Mpox confirmed in Kerala again: Health Department issues guidelines

Kochi: One more case of mpox has been confirmed in Kerala. The disease was confirmed in a man, who recently returned from abroad to Ernakulam and was admitted to a hospital with the symptoms. He is currently undergoing treatment here.

The first case of mpox in Kerala was reported in another man who had returned from the UAE to Malappuram. The Health Department has confirmed that this was the first instance in India where the clade 1B variant of the virus, commonly found in Africa, was detected.

In response, the Health Department has urged everyone arriving from countries with reported cases of mpox to immediately report at the airport in case of any symptoms. Early detection and reporting are key to controlling the spread of the virus.

Global spread of mpox
Mpox has been spreading rapidly since 2022, especially in the last few months.

The virus is typically found in West, Central and East African countries but has recently seen an increase in cases across Europe and America. This new wave of infections began in January of this year, with reports of the disease spreading to countries like Kenya, Rwanda and Uganda.

Due to the rising number of cases and deaths, the World Health Organization (WHO) has declared mpox a global health emergency, one of its biggest precautionary methods. This is only the seventh time since 2009 that WHO has declared such an emergency. Previous health emergencies include outbreaks of the H1N1 swine flu, Zika virus, Ebola and Covid-19.  

The disease, initially called monkeypox, was renamed mpox by WHO to avoid misunderstandings and address concerns over racial discrimination.

What is mpox?

Mpox is a rare viral infection similar to human smallpox. It was first discovered in 1958 in monkeys kept for research. Initially, mpox was a zoonotic disease transmitted from animals to humans. But now it is a direct human-to-human disease. The first human case of monkeypox was recorded in 1970. The disease occurs primarily in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions.

“Mpox is a rare zoonotic disease that is caused by infection with mpox virus. Mpox virus belongs to the family Poxviridae, which also includes the viruses causing smallpox and cowpox disease,” said Dr Monalisa Sahu, consultant, Infectious Diseases, in Hyderabad's Yashoda Hospitals.

 Although less severe, the symptoms of mpox resemble those of smallpox, an orthopoxvirus infection that was declared eradicated worldwide in 1980.

Symptoms

According to the World Health Organization (WHO), mpox typically presents itself with fever, rash and swollen lymph nodes and may lead to a range of medical complications.

Initial symptoms include fever, severe headache, swelling of the sinuses, back pain, muscle pain and lack of energy. Blisters and red spots begin to appear on the body within a week of the onset of fever. Most blisters are found on the face and limbs. Apart from this, they are also found on the palms, genitals and eyes.

The disease is usually self-limiting with the symptoms lasting from two to four weeks.

The severity of mpox depends on a person’s overall health, immune system and any complications they may develop. The disease tends to be more serious in children. Some of the complications include infections, bronchopneumonia, sepsis, encephalitis and eye infections that can lead to vision loss.

Severe cases can occur. In recent times, the case fatality ratio has been around 3-6 per cent but can be up to 10 per cent. There are no reported deaths in this current spread. It is still unclear how often people may have the infection without showing any symptoms.

Transmission

Mpox is not an airborne disease like covid or H1N1 influenza. The risk of infection is high through close contact with an infected person, direct skin contact, sexual intercourse, touching bedding, body fluids, respiratory droplets, clothing, not following safety standards etc.

It's thought to be spread by rodents such as rats, mice and squirrels, WHO said.

Health officials have noted some of these infections may be transmitted through sexual contact. The WHO said it was also investigating many cases of people identifying as gay or bisexual.

“The natural reservoir of mpox remains unknown, although African rodents and non-human primates (like monkeys) can harbour the virus and infect people, causing the disease,” said Sahu.

Mpox can also be passed from a mother to her baby through the placenta or through close contact during and after birth. The decline in smallpox immunity in the general population, due to the worldwide end of smallpox vaccinations, may also lower protection against mpox.

Safety Measures

• People who come into close contact with sick people without using the safety precautions recommended can get mpox.
• Health care workers caring for patients with suspected or confirmed viral infection and those handling infected person's secretions should take mandatory prescribed infection control precautions to avoid transmission.
• A gown, N95 mask, gloves and goggles should be worn when transporting the patient in an ambulance.
• Along with this, the information should also be informed to the hospital where the patient is taken.
• The patient should wear N95 mask triple layer mask.
• If there are wounds, cover them with clothing. Ambulance and equipment should be disinfected after patient delivery.
• Patient-related items should be disposed of according to guidelines.
• Also, ensure that animal meat is thoroughly cooked before eating.

Treatment

Since mpox is a viral disease, there is no specific cure for it.

However, it is important to seek medical care as soon as symptoms appear to manage the illness and avoid complications. Early treatment can help prevent serious health issues and long-term effects.

Mpox vaccine is available, which can provide protection against the virus.