Monkeypox Scare | Gist of Rajya Sabha TV / RSTV (now Sansad TV) - UPSC PDF Download

Introduction

• The epidemic of monkeypox has been deemed a worldwide health emergency by the World Health Organization. 75 different nations have so far recorded more than 16,000 cases. India has made cases known. In contrast to the previous three instances that were reported from Kerala, a 34-year-old man who had never travelled to a country where the disease was present tested positive. 
• The Centre held a high-level review meeting since that in particular has proven troubling. An urgent meeting was held with the joint monitoring group with the Union Health Secretary, Directorate General of Health Services, and Director of the National Center for Disease Control. The recommendation to conduct close surveillance has been given to all states and union territories.

Monkeypox’s reinvention

• Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms similar to those seen in the past in smallpox patients, although it is clinically less severe.
• Human monkeypox was first identified in 1970 in the Democratic Republic of the Congo.
• There are two distinct genetic clades of the monkeypox virus – the Central African (Congo Basin) clade and West African. The Congo Basin clade has historically caused more severe disease and is thought to be more transmissible.
• Since then, most cases have been reported from rural, rainforest regions of the Congo Basin, particularly in the Democratic Republic of the Congo and human cases have increasingly been reported from across central and west Africa.
• Since 1970, human cases of monkeypox have been reported in 11 African countries. In 2003, the first monkeypox outbreak outside Africa was in the US. This outbreak led to over 70 cases of monkeypox in America.
• Monkeypox has also been reported in travelers from Nigeria to Israel and the United Kingdom in September 2018, December 2019, May 2021 and May 2022, to Singapore in May 2019, and to the US in November 2021.
• In May this year, multiple cases of monkeypox were identified in several non-endemic countries.
• Globally, over 16,000 cases of monkeypox have now been reported from 75 countries and there have been five deaths so far due to the outbreak.

Symptoms associated

• Monkeypox is usually a self-limited disease with the symptoms lasting two to four weeks.
• The case fatality ratio has historically ranged from zero to 11 per cent in the general population and has been higher among young children.
• In recent times, the case fatality ratio has been around three to six per cent.

Spread

• Human-to-human transmission is known to occur primarily through large respiratory droplets generally requiring a prolonged close contact.
• It can also be transmitted through direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens of an infected person.

Vaccine against monkeypox

• The WHO, which declared monkeypox as a public health emergency, has stated that a strategy called ‘ring vaccination’ may help in halting the spread of the virus.
• This involves administering smallpox vaccines — which are thought to be effective against monkeypox because the viruses are related — to people who have been exposed to monkeypox through close contact with an infected person.
• Countries like United States, United Kingdom, Canada, Germany, Spain and France have already begun vaccinating people against monkeypox.
• The vaccine being used is the Imvanex shot, known as Jynneos in the United States, made by the Danish biotech company Bavarian Nordic.

Difference with that of smallpox

• The monkeypox virus is an orthopoxvirus, which is a genus of viruses that also includes the variola virus, which causes smallpox, and vaccinia virus, which was used in the smallpox vaccine.
• Monkeypox causes symptoms similar to smallpox, but they are less severe.
• Many symptoms of both the diseases vary like monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not.
• While vaccination eradicated smallpox worldwide in 1980, monkeypox continues to occur in countries in Central and West Africa, and has on occasion showed up elsewhere.

Need for Integrated system to deal with such epidemics

• The unprecedented pandemic has exposed the weaknesses and inadequacies in the public health sector in India right from shortage of doctors, beds, emergency equipment and medicines.
• There is a shortage of PHCs (22%) and sub-health centres (20%), while only 7% sub-health centres and 12% primary health centres meet Indian Public Health Standards (IPHS) norms.
• Doctor-Density Ratio: India has a doctor-to-population ratio well below the level recommended by the WHO — 1:1,445, which adds up to a total of roughly 1,159,000 doctors.
• Shortage of Medical Personnel: Data show that there is a staggering shortage of medical and paramedical staff at all levels of care: 10,907 auxiliary nurse midwives and 3,673 doctors are needed at sub-health and primary health centres,
• Social Inequality: The growth of health facilities has been highly imbalanced in India. Rural, hilly and remote areas of the country are under served.
• The shortage and unwillingness of allopathic doctors, including surgeons, to serve in rural areas is now a chronic issue.