The World Health Organization declared Mpox as a public health emergency of international concern (PHEIC) on August 14. It was spread across central and east Africa, but a few weeks back the first case was reported in Asia and now it has reached India, our next door neighbor. Thailand confirmed the first case of the clade I b Mpox strain in Asia. A 26-year-old Indian man from Haryana with a recent history of travel to an M-pox-infected nation has tested positive for the virus (Mpox clade 2). As Nepal shares an open border with India, the chances of Mpox spreading here are even higher. Clade I and clade II are two Mpox strains. Clade II is milder and was responsible for the 2022 outbreak, but this time, clade I, known as clade I b, causes more serious diseases and higher death rates.
Mpox is caused by the Mpox virus, which is brick or oval in shape and has a size of 200-250 nm and linear double-stranded DNA. The transmission is from face-to-face (talking or breathing), skin-to-skin (touching or vaginal/anal sex), mouth-to-mouth, and respiratory droplets. Animal (rodents and primates) to human transmission is also common. The incubation period is generally 1-21 days from exposure, and symptoms can last 2-4 weeks. The main symptoms are rashes with fever, sore throat, headache, and muscle aches. A rash begins as a flat sore that develops into a liquid blister and may be itchy or painful. It is important to distinguish Mpox from chicken pox, measles, herpes, or some other bacterial skin infection rashes, as people may get confused.
The confirmatory laboratory test is PCR (Polymerase Chain Reaction), which is done by collecting swab samples from the rashes. If people are in contact with someone with Mpox, then vaccination within four days is recommended, or if there is infection with no symptoms, vaccination is recommended within fourteen days. There is another question in everyone’s mind: Can Mpox be fatal? Yes, it can be. At present, WHO recommends the use of MVA-BN or LC16 vaccines, or the ACAM2000 vaccines when the others are not available. People traveling to outbreak regions are also advised to be vaccinated.
Last year, a 60-year-old foreign lady was confirmed positive for Mpox in Nepal. As it has already entered Asia, Nepal should take preventive measures with priority. Early detection and isolation are crucial as WHO recommends contact tracing and quarantine measures. Nepal needs quarantine facilities for people returning from disease-prone zones at the airport and border areas. Vaccination facilities should be available in hospitals. But even despite having a history of Mpox disease, Nepal still does not have the facility of vaccination service.
In this context, the one who suspects having infection can go into quarantine. Washing hands with soap and using masks near the infected person can prevent the disease. Nepal should be ready to handle the first case as there is a possibility of a new health emergency. The hospitals must have a standard operating procedure (SOP) that details the steps to handle the cases of Mpox.
Vidya Laxmi Jaishi is a research scholar currently working in a virology lab at South Asian University, India focusing on HIV multi-drug resistance.
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