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After monkeypox samples from a five-year-old child in Ghaziabad, Uttar Pradesh, were sent for testing, the suspected case was found to be negative on Tuesday.

The girl’s samples were transferred to the ICMR – National Institute of Virology in Pune for testing a few days ago. After the girl complained of itching and rashes on her body, the health department sent her samples.

While the government has stated that the reports are “unnecessary alarm mongering” and that no cases of the illness have been detected in India thus far.

The Chief Medical Officer of Ghaziabad said the test was just a “precautionary measure” as the girl has no other health issues and did not have close contact with anyone who has travelled abroad in the past month.

“Samples of a five-year-old girl have been collected for testing for monkeypox, as a precautionary measure, as she had complaints of itching and rashes on her body. She has no other health issues and neither she nor any of her close contacts travelled abroad in the past month,” CMO Ghaziabad said.

The Union Health Ministry had also issued “Guidelines on Management of Monkeypox Disease” to ensure advance preparedness across the country, in view of the rising reports of monkeypox cases in non-endemic countries.

A confirmed case of Monkeypox virus is defined as the discovery of unique sequences of viral DNA by polymerase chain reaction (PCR) or sequencing, according to the criteria.

On Monday, a petition was filed in the Supreme Court, asking the court to order the Respondent Medical Counselling Committee (MCC) to conduct a Special Stray Round of counselling to allow candidates to compete for empty seats left after the All India Quota stray vacancy round (AIQ).

The petition was set for further hearing on June 8 by the vacation bench comprising Justices MR Shah and Aniruddha Bose. Respondent counsel has also been directed to receive instruction on the petition by the Court. Advocate Milind Kumar Advocate represented the petitioners.

The petitioners claimed that they are aggrieved by the counselling process which was conducted by MCC in a manner that all the vacant seats were not a part of the Stray vacancy round of the counselling.

They said that the cause of action for filing the present Writ Petition arose on May 11 2022 when the Petitioner’s received a reply to the RTI they had filed wherein it was stated that “at the time of online allotment process all medical/ dental post graduate seats were exhausted but due to non-joining, resignation, and non-reported some seats remained vacant”. However, official data has not been provided, the petitioners said.

Hence, the petitioner has sought to direct Respondent MCC to provide the exact number of vacant seats after the conduct of stray vacancy round of AIQ and to conduct a Special Stray Round of counselling to allow the candidates to participate for the vacant seats which are available after the conduct of stray vacancy round of AIQ.

The country registered 3,714 new infections in the past 24 hours, breaking a two-day string of reaching the 4,000-case threshold.

Yesterday, the nation recorded 4,518 COVID cases. As a result of this, the active COVID caseload in the nation has risen to 26,976, accounting for 0.06 percent of all positive cases in India.

The daily positivity rate of 1.21 per cent was observed in the last 24 hours, while the weekly positivity rate was recorded to be 0.97 per cent, the health ministry informed today.

With 2,513 recoveries in the last 24 hours hence, the total recoveries now reached 4,26,33,365. India’s Recovery Rate is currently at 98.72 per cent.

As per the health ministry, India conducted 3,07,716 COVID-19 tests in the last 24 hours. The country has so far conducted 85.32 crore (85,32,09,262) total tests so far, as per the Indian Council of Medical Research (ICMR) data.

The country has administered more than 194.27 crore (1,94,27,16,543) vaccine doses so far under the nationwide vaccination drive. This has been achieved through 2,47,93,056 sessions.

India has also administered 3,69,79,381 precaution doses to all the beneficiaries so far.
COVID-19 vaccination for the age group 12-14 years began on March 16, 2022. So far, more than 3.45 crore (3,45,58,366) adolescents have been administered the first dose of the COVID-19 vaccine.

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An outbreak of nose-bleed fever, also known as Crimean-Congo haemorrhagic fever (CCHF), has been reported in Iraq, with 212 cases reported so far this year and 27 deaths. Gujarat has already recorded two incidents, one of which has resulted in death.

Nasal-bleed fever is widespread in Africa, the Balkans, the Middle East, and Asia, according to the World Health Organization (WHO).

According to their estimations, 3 billion individuals are at danger, with 10,000 to 15,000 illnesses and 500 fatalities every year.

Gujarat reported the first CCHF incidence in India in 2011. India reports 5 to 49 instances of nose-bleed fever each year, according to the WHO’s regional distribution of cases.

