The Union Health Ministry has released an advisory for all states and union territories on the Mpox disease after India became the third non-African country to report a case of clade 1b Mpox infection recently. The Department of Health and Family Welfare on September 26 in its advisory has directed that all suspected Mpox cases be isolated and strict infection prevention and control measures be put in place.


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It has provided a list of laboratories operationalized for testing. The advisory includes clinical management protocols, infection prevention and control practices, as well as a risk communication strategy. The Health Ministry stated that the World Health Organisation had on August 14, 2024 announced that the current outbreak of Mpox disease was a Public Health Emergency of International Concern (PHEIC).


This is the second time such Mpox disease associated with PHEIC has been declared by the WHO under the International Health Regulations, 2005, to which India is a signatory. The ministry has instructed the states to assess public health preparedness at health facilities, with reviews to be conducted by senior officials at both the state and district levels.


The ministry has also directed the identification of isolation facilities in hospitals for managing both suspected and confirmed cases, ensuring the availability of required logistics and trained human resources in such facilities and developing an augmentation plan.


The Ministry, in its letter, said that as per available information, clinical presentation of Mpox clade I in adults remains similar to clade II. However, the rate of complications may be higher in clade I than with clade II infections.
This is the second time such a Mpox disease-associated PHEIC has been declared by WHO under the International Health Regulations, 2005 to which India is a signatory. The previous Mpox outbreak that started in 2002 was caused by Mpox virus clade II.


The 2024 PHEIC is related to MPox virus clade I which is more virulent and more transmissible than Mpox clade II, the release further added. The clade has been found Democratic Republic Of Congo (DRC) only during the current outbreak, and outside Africa, one case each of Mpox clade 1 B has been recently reported from Sweden and Thailand. India is the third non-African country to report a case of 1b Mpox infection recently.


As per available information, clinical representation of Mpox clade I in adults remains similar to clade II, however, the rate of complications may be higher in I than with clade II infections, as per the release. The Ministry has listed out key public health actions are required to be undertaken to prevent and minimise the risk of further spread of Mpox in the country.


These include reviewing public health preparedness, particularly at health facility levels at state and district levels by senior officials, identification of isolation facilities in hospitals for taking care of the suspects and confirmed cases, availability of required logistics and trained human resources in facilities and augmentation plan.


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, as per the advisory.
Samples from skin lesions of any patient with the suspected symptoms of Mpox should be sent to the designated labs immediately, and for those that test positive a sample should be sent to designated labs immediately, and the positive sample should be sent to ICMR-NIV for genome sequencing to determine the clade.


Robust diagnostic testing capability is already available; 36 labs supported by ICMR across the country and three commercial PCR kits validated by ICMR that are now approved by CDSCO, as per the Union Ministry's advisory to states and union territories.


The Union Ministry of Health and Family Welfare said it will continue to monitor the situation closely and we will extend all requisite support in this regard to states and UTs