Monkeypox

The World Health Organization (WHO) has given new designations to monkeypox virus strains that are currently in circulation. The WHO stated in a statement that this is done to prevent creating any cultural or societal offence. Clades I, IIa, and IIb were assigned to Monkeypox variants by the World Health Organization (WHO). Pox virology, evolutionary biology, and research institution representatives from around the world examined the phylogeny and nomenclature of known and novel monkeypox virus variations or clades.

“Newly identified viruses, related diseases and virus variants are given names to avoid causing offence to any cultural, social, national, regional, professional, or ethnic groups, and minimize the negative impact on trade, travel, tourism, or animal welfare,” said WHO said in a statement.

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“A group of global experts convened by WHO has agreed on new names for monkeypox virus variants, as part of ongoing efforts to align the names of the monkeypox disease, virus and variants–or clades–with current best practices. The experts agreed to name the clades using Roman numerals,” said a statement issued by WHO.

“The group reached consensus on new nomenclature for the virus clades which is in line with best practices. They agreed on how the virus clades should be recorded and classified on genome sequence repository sites,” read the statement.

According to WHO, “Consensus was reached to now refer to the former Congo Basin (Central African) clade as Clade one (I) and the former West African clade as Clade two (II). Additionally, it was agreed that the Clade II consists of two subclades.”

Dr Suresh Kumar, Medical Director of Lok Nayak Jai Prakash Narayan Hospital, announced on Saturday that a fifth case of monkeypox has been reported in Delhi.

Dr. Kumar stated that a 22-year-old woman’s sample tested positive on Friday and that she is presently being monitored in the hospital.

“One patient has been admitted in LNJP and her sample tested positive, at present 4 patients are admitted and one has been discharged. Total five cases of Monkey pox has been reported in Delhi. She came positive yesterday. Team of doctors are treating her,” Dr Kumar told ANI here.

Also Read: WHO announces new names for variants of monkeypox virus in circulation

He further stated that the patient had no recent travel history but has travelled one month prior.

On July 24, this year, Delhi verified its first case of monkeypox, a day after the World Health Organization designated it a Public Health Emergency of International Concern.

The national government has issued a slew of instructions to combat the virus’s spread in India, including those at the country’s entrance ports.

International travellers have been warned to avoid coming into contact with sick people, dead or alive wild animals, and other potentially dangerous objects.

On July 14, the first case of monkeypox in India was recorded in Kerala’s Kollam district.

Monkeypox, according to the World Health Organization, is a viral zoonosis (a virus transferred to people from animals), exhibiting symptoms comparable to those observed in smallpox patients in the past, albeit clinically less severe.

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The World Health Organization (WHO) has given new designations to monkeypox virus strains that are currently in circulation. The WHO stated in a statement that this is done to prevent creating any cultural or societal offence.

The WHO assembled a committee of worldwide specialists to settle on the new names, according to the Xinhua news agency.

Clade I refers to the previous Congo Basin clade (group of variations) in Central Africa, whereas Clade II refers to the old West African clade. The latter is divided into two sub-clades, Clade IIa and Clade IIb, with Clade IIb constituting the majority of variations circulating during the 2022 pandemic.

The new names for the clades should be used immediately, according to the WHO.

Also Read: Covid-19: Antibodies to lead to next-gen vaccines effective against all Covid strains found

According to WHO, newly found viruses, linked disorders, and viral variations should be given names that do not offend any cultural, social, national, regional, professional, or ethnic groups and have the least harmful impact on commerce, travel, tourism, or animal welfare.

The monkeypox virus was named when it was first discovered in 1958. Major variants were identified by the geographic regions where they were known to circulate.

WHO officially declared late July that the current multi-country monkeypox outbreak had turned into a public health emergency of international concern.

According to WHO’s situation report on the monkeypox outbreak published on Wednesday, there have now been 27,814 laboratory-confirmed cases, and 11 deaths from the disease in 89 countries and regions worldwide, with Europe and the Americas being hit the hardest.

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The Indian Council of Medical Research-National Institute of Virology examined two monkeypox cases of travellers returning from the UAE on Friday.

