Since the beginning of May there has been an increase in cases of monkeypox in many countries. In our country, no suspected cases of monkeypox have been recorded and the risk is considered low
According to the European Centre for Disease Prevention and Control (ECDC, risk assessment 23/05/2022) the overall risk (probability of infection and impact) for the general public is considered low and for the group with multiple sexual partners moderate.
Based on current epidemiological data, monkeypox is usually a self-limiting disease with symptoms lasting from 2 to 4 weeks. Severe cases occur more frequently among children and are related to the extent of exposure to the virus, the health status of the patient (coexisting diseases) and the nature of the complications. Underlying immunodeficiencies may lead to worse outcomes.
The interval from infection to the onset of monkeypox symptoms is usually 6 to 13 days, but can range from 5 to 21 days.
METHODS OF TRANSMISSION
Animal-to-human (zoonotic) transmission can occur from:
- direct contact with
- blood,
- body fluids,
- skin or mucosal lesions of infected animals,
- consumption of undercooked meat and other animal products from infected animals.
Human-to-human transmission is not common but may occur:
- close contact through respiratory secretions or skin lesions of an infected person or recently contaminated objects; - transmission through respiratory particle droplets usually by prolonged face-to-face contact; - transmission through the placenta from mother to foetus (which may lead to congenital monkeypox),
- in close contact during and after birth, - in close contact with household members, sexual partners, other close contacts (including some hotel and direct flight contacts), - persons providing care in an incident, including health professionals who were not adequately protected.
CASE DEFINITION
- Confirmed case: A person with laboratory-confirmed monkeypox virus infection by PCR test [1] who has symptom onset on or after 1 March 2022.
- Probable case:
Person with a rash of unknown origin on any part of the body
AND
one or more symptoms of simian pox virus with onset on or after 1 March 2022:
- fever (usually high >38.5°C) - headache - dorsalgia - fatigue - lymphadenopathy (localised or generalised)
AND
one of the following:
- positive result in a virus detection test for Orthopoxvirus[2] - epidemiological link to a confirmed or probable case of monkeypox in the 21 days prior to the onset of symptoms - reported history of travel to countries endemic for smallpox a person (of any sexual orientation) who has had multiple or unknown sexual partners in the 21 days prior to the onset of symptoms
Or
(B) Person with a rash of unknown origin, generalised or localised, spotty or vesicular/blistered with a centrifugal distribution, with lesions showing an indented umbilical centre or eschar
KAI
Lymphadenopathy
AND
one or more of the other symptoms compatible with monkeypox:
- fever (usually high >38.5°C) - headache - dorsalgia - fatigue If any of the above symptoms or rashes occur, the public is advised to contact their Personal Physician, Dermatologist or Pediatrician immediately so that appropriate instructions can be given.
CLOSE CONTACTS
Close contacts of a monkeypox case are:
- Sexual partner - Person(s) living in the same household or similar environment (e.g.(e.g. campsite, shared overnight accommodation) - Person(s) who shared clothing, clothing, utensils, etc., while the case had a rash - Person(s) who shared a workplace/office with the case for a long period of time - Carers of a monkeypox case during the period when the case had symptoms without the use of appropriate Personal Protective Equipment (PPE) - Health professionals who have had contact with a monkeypox case (skin lesions or prolonged contact face-to-face) without the use of appropriate Personal Protective Equipment (PPE) - Health professionals or other persons who sustained a sharps injury or were exposed to body fluids of a monkeypox case or a procedure involving aerosol production without the use of PPE - Laboratory personnel exposed to an occupational accident with a sample containing virus (ejection of biological fluids, spurting of biohazardous fluids, exposure to aerosol, etc.) - Co-passengers of a case within 1-2 seats around the perimeter of the case while it was symptomatic, on a plane, bus or train on a journey lasting ≥8 hours
Guidance for confirmed non-hospitalized cases
Confirmed cases: - should be isolated from 2 to 4 weeks and cases should be discharged after evaluation by the attending physician/personal physician for confirmation of rash healing. - should remain in their own room when at home and use separate items from other household members (clothes, bedding, towels, utensils, plates, glasses); they should avoid contact with immunocompromised persons
; they should avoid contact with domestic mammals, especially rodents (mice, rats, hamsters, guinea pigs, guinea pigs, squirrels, etc.); they should avoid contact with other members of the household (e.g. mice, rats, hamsters, gerbils, guinea pigs, squirrels, etc.).etc.), due to the possibility of human-to-pet transmission.
- cases residing at home self-limiting, in case of worsening of their symptoms inform their Personal Physician and transfer to a hospital.
Guidelines for close contacts of confirmed cases
- they should avoid contact with domestic mammals, especially rodents (mice, rats, hamsters, guinea pigs, guinea pigs, squirrels, etc.) due to the possibility of human-to-pet transmission.
- they do not self-limit unless they show suspicious symptoms, as listed above. In this case, they should contact their Personal Physician, Dermatologist or Pediatrician immediately so that appropriate instructions can be given.
Contact telephone numbers: cycomnet@cytanet.com.cy
(AF)
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