MoH prepares as Monkeypox likely to spread with opening of borders and people’s movement

With the opening of borders, the chances of detecting monkeypox in the country is high now, and with WHO declaring a global health emergency, the Ministry of Health (MoH) is prepared to handle a possible outbreak.

An official from MoH said monkeypox is a self-limiting disease, where it sometimes shows signs and symptoms and gets cured on its own, and sometimes, it may not show signs and an infected person gets cured due to their own immune system fighting the virus. So that is why it does not pose as much risk to the public health.

Although monkeypox disease is not as severe as COVID-19, MoH is monitoring monkeypox cases in the South-East Asia Regions (SEARO). As of 17 August, 94 countries have detected monkeypox globally and have reported 39,434 monkeypox cases and 11 confirmed death cases around the world.

The MoH official said already two monkeypox cases have been detected in Bihar and Thailand. Since Bihar is nearest to Bhutan, most of the foreign workers also come from Bihar and Assam. So, it is a matter of time before Bhutan will soon have cases of monkeypox.

The official said MoH has also formed a task force consisting of a dermatologist, microbiologist, and the Royal Center for Disease Control.  The ministry has also drafted monkeypox guidelines, under which they have signs and symptoms, treatment, vaccination, management, and isolation.

Furthermore, the ministry has received 1,000 monkeypox test kits, and they will be only used on suspected cases, and confirmed cases.

The official said in the six points of entry, Phuentsholing, Samtse, Samdrupjongkhar, Gelephu, Nanglam, and Paro Airport, the health ministry has made it mandatory to fill in the health declaration form for all incoming passengers into the country. In terms of foreign workers’ recruitment, they have workers screening procedures for diseases done by occupational health workers. However, no incoming travelers have any signs and symptoms of monkeypox so far.

In case any passenger has any of the symptoms reflected on the declaration form, then sampling will be done and all the suspected cases will be directly taken into the quarantine facilities where the health ministry has allotted COVID-19 infrastructures.

Monkeypox and COVID-19 are not the same, but it is a viral-related infectious disease and has similar signs and symptoms, such as fever, headache shortness of breath, joint pains, and fatigue and most of the signs and symptoms are similar to COVID-19 too. If any incoming travelers happen to have any of these signs, then they will be kept under observation for 24 hours until and unless they get their test results. And if any test positive for monkeypox then they will be kept in an isolation facility for 21 days, and the primary contacts will be home quarantined or put in quarantine and kept under observation for 21 days because the incubation period ranges from 3 days to 21 days, and the period of communicability happens in two to three days.

As per the directives from the TAG and health ministry, the current COVID-19 isolation and quarantine facilities will be used for any suspected cases of monkeypox because the mode of transmission for both diseases is quite similar.

In terms of severity, and as per the current status, the case fatality ratio of monkeypox is low. And that is one reason, why every country is taking it lightly, and the disease is spreading. Within a week, almost 10,000 cases of monkeypox were detected.

“We have to keep vigilant on surveillance,” said the official.

If any passenger has a travel history to infected countries, flight crews will have to wear personal protective equipment and maintain distance.

Other than physical contact, monkeypox can be spread through inanimate objects such as beddings, clothes, etc. For example, if a person shares clothes with an infected person, then that person will also get infected.

The survival of the monkeypox virus depends upon an environmental factor that ranges from 15 days to a month, especially on clothes and beddings.

If any case of monkeypox is detected, the health personnel are at risk followed by the emergency unit.

There is a high chance of having permanent scarring from monkeypox. Monkeypox can result in keloid scars. A Keloid scar is enlarged, raised scar that is often pink, red skin-colored or darker than the surrounding skin. There are high chances of stigmatization. Therefore, the health ministry is creating awareness that no people should be discriminating and stigmatizing any person who is cured, and it should be treated like any other disease.

There is no treatment as such, only symptomatic management for monkeypox will be provided.