The report, published in the journal “Clinical presentation, viral kinetics and case management of human monkeypox from New Delhi, India 2022″, says that increased awareness is needed among healthcare workers, especially those working in STI clinics, to understand the newer presentations of the disease monkeypox infection. A study of the first five monkeypox patients admitted to Delhi’s Lok Nayak Hospital said more intensive surveillance involving men who have sex with men (MSM), female prostitutes and the bisexual community is needed to understand the transmission of the virus. All these patients were isolated at the Lok Nayak Hospital, which was designated for monkeypox cases to reduce secondary transmission and control the infection.
According to researchers involved in the study, including Drs. Pragya Yadava of the Indian Council of Medical Research (ICMR) and Dr. Vineeta Relhan, professor of dermatology at Lok Nayak Hospital, detection of monkeypox cases in Delhi without travel history to endemic or affected areas suggests undetected circulation of MPXV (monkeypox virus) in the community. “It was observed and reported that transmission of MPXV through MSM was the main reason for the 2022 monkeypox outbreak,” he added.
In two cases, detailed details of any sexual contact were denied, primarily due to the stigma associated with the disease, the researchers said. “This calls for counseling for monkeypox-positive cases to alleviate the fear, stigma, anxiety, stress and depression associated with the infection,” they said. Asymptomatic or paucisymptomatic cases of monkeypox could lead to community transmission in vulnerable populations such as children, pregnant women and immunocompromised individuals, the study said. “In our study, cases of monkeypox were mild and fully recovered.” This emphasizes the importance of early clinical and laboratory diagnosis for timely detection and treatment of the patient leading to recovery without secondary complications.”
Confirmed cases of monkeypox occurred between 5 and 14 days after the onset day (POD) of the disease. Of the five cases, three were male and two were female with a mean age of 31.2 years and presented with mild to moderate intermittent fever with myalgia. “All presented to the hospital with vesicles and pustules, with the absence of the traditional progression of lesions from maculopapular to crusted.” Lesions were most commonly observed on the genitalia, groin, lower extremities, trunk, and upper extremities and were pruritic,” the report states. The report added that patients were encouraged to wear clothing with full sleeves and full coverage to prevent secondary infection in the lesions. The lesions were covered with disposal sheets to reduce exposure. Patients were also provided with surgical masks to reduce respiratory droplets and fomites.
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