Getting ready for monkeypox

Ahmed Morsy , Wednesday 27 Jul 2022

Egypt is on alert for monkeypox, though no cases have yet been detected.

Getting ready for monkeypox
Getting ready for monkeypox

 

Monkeypox has made headlines globally since 23 July when World Health Organisation (WHO) Director-General Tedros Gebreyesus declared the escalating global outbreak a Public Health Emergency of International Concern (PHEIC), with more than 16,000 reported cases in 75 countries and territories and five deaths at the time.

“No confirmed [monkeypox] cases have been detected in Egypt to date,” Egyptian Health Ministry Spokesperson Hossam Abdel-Ghaffar said, stressing that the Ministry of Health had raised the level of surveillance in all land and sea ports and quarantine sites, with the issuance of a guide for doctors nationwide to show how to diagnose and treat any confirmed cases.

The WHO has divided the countries into groups. The first group, which includes Egypt, has no confirmed infections, Abdel-Ghaffar said.

“As Egypt is one of the countries in the first group, we are dealing with the procedures of the first group,” the spokesperson said, adding that the procedures necessitate raising awareness and training medical personnel on diagnosis and referral, and raising the level of surveillance and the availability of diagnostic tools.

Monkeypox was discovered in 1958 when it was first identified as a distinct illness. Scientists and doctors know its symptoms and means of its spread, and there are treatments and vaccines. “There is no comparison between the coronavirus and the new virus. The coronavirus is a rapidly spreading disease and spreads much faster than monkeypox, which is only transferred by close contact,” said Abdel-Ghaffar.

Moreover, those infected by monkeypox do not spread it until after symptoms appear which according to the WHO, takes from two to four weeks, unlike the coronavirus, when a patient may be infected and contagious without any symptoms.

The WHO says monkeypox spreads from person to person through close contact with someone who has a monkeypox rash, including face-to-face, skin-to-skin, mouth-to-mouth or mouth-to-skin contact, including sexual contact. Though the health organisation says it is still trying to understand how long people with monkeypox are contagious, generally they are considered infectious until all of their lesions are crusted over, scabs fall off and a new layer of skin has formed underneath.

Monkeypox is an illness caused by the monkeypox virus. It is a viral zoonotic infection, meaning that it can spread from animals to humans and can also spread from person to person, according to the WHO.

Gebreyesus said that the current risk of monkeypox is moderate globally and in all regions, except in Europe where the risk is high, indicating that for the moment the monkeypox outbreak “is concentrated among men who have sex with men, especially those with multiple sexual partners”.

Abdel-Ghaffar said the PHEIC was declared only because there is unprecedented spreading, unlike what the world has been used to since 1958.

Islam Anan, a pharmacoepidemiology and pharmacoeconomics lecturer at Misr International University, said the PHEIC was issued despite nine votes against the declaration compared to only six in favour of the decision.

“In my opinion, the PHEIC is a proactive decision so that the coronavirus scenario is not repeated in terms of the delay in declaring it a global pandemic. The scientific community criticised them at that time for the delay,” Anan said.

“I also think that it is targeting health authorities in order to urge them to start taking the issue seriously as Europe had been reluctant to trace and take public health measures for monkeypox following the organisation’s previous warning.”

Meanwhile, Egypt has been witnessing a surge in coronavirus infections since early July, according to Prime Minister Mustafa Madbouli and Acting Health Minister Khaled Abdel-Ghaffar.

Earlier this month, Madbouli urged all Egyptians to maintain precautionary measures against the coronavirus “as infections have risen recently”.

On 15 July, the minister stated “there is a daily average of 38 cases of coronavirus” in the country, with the coronavirus-related fatality rates “remaining steady with a daily average of four to five deaths”.

On 16 July, Spokesperson Abdel-Ghaffar indicated “it is too early to say that the current pandemic situation in Egypt is a new wave of Covid-19.”

Though the detected daily infections have not been issued by the ministry for months, on 20 July the minister said infections had increased during the 28th week in 2022, specifically from 10 to 16 July, without disclosing the percentage of increase compared to the week before.

A week earlier, however, the ministry made it clear that during the 27th week, 4-10 July, Egypt witnessed an increase of 15 per cent infections and seven per cent deaths, compared to the previous week.

“Statistically speaking, we are now in the sixth wave of the coronavirus,” Anan told Al-Ahram Weekly on 26 July in light of the still rising number of infections.

“The peak of this sixth wave locally should be during the current week [July’s fourth week]. Infections will still be high until the second week of August. The rate of infections should be lower starting the third week of August, in which death rates may rise. By the end of August infections should reach their lowest point,” Anan said.

Anan, however, noted that during this wave, the number of people with symptoms so severe that they require medical care in hospital are few because most of the infections “are in the upper respiratory system”.

This is due to the fact that the most widely spread omicron variant is the sub-type BA.5 which is more infectious than the main variant but less severe in terms of symptoms, Anan said.

In remarks made last week, the acting health minister stated that the occupancy rates in isolation hospitals of the Health Ministry do not exceed 12 per cent for ICU beds and four per cent for ventilators, noting that these are “satisfying rates”.

Most infections in Egypt do not require isolation in hospitals but at home, for five to seven days after symptoms appear, the minister explained.

A runny or stuffy nose, sore throat, headache, and fatigue are common symptoms, the spokesperson said, adding that fever and loss of taste and smell were no longer common.

“Any respiratory symptoms must now be treated as a coronavirus, until proven otherwise, and not as a flu until it is proven that it is a coronavirus,” the spokesperson said.

“The virus is not over yet. It is still mutating and reaching a large number of infections,” the spokesperson said, stressing the necessary adherence to precautionary measures and getting vaccinations.

A total of 38 million Egyptians were fully vaccinated against the coronavirus by 20 July, according to the spokesperson.

The ministry stated that anyone over the age of 65 and those who suffer from chronic illnesses may now get their booster shots three months after receiving their third vaccine without prior registration.

The ministry also recently called on foreigners living in Egypt to visit any of its 1,393 vaccination centres nationwide to get vaccinated free of charge.

*A version of this article appears in print in the 28 July, 2022 edition of Al-Ahram Weekly.

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