Notably, all the three confirmed cases of monkeypox in India so far have been reported in Kerala. While India’s second monkeypox case was reported in Kerala’s Kannur district on July 18, just four days prior to that on July 14, the country’s very first case was reported in Kerala. In view of the rise in monkeypox cases in India, and considering reports stating that monkeypox is a viral zoonotic infection and it spreads mostly through human contact, the Union Health Ministry released new guidelines in an attempt to mitigate the outbreak and listed out points for the general public to avoid the contracting the virus. 

Monkeypox in India: What has happened so far

Following the reports of the very first confirmed monkeypox case, the Indian government deployed a multi-disciplinary team to the southern state in an attempt to mitigate the outbreak. Notably, the Indian Council of Medical Research (ICMR) trained 15 research and diagnostic laboratories across the country for early detection of the virus. The ICMR notified that, “to help country’s preparedness for Monkey Pox detection, 15 Virus Research & Diagnostic Laboratories across the country, which are geographically well distributed & strategically located, have already been trained in the diagnostic test by ICMR -NIV, Pune.” 

The Health Ministry issued guidelines after reports of the first monkeypox case emerged:

• International passengers have been advised to avoid close contact with sick people, contact with dead or live wild animals and others. 
• Additionally, the international travelers advised against eating or preparing meat from wild game (bushmeat) or using products (creams, lotions, powders) derived from wild animals from Africa. 
• International passengers have been asked to avoid contact with contaminated materials used by sick people such as clothing, bedding or materials used in healthcare settings, or that came into contact with infected animals, as per the guidelines. 
• In addition, if people develop symptoms suggestive of monkeypox like fever and skin rash and were in an area where monkeypox has been reported or had come in contact with a person who might have monkeypox have been advised to immediately consult the nearest health facility.

Measures taken by the Kerala government: 

Kerala Health Minister Veena George on July 20 shared details of the SOP to be followed by all private and government hospitals in the state. 

• The SOP noted that any person who has travelled in the last 21 days to a country where monkeypox has been reported and is having red spots on the body along with one or more of the other symptoms, like fever, headache, body ache or fever, should suspect infection by the virus.
• The minister highlighted that the risk of infection is high through close physical or direct skin-to-skin contact or sexual intercourse with an infected person or by touching their bedding or clothing, so anyone falling in these categories would come in the primary contact list.
• As per the Health department’s SOP, suspected and probable cases of monkeypox are to be treated separately and in isolation and the District Surveillance Officer (DSO) should be informed immediately.
• It said, samples should be collected as per the protocols laid down for the same by the National Institute of Virology (NIV) and the DSO would be responsible for sending the same to the lab.
• It further notified that the referrals from private hospitals to government facilities should be on patient request and only critically ill patients from state-run hospitals with isolation facilities should be referred to medical colleges.
• Additionally, the Health department’s SOP informed that while transporting infected persons from to a hospital or from one medical institution to another, PPE kit, N95 masks, gloves and goggles should be worn by the health professionals and the patients too should wear an N95 or triple layered mask and any wounds on their bodies should be covered.
• After patient delivery, the ambulance and equipment therein should be disinfected and the patient’s items like clothing, should be disposed of, the Health department release said.
• Confirmed cases of monkeypox should be managed as per the Centre’s guidelines and in case of any doubt regarding treatment, the state medical board should be consulted, it added.
• The release further stated that as all international airports in the state have thermal scanners, anyone showing signs of fever would be examined for red spots by a medical team and if such signs are found, they will be transferred to the nearest hospital with isolation facilities and the DSO would be informed about the same.
• Meanwhile, the government release directed the health workers to monitor those in the primary contact list for 21 days for any symptoms by calling them over the phone and recording their temperature twice a day, adding that those in the contact list who are not showing symptoms should not donate blood, cells, tissue, organs, or semen.

(With inputs from AFP, PTI, ANI)

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