The investigation revealed that two patients were infected with monkeypox virus strain A.2, which belongs to the hMPXV-1A clade 3 lineage.

“The complete genome sequences obtained from skin lesions of cases 1 and 2 showed similarity of 99.91 and 99.96 per cent respectively with MPXV_USA_2022_FL001 West African clade,” read the ICMR-NIV study

“Phylogenetic analysis revealed that the two cases were infected with Monkeypox virus strain A.2 which belong to hMPXV-1A lineage of clade 3,” it added.

The study also mentioned the details about both the cases where a 35-year-old male and 31-year-old male from UAE tested positive for Monkeypox. Both the cases had no traces of sexual contact.
The background of the first male revealed a history of similar lesions amongst his friends and contact with a suspected Monkeypox case.

“Case 1, a 35-year, male, resident of UAE had developed low-grade fever and myalgia on July 5 2022. On the next day, he developed multiple vesicular rashes in the oral cavity and lips followed by a single lesion on the genital organ. The lesions were umbilicated with the size 0.5 to 0.8 cm,” the study explained the history of the first case.
Another case of a 32-year-old male from Dubai, UAE travelled to his hometown Kerala on July 13, 2022, and tested positive for Monkeypox.

“A 31-year male in Dubai, UAE had developed dysuria and genital swelling on July 8, 2022. On the next day, he developed fever with chills, myalgia, backache and headache,” the study stated.

As per the research, he developed multiple vesicular rashes on the genital organ and on both hands on July 10, 2022. The lesions progressed and later spread to the face, back, neck and forearm with cervical lymphadenopathy by July 15, 2022.

“He did not have any co-morbidity and denied any sexual or physical contact with suspected or confirmed MPXV case,” it added.

On the ninth post-onset day of sickness, July 13, 2022, and July 16, 2022, respectively, samples were obtained from different locations (lesion fluid, lesion roof, and lesion base) in both patients. For the MPXV diagnosis, they were directed to the World Health Organization Collaborating Centre for Emerging and Re-Emerging Diseases, ICMR-National Institute of Virology, Pune, India.

The virus outbreak i.e. monkeypox, has off late been making news and been a cause for concern. The worry is much greater when it comes to children, and it is important to know some basic facts about this new outbreak, before getting unnecessarily anxious.

Monkeypox has several symptoms common to other viruses, including ‘hand, foot and mouth disease’ or measles and chicken-pox, and it is best to consult a paediatrician for a correct diagnosis. This virus is contagious, and usually spreads through close physical contact. It can take between 5 days to 3 weeks after exposure, for symptoms to become evident.

Though children can contract this virus, parents can rest assured that in nearly all children the risk is low.

SYMPTOMS:

• Fever
• Shivering / Chills
• Headache
• Muscle Soreness
• Backache
• Fatigue
• Swollen lymph nodes
• Rash or blisters that appear on the face, in the mouth or on other parts of the body (hands, feet or chest)

The rash is the most significant symptom. Like in measles and chicken-pox, the rash turns into boils. They become reddish, filled with fluid/pus, turn into scabs and eventually fall off. After this, the skin heals.

HOW IT SPREADS: 

• Direct contact with rash, scabs or body fluids
• Touching, hugging, cuddling an infected person
• Prolonged face-to-face contact (through respiratory particles, while breathing in close proximity)
• Touching contaminated items like bedding, clothing or objects (toys, pillows) previously touched by a person.
• Foetus getting it within the womb (via placenta)
• Getting scratched or bitten by an infected animal or eating contaminated meat.

An infected person may keep transmitting the virus from the time s/he contracts it, until the skin has healed after the rash disappears.

RISK LEVEL OF MONKEYPOX: PREGNANT WOMEN & CHILDREN

• Compared to COVID-19, monkeypox takes much longer to transmit to another person, so one need not panic.
• It is still quite rare, and this makes it a less dangerous illness.
• Most people are known to heal by themselves but, in exceptional cases, pneumonia, eye or brain infections can occur.
• A foetus may contract it from the mother, in the womb.
• Pregnant women and children below 8 are at a greater risk for severe disease.

VACCINES IN INDIA:

As we have witnessed in the case of COVID-19, vaccines help patients get a less severe form of the virus, and they tend to recover better and faster.

