A woman holds mock-up vials labeled “monkeypox vaccine” in an illustration taken, May 25, 2022.
Image Credit: REUTERS

Budapest/Berlin: Hungary and Norway on Tuesday confirmed its first cases of monkeypox.

The patient in Hungary is a 38-year-old man and health authorities are still investigating whether he travelled abroad recently. Norway’s infected person had recently travelled abroad, and the case is linked to the ongoing outbreak in Europe, the Institute of Public Health (FHI) said on Tuesday.

Meanwhile, the World Health Organisation said it is not clear yet whether the spread of monkeypox can be contained completely, adding that its goal was to contain the outbreak by stopping human-to-human transmission to the maximum extent possible.

“Tools to manage it “ including readily available diagnostics, vaccines and therapeutics “ are not likely to be immediately or widely accessible to countries,” it said in a statement.

Over 20 countries where monkeypox is not endemic have reported outbreaks of the viral disease, with more than 300 confirmed or suspected infections mostly in Europe.In view of the increasing reports of monkeypox cases in non-endemic countries, India’s federal Health Ministry issued ‘Guidelines on Management of Monkeypox Disease’ to ensure advance preparedness across the country.

“There are no reported cases of monkeypox disease in India, as of date,” the Health Ministry said in a statement.

As per the guidelines, a confirmed case is laboratory confirmed for monkeypox virus by detection of unique sequences of viral DNA either by polymerase chain reaction (PCR) and/or sequencing.

“All the clinical specimens should be transported to the Apex Laboratory of ICMR-NIV (Pune) routed through the Integrated Disease Surveillance Programme (IDSP) network of the respective district/state,” it said in the guidelines.

The Guidelines on Management of Monkeypox Disease include the epidemiology of the disease (including host, incubation period, period of communicability and mode of transmission; contact and case definitions; clinical features and its complication, diagnosis, case management, risk communication, guidance on Infection Prevention and Control (IPC) including use of personal protective equipment.

British health authorities are recommending people with monkeypox symptoms should abstain from sex, as the country reported 179 confirmed cases of the disease.

The guidance advises those who have been infected with monkeypox to use condoms for at least eight weeks after the infection abates as a “precautionary” measure, while public health experts learn more about how the virus spreads between people.

Avoid contact

People who have monkeypox or think they could have it “should avoid contact with other people until their lesions have healed and the scabs have dried off,” the guidance says.

The British government’s new guidance is designed in part to help those who have the disease or are exposed to it, in addition to being a summary of what is known and not known about the virus. The document states that most infections so far have occurred through close, direct contact.

People with monkeypox can isolate at home, as long as they are monitored by local health authorities, the guidance states. Their close contacts don’t have to quarantine if they are asymptomatic but will be monitored and may be “told to isolate for 21 days if necessary.”

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People with confirmed or suspected monkeypox should “abstain from sex while symptomatic, including the period of early symptom onset, and while lesions are present,” it says.

It adds that “there is currently no available evidence of monkeypox in genital excretions” but recommends “as a precaution” that those who have had monkeypox “use condoms for 8 weeks after infection,” noting that the guidance could change.

The British Health Security Agency, one of the departments behind the guidance, has started offering a smallpox vaccine, a new version of which has been approved in the United States for use against monkeypox, to close contacts of confirmed cases “to reduce the risk of symptomatic infection and severe illness.”

Studies suggest that the smallpox vaccine is at least 85% effective against monkeypox, according to the US Centers for Disease Control and Prevention. The United States stopped vaccinating people against smallpox – which was eradicated globally in 1980 – as a matter of routine in the 1970s.

The WHO has not recommended universal monkeypox vaccination, though it says countries may want to vaccinate close contacts after they have been exposed to the virus or health-care workers who may be exposed in the future.

In the briefing Monday, the WHO’s Lewis said “it would be unfortunate” if monkeypox were to be allowed to “establish itself as . . . an infection capable of human-to-human transmission, and exploit the immunity gap left by smallpox 40 years ago.”