India Steps Up Measures Against Mpox Outbreak: Health Ministry Issues Comprehensive Advisory
In response to a suspected case of mpox reported in Delhi, India’s Union Health Ministry has issued a formal advisory to states and union territories, emphasizing the need for intensified surveillance, testing, and contact tracing.
The advisory aims to bolster the country’s preparedness and response to the mpox outbreak, reassuring the public that the situation is under control and there is no immediate cause for alarm. This article explores the details of the advisory, the guidelines issued by the National Centre for Disease Control (NCDC), and the current stance on vaccination.
The Advisory On September 9, 2024, Union Health Secretary Apurva Chandra issued an urgent advisory to all states and union territories in India. The directive underscores the necessity for enhanced surveillance, systematic testing, and meticulous contact tracing of suspected mpox cases.
The advisory comes in the wake of a suspected mpox case in Delhi involving an individual who had recently traveled abroad. The patient has been isolated and is in stable condition, with samples dispatched for confirmation. Contact tracing is actively underway to evaluate any broader impact.
Key Points of the Advisory
1.Enhanced Surveillance and Testing: The Health Ministry has stressed the importance of improving surveillance mechanisms and testing protocols. States and union territories are encouraged to set up robust screening procedures and isolate suspected cases promptly.
2.Hospital Preparations: States are instructed to identify and prepare hospitals with isolation facilities to manage both suspected and confirmed mpox cases. This measure is intended to ensure that the healthcare infrastructure is ready to handle potential outbreaks efficiently.
3.Public Health Review: The advisory calls for a comprehensive review of public health preparedness by senior officials. This review is aimed at ensuring that all necessary protocols are in place and that the response to any mpox cases is swift and effective.
4.Dissemination of Guidelines: The Health Ministry has urged states and union territories to widely circulate the “Guidelines for Management of Monkeypox Disease” and act on the updated Communicable Disease Alert (CD-Alert) issued by the NCDC.
NCDC Guidelines The NCDC has outlined a detailed surveillance strategy to manage mpox cases effectively.
The strategy includes:
Early Detection: Prioritizing the early identification of mpox cases to facilitate prompt action.
Laboratory Testing: Guidelines for laboratory testing are provided to ensure accurate and timely diagnosis of mpox.
Clinical Management: Protocols for the clinical management of mpox cases, including treatment and patient care guidelines.
Infection Control: Measures to prevent the spread of the virus within healthcare settings and the community. Key stakeholders in the surveillance strategy include the National AIDS Control Organization (NACO), Integrated Disease Surveillance Programme (IDSP), points of entry (PoEs), and designated laboratories. The strategy mandates that even a single case of mpox be treated as an outbreak, requiring immediate investigation and contact tracing.
Reporting and Sample Testing The advisory emphasizes the importance of reporting suspected cases to District Surveillance Units (DSUs), State Surveillance Units (SSUs), and the Central Surveillance Unit (CSU). Samples should be sent to designated laboratories for testing, and a record of all samples and results must be maintained by the IDSP SSUs.
The transport of clinical specimens should follow protocols to ensure they reach the NCDC, National Institute of Virology (NIV) Pune, or other Virus Research and Diagnostic Laboratories (VRDLs) via the IDSP network.
Monitoring and Quarantine The advisory recommends home quarantine and active follow-up for contacts of confirmed cases. Contacts should be monitored daily for symptoms for a period of 21 days from the last contact with a patient or their contaminated materials. Self-monitoring is advised for contacts of probable cases.
Vaccination Guidelines The NCDC has provided information on available vaccines for mpox, which include:
1.Modified Vaccinia Ankara-BN (MVA-BN, JYNNEOS, Imvamune, Imvanex): A third-generation smallpox vaccine approved in the USA, Canada, and Europe.
2.LC16-KMB: Licensed in Japan.
3.OrthopoxVac: Licensed in the Russian Federation. The World Health Organization (WHO) has advised that mass vaccination is not currently necessary for mpox. WHO recommends vaccination only for individuals at high risk of exposure, such as certain healthcare workers and travelers. The decision for mass vaccination has not been recommended by WHO or the Indian Health Ministry at this time.
Contagious Nature of Mpox According to a report from the US Centers for Disease Control and Prevention (CDC), mpox does not spread as easily as COVID-19 through the air. The CDC’s findings suggest that traveling on a flight with someone infected with mpox does not pose a significant exposure risk or require routine contact tracing. However, individuals with mpox should isolate themselves and avoid travel until they are no longer infectious. The CDC’s recommendations apply to all variants of mpox, including both clade I and clade II.
WHO Advisory The WHO’s recent report highlights that mpox has been declared a Public Health Emergency of International Concern (PHEIC). As of July 31, 2024, there have been 102,997 laboratory-confirmed cases and 186 probable cases reported in 121 member states. This global context has prompted the Indian Health Ministry to take proactive measures to manage and contain the outbreak.
India’s Union Health Ministry’s advisory represents a critical step in managing the mpox outbreak effectively. By enhancing surveillance, testing, and contact tracing, and by preparing hospitals and healthcare systems, India aims to mitigate the impact of mpox. While the current guidelines do not recommend mass vaccination, the situation remains under close monitoring.
The coordinated efforts of the Health Ministry, NCDC, and other stakeholders are pivotal in ensuring a robust response to this emerging health threat. As the situation evolves, continued vigilance and adherence to guidelines will be essential in managing and containing mpox within India and preventing its further spread.
This comprehensive overview of the mpox advisory issued by the Indian Health Ministry provides insights into the measures being taken to address the outbreak and manage public health effectively.
Mpox, Health Ministry, India,
Advisory, Surveillance, Testing, Vaccination, NCDC, WHO
“मंकीपॉक्स: संक्रमण, लक्षण और बचाव के पूर्ण जानकारी के साथ जानें सब कुछ”