Mpox case confirmed, strain not part of WHO's health emergency: Govt

Union Health Ministry asks states/UT's to review preparedness, increase screening

The government on Monday evening confirmed that a patient kept in an isolation ward due to Monkeypox-related symptoms has tested positive for the infection.

But the government has clarified that it was “clade 2” strain of Monkeypox or Mpox, and not the “clade 1” for which the current public health emergency has been sounded by the World Health Organisation (WHO).

The ministry said that the patient was a young male, but didn’t disclose his identity. The case has been verified as a travel-related infection.

“Laboratory testing has confirmed the presence of Mpox virus of the West African clade 2 in the patient. This case is an isolated case, similar to the earlier 30 cases reported in India from July 2022 onwards, and is not a part of the current public health emergency (reported by WHO) which is regarding clade 1 of Mpox,” the ministry said.

 

The ministry said that the patient travelled from a country experiencing ongoing Mpox transmission. He is currently isolated at a designated tertiary care isolation facility. “The patient remains clinically stable and is without any systemic illness or comorbidities,” the ministry said. 

India has already stepped up action to check the spread of this virus, and is reviewing public health preparedness. 

Earlier in the day, the Union health ministry directed all states and Union Territories (UT) to review their public health preparedness, along with screening and testing of all suspected cases of Mpox, while asserting that it was closely monitoring the evolving situation. 

In a letter issued on September 9, Union Health Secretary Apurva Chandra asked all the state governments and UT administrations to follow surveillance strategies laid down by the National Centre for Disease Control (NCDC).

The central and state governments had sprung into action after the WHO designated Mpox as a public health emergency of international concern (PHEIC), following a surge in cases in African countries last month.

The central government has identified three major hospitals in Delhi - Ram Manohar Lohia Hospital, Safdarjung Hospital and Lady Hardinge Hospital, as the nodal centres in the national capital for the isolation, management and treatment of any Mpox patient. 

This was followed with the All India Institute of Medical Sciences (AIIMS), New Delhi issuing a guideline to flag patients exhibiting fever, rash, or a history of contact with confirmed Mpox cases for immediate assessment. 

Tamil Nadu too has set up isolation wards for Mpox in four government hospitals in Chennai, Madurai, Coimbatore and Tiruchirappalli, according to a state health official.

The health ministry has also directed all states to increase screening and identification of isolation facilities in hospitals for taking care of both suspected and confirmed cases, availability of required logistics and trained human resources in such facilities and augmentation plan. 

Currently, there are 22 laboratories actively conducting Mpox testing, according to a communicable disease alert (CD Alert) shared by the NCDC.

These include labs at Pune’s ICMR-National Institute of Virology (NIV), NIV Field Unit in Kerala, the NCDC Lab in New Delhi and Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata. 

Two AIIMS labs, at New Delhi and Nagpur are also conducting Mpox tests.

Union health secretary Chandra asked the states and UT officials to engage with key stakeholders, especially healthcare workers deployed in skin and sexually-transmitted disease (STD) clinics to understand about common signs and symptoms in Mpox, along with differential diagnosis and actions to be undertaken following detection of a case. 

State AIDS control societies too have been told to be on alert to pick up suspected cases and improve community awareness as around half the cases are reported to be in persons with HIV. 

The latest WHO update on Mpox suggests that around half (51.9 per cent) of Mpox cases are reported to be in persons living with HIV.

The advisory also directed senior officials at state and district level to review preparedness at health facilities. 

The health ministry also said that most cases reported from around the world are young males with a median age of 34 years (range 18 to 44 years). 

“Among modes of transmission reported globally, sexual contact is the most commonly reported, followed by person-to- person non-sexual contact, with the most common symptom being rash (including systemic or genital rash), followed by fever,” Chandra added. 

Mpox, or monkeypox is a zoonotic disease, which can be transmitted through direct contact with infectious skin or other lesions (mouth, genitals). Infection can also occur via use of contaminated objects such as clothing or linens or in a community setting.

Symptoms: 

Common symptoms of Mpox are skin rash (like in chicken pox) or mucosal lesions which can last 2–4 weeks accompanied by fever, headache, muscle aches, back pain, low energy and swollen lymph nodes.

Standard of Care:

Mpox is treated with supportive care for symptoms such as pain and fever, with close attention to nutrition, hydration, skin care, prevention of secondary infections and treatment of co-infections, including HIV where present.

Vaccination:

“Based on currently assessed risks and benefits, mass vaccination is not recommended by WHO for Mpox at present. India has also not issued any advisory pertaining to Mpox vaccination at present”, the NCDC stated in its CD Alert in August 2024.