Kerala issues SOP for treatment, isolation of monkeypox cases

Following two confirmed cases of monkeypox in the country reported from Kerala, the state government on Wednesday issued Standard Operating Procedures (SOP) to isolate and collect samples and treat those infected or showing signs of it.

Kerala Health Minister Veena George, in a statement, provided details of the standard operating procedure that all private and government hospitals will follow.

She said anyone who has traveled in the last 21 days to a country where monkeypox has been reported and red spots on the body along with one or more other symptoms, such as fever, headache, body aches or fever, should have a suspected infection with the virus.

In the statement, the minister said, the risk of infection is high through direct physical contact, direct skin-to-skin contact, sexual contact with an infected person, or through contact with bedding or clothing. She added that anyone who falls into those categories will come on the primary contact list, where infection is confirmed with a polymerase chain reaction (PCR) test.

According to the Department of Health’s Standard Operating Procedures, as stated in the statement, suspected and probable cases of monkeypox should be treated separately and isolated and the District Control Officer (DSO) should be reported immediately.

Samples must be collected according to protocols established for themselves by the National Institute of Virology (NIV) and DSO will be responsible for sending them to the laboratory.

The standard operating procedures said that referrals from private hospitals to government facilities should be at the request of the patient, and only critically ill patients from state-run hospitals with isolation facilities should be referred to medical colleges.

While transporting infected people to a hospital or from one medical institution to another, a personal protective equipment (PPE) kit, N95 masks, gloves and goggles must be worn by health professionals and patients must also wear an N95 mask or a three-layer mask, and any wounds on their bodies should be covered, she added.

After the patient is born, the ambulance and the equipment in it should be disinfected and the patient’s items such as clothing disposed of, according to the guidelines, according to a health ministry statement. She added that confirmed cases of monkeypox should be dealt with strictly according to the center’s guidelines and in case of any doubt about treatment, the government medical council should be consulted.

Since all international airports in the country have thermal scanning devices, the statement said that anyone showing signs of fever will be examined by a medical team, and if these signs are found, they will be transferred to the nearest hospital with isolation facilities and the DSO will be informed of the same.

Health workers were instructed to monitor those on the initial contact list for a period of 21 days for any symptoms by contacting them by phone and recording their temperature twice daily, and added that the health worker or nurse responsible for monitoring should visit the contacts’ home periodically to ensure that they are following Guidelines.

If a person in primary contact develops a fever, he should be immediately isolated, and if red spots appear, his samples should be sent for monkeypox testing, the statement said. She added that people on the contact list who are asymptomatic should donate blood, cells, tissues, organs or semen.

The Kerala government on Tuesday started testing monkeypox infection at Alappuzha NIV with test kits brought from Pune NIV.

On Monday, India reported a second confirmed case of monkeypox in the Kannur district of Kerala state.
The patient, who arrived in Kerala on July 13, was a native of Kannur in northern Kerala, and was undergoing treatment at Pariyaram Medical College there.

The first case of monkeypox, a rare but potentially serious viral disease, was reported from Kollam district of southern Kerala on July 14. He is currently undergoing treatment at Government Medical College Hospital, Thiruvananthapuram.

Both of their samples were sent to the National Institute of Virology (NIV), Pune, and tested positive for the virus.
The minister also said that all those who had close contact with the patient are being closely monitored.

According to the World Health Organization, monkeypox is a viral zoonosis (a virus transmitted to humans from animals), with symptoms similar to those seen in the past in patients with smallpox, although clinically less serious.
With the eradication of smallpox in 1980 and the subsequent discontinuation of smallpox vaccination, monkeypox emerged as the most important orthopoxvirus for public health.

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