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Monkeypox, is India at risk of an outbreak?

India has now reported its second case of monkeypox, with both cases occurring in the state of Kerala. As the world now deals with new COVID-19 strains causing fresh outbreaks, can India expect an outbreak of monkeypox to add to its healthcare burden?

One of the symptoms of monkeypox are lesions that can develop across the body. (CDC’s Public Health Image Library) Media ID #2329

The government of Kerala issued standard operating procedures for the isolation, sample collection and treatment of those infected or showing signs of monkeypox on Wednesday 20th July. Containment and surveillance efforts are underway, and given the currently low caseload, may be enough to curb a rise in cases.

As previously reported by Health Issues India, monkeypox, much like COVID-19, is another zoonotic condition – spread to humans from animals. Typically the disease is endemic only to a few regions of Africa. The disease suddenly spread across May to a list of non-endemic countries now extending the world over. Notably, the disease is far less transmissible than COVID-19, and so holds a far lower chance of ever becoming a pandemic-level situation. 

Monkeypox, as noted by the CDC, typically requires either skin contact, or prolonged exposure to large respiratory droplets. The disease has been proliferating rapidly among men who have sex with men (MSM), prompting some countries to look into further measures to offer protection to this community.

The World Health Organization (WHO) has so far not declared monkeypox as a global health emergency. “While a few members expressed differing views, the committee resolved by consensus to advise the WHO director-general that at this stage the outbreak should be determined to not constitute a global health emergency”, the WHO said in a statement.

The WHO panel’s conclusion that monkeypox did not yet constitute a Public Health Emergency of International Concern (PHEIC) was widely criticised by virologists, epidemiologists, and public health experts. Some cited the delay in public health emergency declarations for COVID-19 and the Ebola epidemics in West Africa and the Democratic Republic of the Congo as evidence that the WHO is typically hesitant to make such declarations. 

“Right now PHEICs send the message that WHO is the last institution to grasp that a newly identified outbreak is indeed a public health emergency of international concern,” said biologist Michael Worobey of the University of Arizona. “The window may already have closed on stopping the establishment of a new sexually transmitted disease worldwide, but a PHEIC has not even been declared.”

While India’s confirmed cases currently only number at two individuals, there is always the possibility that monkeypox could begin to spread through the population. In addition to the current cases, other infected individuals could travel to the country, warranting continued vigilance and screening efforts to prevent yet another disease from becoming an endemic condition.

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