Strategy for Monkeypox

What is the issue?

The World Health Organization declared monkeypox a public health emergency of international concern (PHEIC).

What is monkey pox?

• Monkeypox is a zoonosis, that is, a disease that is transmitted from infected animals (squirrels, Gambian poached rats, dormice, some species of monkeys) to humans.
• It is caused by monkeypox virus, a member of the Orthopoxvirus genus in the family Poxviridae.
• African rodents and monkeys are suspected of transmission and infection.
• Transmission occur through contact with bodily fluids, lesions on the skin or on internal mucosal surfaces, respiratory droplets and contaminated objects.
• Human-to-human transmission is limited.
• Until now, monkeypox fell under the category of neglected tropical diseases.
• Vaccines used during the smallpox eradication programme also provided protection against monkeypox.
• Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks.
• In recent times, the case fatality ratio has been around 3–6%.

To know about monkey pox, click here

What is PHEIC?

PHEIC is defined in the International Health Regulations (IHR) as, “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”.

• PHEIC is the highest level of alert the global health body can issue but is just one step short of a ‘pandemic’ classification.
• Only polio and SARS-CoV-2 were ongoing PHEIC prior to monkeypox.
• After a split verdict at the IHR Emergency Committee meeting on whether monkeypox deserves to be termed a PHEIC, the WHO Director-General declared monkeypox PHEIC.
• Factors that influenced the decision
  1. Information provided by countries
  2. The three fulfilled criteria for declaring a PHEIC under the International Health Regulations
     • serious, sudden, unusual or unexpected
     • carries implications for public health beyond the affected State’s national border
     • may require immediate international action
  3. Advice of the Emergency Committee
  4. Scientific principles and evidence which remains unclear
  5. The risk to human health
• Consequences
  1. Monkeypox will now be on the radar of several national leaders to be on the lookout for.
  2. The decision to declare it as a PHEIC also opens up avenues for new funding.
  3. The WHO can make recommendations for countries which are not binding but if countries stray from it, they must show scientific reason for doing so.

What role has WHO played in containing the monkeypox?

1. Supporting countries assess risk, and initiate public health measures
2. Building and facilitating testing capacities
3. Engaging and protecting the affected communities
4. Intensifying surveillance and public health measures
5. Strengthening clinical management and infection prevention and control in hospitals and clinics
6. Accelerating research into the use of vaccines, therapeutics and other tools

What strategy has to be followed to contain the disease?

• The experience from the COVID-19 pandemic has shown that governments implement measures to avoid ‘panic’.
• Government must begin coordinated action with the States to accurately summarise and disseminate the extent of the threat.
• Indian labs and biotech companies must step up research and mine their arsenal to prepare adequate defences if the need arises.
• States with recently imported cases of monkeypox in the human population have to implement response actions with the goal of stopping human-to-human transmission of the virus.
• Representatives of affected communities, elected officials and civil society, and behavioural scientists are to be engaged to advise on approaches to avoid the stigmatization of affected persons.
• The surveillance for illness compatible with monkeypox has to be intensified and reported to WHO on a weekly basis.
• There is a need to use recommended clinical care pathways and protocols for the screening, triage, isolation, testing, and clinical assessment of suspected cases of persons with Monkeypox.

References

1. https://www.thehindu.com/opinion/editorial/learning-lessons-on-a-strategy-for-monkeypox/article65681854.ece
2. https://www.downtoearth.org.in/news/health/who-declares-monkeypox-public-health-emergency-of-international-concern-83900
3. https://www.who.int/news/item/23-07-2022-second-meeting-of-the-international-health-regulations-(2005)-(ihr)-emergency-committee-regarding-the-multi-country-outbreak-of-monkeypox