Health ministry preparing new Mpox advisory as a deadlier strain spreads

New Delhi: India’s health ministry is working on an updated advisory and guidelines on Mpox a week after World Health Organization (WHO) declared it a global emergency as a deadlier strain of the virus spreads to more countries.

Incorporating suggestions from the National Centre for Disease Control (NCDC), the updated alert will include identifying sick patients at the ports of entry; isolation of suspected and confirmed cases; lab tests; symptoms, prevention, reporting of patients to the hospitals; surveillance strategies; community awareness; and hospital infection control measures, said an official aware of the matter. The ministry may release the advisory to the public soon, the official said.

The new Mpox strain found in Africa is more lethal than the previous one detected in 2022 and can also spread through sexual contact. As many as 99,176 laboratory-confirmed cases, including 208 deaths, were reported to WHO from 116 countries from 1 January 2022 through 30 June 2024. That the virus has turned deadlier is reflected in 537 deaths from among 15,600 cases since last year.

Also read | How prepared is India for an Mpox outbreak?

“It is very important to sensitize the general public about common symptoms and how to report it to a doctor,” the official quoted earlier said. “The virus may entre India via international travel, therefore, strong surveillance at the port is a must.”

The first human case of Mpox, formerly known as Monkeypox virus, was detected in 1970 in the Democratic Republic of Congo but was neglected. The virus caused a global outbreak in 2022. The current upsurge in parts of Africa, along with the spread of a new sexually transmissible strain, is an emergency, not only for Africa, but for the entire globe.

Mpox virus spreads through prolonged close contact, including the sexual route, with an infected patient. It is transmitted by body/lesion fluid of the patient or contaminated clothing/linen. Occasionally, the virus is passed on via objects and surfaces touched by an infected person.

Infections are generally self-limiting, lasting between two and four weeks; patients usually recover with supportive medical care and management. 

Difficult to prevent from entering India

"The way the virus is spreading to different countries, it is not easy to stop it from getting into any country, including India, due to high global mobility,” said Raman Gangakhedkar, former scientist and national chair at the Indian Council of Medical Research (ICMR).

He said cases in the country will rise only if people start hiding infections and don’t report it to the doctor. Stressing that there is no reason to panic as of now, he said, “We will have to educate people. The government has done the right thing by strengthening surveillance especially at airports."

According to Gangakhedkar, there is a need to update the advisory as the new Mpox clade 1b has high chances of getting transmitted to the sexual route. Even when the previous clade 2 entered Europe in 2022-23, scientists suspected it was coming in the gay community, but definitive evidence could not be obtained as the spread stopped in 2023, he said.

Also read | ICMR conducting serosurvey to assess mpox risk in India

The previous clade showed lesions near genitals in adults and on face and extremities in children, he said. Since clade 1b shows legions all over the body within five days of acquiring the infection, Gangakhedkar said this will help in screening passengers at airports.

“One of our successful public health programs—National AIDS Control Program—will help us as we have access to the at-risk population, if Mpox establishes itself in our country,” he said. “The covid-19 pandemic exposed healthcare system to barrier nursing and preventive measures. We will be able to contain the Mpox virus well in India.”

And read | Principal Secretary to PM reviews Mpox situation in country