In the case of monkeypox, 2 vaccines have been approved and licensed by the FDA (Food & Drug Authority) – JYNNEOS and ACAM2000. They not yet available in India.

Pregnant women and nursing mothers are not eligible for these vaccines. The former can receive treatment via monoclonal antibodies, if they contract the virus.

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DO’s & DON’Ts for PARENTS:

It is only natural that parents may feel worried about this new virus. Therefore, some simple precautions and steps can ensure that the virus does not spread further, and children and adults are safe.

Frequent hand washing:

It is essential that you and your children maintain good hygiene practices, in order to help contain the virus before it spreads. Washing hands with a mild soap or an alcohol-based sanitizer can prevent most infections anyway.

Avoiding close contact with suspected or confirmed cases:

If someone has been diagnosed with the monkeypox virus, it is safest to avoid close contact.

Little children, pregnant women and nursing mothers should not have any physical interaction with the person. Touching any objects used by that person is a big ‘No!’.

Speak to your child’s doc:

If any person in the family seems to have a boil, rash or symptoms listed above, speak to your doctor immediately. A blood test maybe recommended, to confirm whether it is monkeypox or something else. Presently testing is done by government authority only.

In a population of over 1 billion, 8 or 9 cases is still a very small number. This reflects how one need not get overly anxious or panicky about the situation. By taking basic precautions one can stay safe and healthy.

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According to an official on Thursday, the All India Institute of Medical Sciences (AIIMS) in Delhi has analysed 12 samples of probable Monkeypox cases thus far. The AIIMS Virology Lab is one of 15 labs in the country authorised by the Department of Health Research-Indian Council of Medical Research (ICMR).

Speaking to ANI, Dr Lalit Dar, Professor, Department of Microbiology, AIIMS said, “At the Virology Laboratory Department of Microbiology, we have received 12 samples from different states. We have also received samples from Delhi.”

AIIMS, Delhi received samples from Delhi, Bihar, Uttar Pradesh, Himachal Pradesh and Haryana so far.
Pertinent to mention, two samples of Delhi tested positive for Monkeypox and both the patients are admitted at LNJP hospital.

“Out of these 12 samples, who have tested positive and they are both from Delhi,” Dr Dar said. He said some of the samples tested positive for chicken pox.

Also Read: India records two more monkeypox cases

Notably, the patients who tested positive for Monkeypox in the AIIMS lab do not have any recent travel history abroad.
On the capacity of conducting tests, Dr Lalit said, “Right now we are getting a couple of samples on daily basis, which is not a large number. During COVID, the government augmented the RTPCR testing capacity. For Monkeypox, RTPCR is done. We have the capacity of conducting 400 samples a day depending on requirement and number of patients.”

He further said, “So, far there is really more than enough capacity in the country to do the testing. 15 labs are already authorised by the Department of Health Research, ICMR for testing across the country.”

The laboratory staff in AIIMS, Delhi has received training from ICMR-NIV Pune for conducting real-time RTPCR, biosafety measures, storage and transportation of samples, Dr Lalit said.

The results of testing for Monkeypox come in 24 hours.

“We are giving the report within 24 hours. We usually try to give it on the same day. Even if a sample arrives late in the evening, we still give the report within 24 hours,” he said.

So far, India has documented nine cases of monkeypox, five from Kerala with a history of overseas travel and four from Delhi with no recent travel history.

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According to authorities, two of the 12 samples obtained by the All India Institute of Medical Sciences (AIIMS) in Delhi proved positive for monkeypox.

These patients were admitted to Lok Nayak Jai Prakash Narayan Hospital (LNJP) upon confirmation.

“Both the patients who tested positive for monkeypox here have no recent travel history. So, far there is really more than enough capacity in the country to do the testing. 15 labs are already authorised by ICMR for testing across the country,” said Dr Lalit Dar, Professor, Dept of Microbiology, AIIMS.

According to an official on Thursday, the All India Institute of Medical Sciences (AIIMS) in Delhi has analysed 12 samples of probable Monkeypox cases thus far.

