Monkeypox?
Monkeypox was almost unheard of outside some endemic nations in African region till April this year. It is a Viral disease that spreads from person to person by close contact.
It is spread through contact to lesions caused by the Virus in the infected person and body fluids, respiratory droplets and contaminated clothes, masks, bedding and other surfaces. A person infected with Monkeypox May develop fever, rashes, swollen lymph nodes and may require hospitalization.
The symptoms usually last two weeks and can continue upto a month. Though the disease is usually mild and even milder than smallpox, which it resembles in presentation, it can also cause death. The mortality of Monkeypox is around 5 percent, and may vary from country to country.
“The incubation period of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.” As per the research data, the disease caused by the Monkeypox Virus may be severe in “children, pregnant women or persons with immune suppression due to other health conditions' ', like other viral infections. .
The status: Global
The World Health Organization has said that Monkeypox cases have been confirmed from 92 laboratories in 12 countries that have not been endemic to the Viral disease in the past. Portugal, the United Kingdom and Spain have confirmed more cases than other countries in the region. Cases have been confirmed as far as Australia.
“The identification of confirmed and suspected cases of monkeypox with no direct travel links to an endemic area represents a highly unusual event,” the WHO said on Monday. It said that cases without any travel history to endemic countries being reported from a growing list of countries was a concern and needed immediate steps.
It said that there has been no surveillance in the non-endemic areas but with the changing scenario has and must start. “WHO expects that more cases in non-endemic areas will be reported. Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic.”
No cases of Monkeypox have been confirmed in India till date. The Ministry of Health and Family Welfare recently directed states and Union territories to start some form of surveillance and watch out for symptoms associated with monkeypox.
The advisory also mentioned a link with history of travelling to the affected countries, although the travel connection is yet to be established. The states and UTs have also been directed to identify isolation facilities and quarantine the suspected cases. “The isolation period must extend upto the time the lesions have resolved and a fresh layer of skin has formed”.
The suspected cases are to be sent to National Institute of Virology (NIV) for confirmation through Genome Sequencing.
Jammu and Kashmir
A recent letter from Directorate of Health Services Jammu (DHSJ) to Healthcare administrators in the region reads “Monkeypox has not been reported in India, but with new cases being detected from various countries chances of this disease occurring in India cannot be ruled out.” Rightly, the cases that have been reported worldwide are both due to local transmission and also due to travel to African countries, it reads.
The advisory from DHSJ reads that "Incubation period is usually 7-14 days but can range from 5-21 days and the person is usually not contagious during this period and an infected person may transmit the disease from 1-2 days before appearance of the rash and remain contagious till all the scabs fall off.
This is where the actual problem starts. Even before one knows, one can spread or contract infection. What can be done in such a scenario?
Do not Panic!
While the disease seems relatively new, it has affected many countries in Africa for decades now. Its severity is stated to be lesser than that of smallpox, which it resembles. Virology, Epidemiology and other experts have been quoted by the media advising people not to panic.
At the same time, many countries have started mulling inoculation of high-risk groups with smallpox vaccine, which is thought to offer some degree of protection against the Monkeypox Virus. The WHO has also said tat people younger than 50 years, who may not have received small pox vaccine, may be at a higher risk.
The recent Pandemic of COVID19 has shown how Public Health Measures can help reduce and mitigate risks of infection spread. Masks, social distancing and ‘going out only if necessary’ are some of the habits that seem to be cardinal and must be incorporated as part of lives. Close contact with people must be avoided.
Despite these, the possibility of an outbreak of Monkeypox Virus cannot be ruled out and J&K must up its guard and surveillance and preparedness. The COVID19 is yet to be over and another healthcare emergency seems to be taking shape. May this be a false alarm, healthcare providers pray.