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India’s ministry of health and family welfare will issue comprehensive guidelines later this week for the treatment and prevention of monkeypox amid an outbreak of the viral disease with nearly 100 confirmed cases globally.

The decision was taken at a meeting held on Monday attended by officials from the Indian Council of Medical Research (ICMR), World Health Organization (WHO), National Centre for Disease Control (NCDC), clinicians and health ministry to firm up standard operating procedures for travellers who show symptoms of moneypox after returning from affected countries.

The detailed guidelines will include identifying sick patients at airports, lab tests, symptoms, prevention, surveillance strategies, reporting to hospitals and community awareness. According to WHO, more than 92 cases have been reported from a dozen countries so far. “We should not be worried about monkeypox but vigilant. Ministry of health and ICMR is developing the guidelines for monkeypox with regards to the treatment, prevention, community awareness, signs and symptoms of monkeypox, isolation of sick patients who returned from monkeypox affected countries, surveillance strategy at the airports and sea ports, hospital infection control measures if any suspected cases have been reported and many other preventive measures. So, these are going to be comprehensive guidelines which the ministry of health is likely to release in the coming days," said Dr Nivedita Gupta, senior scientist of ICMR.

“Common people have to be sensitized about the disease and how to report to the health facility if they show any symptoms. We are expecting the virus would come to India only via international travel, therefore, surveillance at the ports is very important," said the scientist.

Queries emailed to a spokesperson for ICMR remained unanswered till press time.

Monkeypox originates from animals such as rodents and primates and transmits to people. It is found in Africa, mostly around tropical rainforest regions. The major symptoms are fever with an unexplained acute rash all over the body. Other symptoms include headache, swollen lymph nodes, muscle and body aches, back pain and weakness.

Meanwhile, the NCDC has identified a few public health actions against monkeypox.

Explaining the measures, Priya Abraham, director of National Institute of Virology said, “Health facilities have to keep a heightened suspicion in people who present with stated symptoms. All suspected cases have to be isolated in designated healthcare facilities until lesions subside and they are deemed fit to end isolation. All such patients have to be reported to the District Surveillance Officer of IDSP. Besides, all recommended infection control practices to be followed. Furthermore, clinical samples such as fluid from the vesicles, blood, sputum, nasopharyngeal and oropharyngeal specimens have to be sent to ICMR-NIV, Pune if there is clinical suspicion."

Priya said that if there is a positive case, contact tracing has to be initiated immediately for all contacts over the past 21 days. “Airport authorities will be collecting a 21-day travel history of passengers coming from nations with monkeypox cases and check their current health status," she said.

Asked if NIV, Pune received some suspected samples or any suspected cases, she said: “We are prepared but have not yet got any suspect /confirmed samples. NCDC is already geared for surveillance and ICMR-NIV is ready to receive the samples."

According to public health experts, cases of monkeypox worldwide can potentially be an additional challenge in these times. However, as a country, India needs to keep a very close watch on the global situation and there is no need to panic yet.

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