Vaccination and cases of monkeypox, what the circular of the Ministry of Health provides
What to do if you have had contact with monkeypox cases. Vaccination and therapies. Risk probability and spillover hypothesis. All the details contained in the circular of the Ministry of Health
Following the confirmed and suspected cases of monkeypox, also known as monkeypox (Mpx), the Ministry of Health yesterday issued a circular with the update of the epidemiological situation and indications for reporting, contact tracing and management. of cases.
Here's what it predicts.
IDENTIFICATION, TRACKING AND INCUBATION TIMES
The key objectives of surveillance, the circular reads, are to rapidly identify cases, clusters and sources of infection as soon as possible in order to provide optimal clinical care, isolate cases to prevent further transmission, identify and manage contacts and adopt effective methods of control and prevention.
In non-endemic countries, a case is considered an outbreak.
The suspected, probable and confirmed cases must be promptly reported by the doctor to the local health authority and from this to the Region / Autonomous Province, who report it to the Ministry of Health.
The incubation period is usually between 6 and 13 days, but can range from 5 to 21 days. The disease is often self-limited and symptoms resolve spontaneously within 2-4 weeks.
SURVEILLANCE OF CONTACTS
Individuals who have come into contact with an infected patient should be monitored daily for signs / symptoms referable to monkeypox for a period of 21 days from the last contact with a patient or its contaminated materials during the infectious period. During this period, those under surveillance must avoid contact with immunosuppressed people, pregnant women and children under the age of 12. Contacts must also monitor their temperature twice a day.
Signs / symptoms include headache, fever, chills, sore throat, malaise, asthenia, myalgia, back pain, rash and lymphadenopathy.
Asymptomatic contacts should not donate blood, cells, tissues, organs, breast milk or sperm while under surveillance.
HOW MUCH THE HEALTHCARE STAFF RISK
As for healthcare personnel, more exposed to contact with the monkeypox virus, the ministry believes that by properly using appropriate personal protective equipment (disposable gown, disposable gloves, disposable shoe covers or boots, respiratory protection type FFP2, and eye protection with glasses or visor) the risk is very low.
In case of unprotected close contacts, the risk is still considered "moderate".
MEASURES FOR HEALTHCARE STAFF
Healthcare personnel, in accordance with the circular, must implement standard contact and droplet precautions, i.e. strict compliance with hand hygiene, appropriate handling of contaminated medical equipment, laundry, waste and cleaning and disinfection of environmental surfaces .
In addition, timely isolation of suspected or confirmed cases is recommended. The isolation time can only end with the resolution of the symptoms.
VACCINE AND THERAPIES
Post-exposure vaccination (ideally within four days of exposure) "may be considered for higher risk contacts such as healthcare professionals, including laboratory staff, after careful evaluation of the risks and benefits."
Drugs, including specific antivirals , may be considered "as part of experimental or compassionate use protocols, particularly for those with severe symptoms or who may be at risk of poor outcomes, such as immunosuppressed people."
TRANSMISSION
The circular reiterates that person-to-person transmission “occurs through close contact with infected material from the skin lesions of an infected person, as well as through droplets in case of prolonged face-to-face contact and through fomites. Furthermore, the virus can be transmitted by direct contact with the body fluids of an infected person, the contact of mucous membranes or non-intact skin with open exanthematous lesions or with contaminated objects such as fomites or clothing ".
In the current outbreak of human monkeypox, the document continues, the nature of the lesions present in some cases suggests that transmission occurred during sexual intercourse. Transmission through contact with intact skin is less likely but cannot be ruled out.
Given the "extraordinary resistance to drying and a greater tolerance to temperature and pH than other enveloped viruses" it is also suggested that the spaces be thoroughly cleaned in the presence of an infected patient and everything that is not disposable must be collected and washed at 60 ° C.
SPILLOVER HYPOTHESIS
As Start wrote, reporting the words of virologist Pasquale Ferrante, professor at Temple University in Philadelphia and medical and scientific director of the Città Studi Clinical Institute in Milan, it cannot be excluded that the origin of the recent cases of monkeypox that emerged may be " an infection in some reservoir animals that are no longer only African, but also 'local', for example a rodent ”, as occurred in 2003 in the United States.
The circular also states that at present little is known “about the suitability of European peri-domestic animal species (mammals) to act as hosts for the monkeypox virus. However, it is suspected that rodents, and in particular species of the Sciuridae family (squirrels), are more suitable hosts than humans, and transmission from humans to (companion) animals is therefore theoretically possible. Such a spillover event could ultimately lead the virus to settle in European wildlife and the disease to become an endemic zoonosis ”, as has already happened in some Central and West African states.
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/vaccinazione-e-casi-di-vaiolo-delle-scimmie-cosa-prevede-la-circolare-del-ministero-della-salute/ on Thu, 26 May 2022 09:45:24 +0000.