Also Read: Covid case update: 20,551 cases recorded in India

The AIIMS Virology Lab is one of 15 labs in the country authorised by the Department of Health Research-Indian Council of Medical Research (ICMR).

Speaking to ANI, Dr Lalit Dar, Professor, Department of Microbiology, AIIMS said, “At the Virology Laboratory Department of Microbiology, we have received 12 samples from different states. We have also received samples from Delhi.”

So far, AIIMS in Delhi has received samples from Delhi, Bihar, Uttar Pradesh, Himachal Pradesh, and Haryana.

It is worth noting that two samples from Delhi tested positive for monkeypox, and both patients are being treated at LNJP hospital.

“Out of these 12 samples, who have tested positive and they are both from Delhi,” Dr Dar said. He said some of the samples tested positive for chicken pox.

Notably, the patients who tested positive for Monkeypox in the AIIMS lab do not have any recent travel history abroad.

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According to media sources, the United States designated Monkeypox a Public Health Emergency on Thursday, indicating that the virus poses a serious risk to Americans.

President Biden’s health secretary, Xavier Becerra, made the news. According to the New York Times, the designation will free up emergency cash and remove certain bureaucratic barriers. The World Health Organization declared a global health emergency over the outbreak more than a week ago, granting federal agencies the authority to direct funds toward the development and evaluation of vaccines and drugs, to access emergency funding, and to hire additional workers to help manage the outbreak, which began in May.

“We’re prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously,” the health secretary, Xavier Becerra, said at a news briefing.

This action comes as US President Joe Biden and California Attorney General Xavier Becerra have been under great pressure from campaigners and public health professionals to act more forcefully to address the outbreak.

Biden had already recruited an experienced emergency response official and a recognised infectious disease specialist to lead the White House response, indicating that the administration is ramping up its efforts.

Also Read: India records two more monkeypox cases

Jynneos, the monkeypox vaccine, is in short supply, and the administration has been chastised for acting too slowly to increase the quantity of doses. Declaring an emergency would not alleviate the shortage, but the government might take efforts to improve availability of tecovirimat, the prescribed treatment for the ailment.

As of Wednesday, the United States has documented over 7,000 cases of monkeypox, with Washington, New York, and Georgia having the highest rates per capita. More than 99 percent of the instances involve males who have intercourse with other men.

The virus is usually spread by intimate personal contact; the illness is seldom lethal (no deaths have been documented in the United States), but it can be very painful. The country already has one of the world’s highest rates of monkeypox infection, and the figure is projected to climb as surveillance and diagnostics improve.

Declaring monkeypox an emergency sends “a strong message that this is important, that it must be dealt with now,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles, and a member of the W.H.O.’s advisory panel on monkeypox, as per the media portal.

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On Wednesday, a 31-year-old woman in the national capital tested positive for Monkeypox, bringing India’s total to nine.
This is India’s first occurrence of the sickness among women. She is being treated at one of Delhi’s government hospitals.

Another 35-year-old Nigerian guy residing in Delhi with no recent travel history tested positive for monkeypox earlier on Tuesday.

The patient has been admitted to the Lok Nayak Jaiprakash hospital, which is run by the Delhi government.

So far, India has documented 9 cases of monkeypox, 5 from Kerala and 4 from Delhi.

According to reports, following a surge in the number of Monkeypox cases in the country, isolation rooms for the treatment of such diseases have been made active in three central government hospitals.

“The isolation rooms for the treatment of Monkeypox patients are operational in three major central government hospitals i.e Safdarjang hospital, RML hospital and Lady Hardinge hospital,” official sources told ANI.

The Delhi Government issued the official statement on Tuesday on the preparation of isolation rooms in government and private hospitals. The 20 isolation rooms at the Lok Nayak Jai Prakash Narayan (LNJP) Hospital, while 10 isolation rooms have been set up in Guru Teg Bahadur Hospital (GTB) hospital and 10 at Dr Baba Saheb Ambedkar Hospital.

Notably, the Delhi government has also asked private hospitals to provide isolation rooms for Monkeypox patients. Kailash Deepak Hospital in East Delhi, MD City Hospital in North Delhi, and Batra Hospital and Research Centre in Tughlakabad in South Delhi are the three hospitals.