What is CCHF?

Crimean-Congo haemorrhagic fever is a viral haemorrhagic fever usually transmitted by ticks. It can also be contracted through contact with viraemic animal tissues (animal tissue where the virus has entered the bloodstream) during and immediately post-slaughter of animals, according to the WHO.

CCHF outbreaks constitute a threat to public health services as the virus can lead to epidemics, has a high case fatality ratio (10-40%), potentially results in hospital and health facility outbreaks, and is difficult to prevent and treat, it added.

“The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats. Many birds are resistant to infection, but ostriches are susceptible and may show a high prevalence of infection in endemic areas, where they have been at the origin of human cases. For example, a former outbreak occurred at an ostrich abattoir in South Africa. There is no apparent disease in these animals.

“Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with the CCHF virus, ticks of the genus Hyalomma are the principal vector,” the WHO explained.

Crimean haemorrhagic fever was the term given to the disease when it was originally identified in Crimea in 1944. It was discovered in 1969 that the pathogen causing Crimean haemorrhagic fever was the same as the one that caused a disease in the Congo in 1956. The sickness and virus are now known by their present names, which are derived from the combination of the two location names.

Primary human infections

The WHO said that CCHF is a viral tick-borne disease that is transmitted to humans by bites of infected ticks, and by direct contact with blood or tissues from infected humans and livestock. About 80 to 90 % of humans are infected through tick bite or direct contact with blood of infected ticks; direct contact with blood/tissues of infected wild animals and livestock. Secondary human-to-human transmission occurs through direct contact with the blood, secretions, organs or other body fluids of infected persons. High transmission risk when providing direct patient care or handling dead bodies (funerals).

The WHO said that studies have shown sheep and cattle husbandry are regularly infested with tick species, mainly Hyalomma species, the principal vector of CCHF.

Ticks’ sizes

Ticks live in the ground vegetation and move mainly by climbing up plants and walking on the ground. They latch on to a passing animal or human host by using hooks on their legs. The sizes of ticks can vary from 0.5 to 15 mm, depending on tick species.

Symptoms

Most common symptoms include abrupt onset fever, chills, shudders, myalgia, headaches, sicknesses and vomits, abdominal pain, arthralgia. After a few days – bleeding from mucous membranes, hematomas, ecchymosis, melena, hematuria, nose bleeding, vaginal bleeding, bradycardia, thrombocytopenia, leukopenia, according to the WHO.

The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually one to three days, with a maximum of nine days. The incubation period following contact with infected blood or tissues is usually five to six days, with a documented maximum of 13 days, said the WHO.

Tachycardia (rapid heart rate), lymphadenopathy (enlarged lymph nodes), and a petechial rash (a rash caused by bleeding into the skin) on internal mucosal surfaces, such as the mouth and throat, as well as on the skin, are further clinical indications. Petechiae can lead to ecchymoses, which are bigger rashes, and other haemorrhagic symptoms. After the fifth day of sickness, there is frequently evidence of hepatitis, and critically unwell individuals may undergo fast renal deterioration, abrupt liver failure, or pulmonary failure.

Mortality rate

The mortality rate from CCHF, as per the WHO, is approximately 30%, with death occurring in the second week of illness. In patients who recover, improvement generally begins on the ninth or tenth day after the onset of illness.

Treatment

General supportive care with treatment of symptoms is the main approach to managing CCHF in people and the antiviral drug ribavirin has been used to treat CCHF infection with apparent benefit. Both oral and intravenous formulations seem to be effective, as per the WHO.

No vaccines available

The WHO said that there are no vaccines widely available for human or animal use. In the absence of a vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus.

Reducing the risk of infection in people

To reduce the risk of tick-to-human transmission, the WHO recommends the following:

Avoid tick-infested areas; wear protective clothing (long sleeves, long trousers); wear light coloured clothing to allow easy detection of ticks on the clothes; use approved acaricides (chemicals intended to kill ticks) on clothing; use approved repellent on the skin and clothing; regularly examine clothing and skin for ticks; if found, remove them safely; seek to eliminate or control tick infestations on animals or in stables and barns; and avoid areas where ticks are abundant and seasons when they are most active.

Wear gloves and other protective clothing when handling animals or their tissues in endemic areas, especially during slaughtering, butchering, and culling procedures in slaughterhouses or at home; quarantine animals before they enter slaughterhouses; or treat animals with pesticides two weeks prior to slaughter.