As India prepares to combat the likely more severe strain of the Mpox infection, the union health ministry has directed states and union territories to step up efforts.
The union health ministry on Thursday informed states and union territories that the infection caused by clade 1b could be more complicated than what India has already seen with clade II.
Clade 1b entry
The move was triggered by the entry of the clade 1b strain via a 38-year-old Kerala-based man who came back to India after travelling from the United Arab Emirates and reported symptoms soon after he arrived at the dermatology outpatient department at Manjeri Medical College Hospital, Malappuram, Kerala.
“As per available information, clinical presentation of Mpox clade 1 in adults remains similar to clade II. However, the rate of complications may be higher in clade 1 than with clade II infections,” health secretary Apurva Chandra wrote to chief secretaries of states and union territories.
The previous Mpox outbreak — which began in 2022 — was caused by the clade II virus.
However, the 2024 Public Health Emergency of International Concern (PHEIC) is related to Mpox virus clade 1 which is more virulent and more transmissible than Mpox clade II, as per the government letter dated September 26.
The letter clarifies that clade 1 has been found outside the Democratic Republic of Congo (DRC) only during the current outbreak. Outside Africa, one case each of Mpox clade 1b has been recently reported from Sweden and Thailand.
“India is thus the third non-African country to report a case of clade 1b Mpox infection recently,” the letter confirmed.
Chandra wrote that by implementing the preventive measures, states and UTs can “safeguard the health and well-being of individuals and reduce the impact of Mpox outbreaks”.
He further said that the ministry “shall continue to monitor the situation closely” and we will extend all requisite support in this regard to States and UTs”.
Guidelines for states and union territories
The central government has told states and UTs to take multiple actions across the nation to prevent and minimise the risk of further spread of Mpox in India.
It has asked to undertake appropriate activities to make communities aware of the disease, its modes of spread, the need and importance of timely reporting, and preventive measures.
“It is crucial that any panic amongst the masses is prevented,” the letter said.
The ministry has asked states and UTs to conduct a review of public health preparedness, particularly at the health facility level in states and districts by senior officials.
It has also asked to identify isolation facilities in hospitals for taking care of both suspect and confirmed cases along with making available the required logistics and trained human resources in such facilities and augmentation plans.
“All suspected Mpox cases should be isolated and strict infection prevention and control measures should be put in place. Treatment is symptomatic and available treatment guidelines should be followed,” said the letter.
Also, samples from skin lesions of any patient with suspected symptoms of Mpox will be sent to the designated labs immediately, and for those that test positive a sample will be sent to Pune-based ICMR-National Institute of Virology for genome sequencing to determine the clade.
India already has robust diagnostic testing capability with 36 labs supported by ICMR across the country and three commercial kits validated by ICMR that are now approved by the health regulator as well.
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