Kalain Ho­sein

Re­porter

kalain.ho­sein@guardian.co.tt

Ex­act­ly two months af­ter the World Health Or­ga­ni­za­tion (WHO) down­grad­ed Mon­key­pox (mpox) from a Pub­lic Health Emer­gency of In­ter­na­tion­al Con­cern, the Min­istry of Health de­tect­ed the first case of the virus yes­ter­day in T&T.

Ac­cord­ing to the Min­istry of Health (MoH), the pa­tient is a mid­dle-aged male with trav­el-re­lat­ed his­to­ry. The MoH said in a me­dia re­lease that the pa­tient was test­ed yes­ter­day, and the sam­ple was sent to the Caribbean Pub­lic Health Agency’s lab­o­ra­to­ry via the Trinidad Pub­lic Health Lab. Min­is­ter of Heath Ter­rence Deyals­ingh spoke to CNC3 News last night, say­ing, “The pa­tient is do­ing fine, clin­i­cal­ly well.”

The rel­e­vant Coun­ty Med­ical Of­fi­cer of Health has ini­ti­at­ed the lo­cal pub­lic health re­sponse.

Deyals­ingh said, “The rel­e­vant Coun­ty Med­ical Of­fi­cer of Health has al­ready be­gun the con­tact trac­ing. Once the con­tact trac­ing is fin­ished be­tween tonight (Tues­day night) and to­mor­row (Wednes­day), we start to ad­min­is­ter vac­cines.”

The MoH placed an in­dica­tive or­der with the Pan Amer­i­can Health Or­ga­ni­za­tion in Ju­ly 2022, with 1,400 mpox vac­cines ar­riv­ing in the coun­try on De­cem­ber 14, 2022. The MoH said an ad­di­tion­al 1,400 vac­cines were sched­uled to ar­rive in the coun­try in the near fu­ture.

In T&T, the Na­tion­al Im­mu­niza­tion Tech­ni­cal Ad­vi­so­ry Group re­viewed the WHO’s in­ter­im guide­lines at the end of 2022. It rec­om­mend­ed that avail­able vac­cines be ad­min­is­tered to those who are close con­tacts of con­firmed pos­i­tive cas­es that are 18 or old­er but not preg­nant and/or breast­feed­ing and as a post-ex­po­sure pre­ven­ta­tive vac­ci­na­tion. The MoH added that on­ly those who meet their cri­te­ria would be el­i­gi­ble, and a mass vac­ci­na­tion cam­paign would not be utilised.

Min­is­ter Deyals­ingh added, “We are re­serv­ing vac­cines, per WHO pro­to­cols, for close con­tact health care work­ers in case per­sons need to go to a health fa­cil­i­ty. It is not rec­om­mend­ed to open it up to the wider pub­lic be­cause its threat to the wider pub­lic is ex­treme­ly low as op­posed to COVID-19 if we use COVID-19 as a bench­mark.”

Since Jan­u­ary 1, 2022, through Ju­ly 3, 2023, the WHO has re­ceived over 88,144 lab­o­ra­to­ry-con­firmed cas­es and 1,084 prob­a­ble cas­es, in­clud­ing 149 deaths across 112 coun­tries. Glob­al­ly, the Unit­ed States of Amer­i­ca is the most af­fect­ed coun­try, with over 30,000 con­firmed cas­es.

On av­er­age, 95 cas­es are still re­port­ed week­ly across the globe, with the Re­gion of the Amer­i­c­as, where T&T is lo­cat­ed, re­main­ing the most af­fect­ed WHO re­gion. T&T now joins Puer­to Ri­co, Do­mini­can Re­pub­lic, Ja­maica, Cu­ba, Mar­tinique, Aru­ba, the Ba­hamas, Cu­ra­cao, Guyana, Bar­ba­dos, Bermu­da, Guade­loupe, and Saint Mar­tin, where mpox cas­es have been re­port­ed in the Caribbean to the WHO.

Even with this lat­est de­vel­op­ment, the Min­is­ter of Health stressed, “Don’t pan­ic but be care­ful. Be care­ful in hav­ing close phys­i­cal con­tact, es­pe­cial­ly sex­u­al con­tact. It is trans­mit­ted main­ly by very close, in­ti­mate phys­i­cal con­tact,” Deyals­ingh said. “It is not like COVID-19, which you can get just sit­ting on a maxi-taxi next to some­body.”

Deyals­ingh added, “There are no trav­el re­stric­tions for air­ports, ei­ther in or out of Trinidad and To­ba­go or any oth­er coun­try for that mat­ter. There is go­ing to be no lock­down. There’s go­ing to be no re­stric­tions on any­body’s move­ment. Life goes on as nor­mal, ex­cept for those per­sons who in­tend to have very close, in­ti­mate phys­i­cal con­tact with any­body from those 112 coun­tries that have seen mpox from 2022 to now.”

Ge­neti­cist Dr Nicole Ram­lachan ex­plained that a con­firmed mpox case might not lead to the same fate as COVID-19.

“Mon­key­pox spread, con­ta­gious­ness, and fa­tal­i­ty rates are not re­al­ly com­pa­ra­ble to the pan­dem­ic pro­por­tions of COVID-19 nor the nov­el na­ture of the dis­ease as Mon­key­pox has been in­fec­tious to hu­mans for decades. It is not nec­es­sar­i­ly new to our im­mune sys­tems, as was the case for the COVID-19 causative SARS-CoV-2 virus. A very se­lec­tive ap­proach called “Ring” vac­ci­na­tions is avail­able, usu­al­ly on­ly giv­en as a “ring” of peo­ple around the first in­fect­ed in­di­vid­ual de­tect­ed rather than vac­ci­nat­ing an en­tire pop­u­la­tion.

“Pre­cau­tions should be tak­en, as with all new out­breaks, but there should be no need to pan­ic. Con­tin­ue prac­tic­ing the usu­al pre­cau­tion­ary mea­sures dur­ing trav­el around large groups or known in­fec­tions,” she said.

Symp­toms

For those still wary of mpox, the Min­istry of Health said, “Com­mon signs and symp­toms may in­clude a skin rash or mu­cos­al le­sions which can last two to four weeks ac­com­pa­nied by fever, headache, mus­cle aches, back pain, low en­er­gy, and swollen lymph nodes. Any­one ex­pe­ri­enc­ing these symp­toms is ad­vised to vis­it their near­est health fa­cil­i­ty.”

How does mpox spread?

Per­son-to-per­son trans­mis­sion of mpox can oc­cur through di­rect con­tact with in­fec­tious skin or oth­er le­sions, such as in the mouth or on the gen­i­tals, in­clud­ing

• Face-to-face (talk­ing or breath­ing)

• Skin-to-skin (touch­ing or vagi­nal/anal sex)

• Mouth-to-mouth (kiss­ing)

• Mouth-to-skin (oral sex or kiss­ing the skin)

• Res­pi­ra­to­ry droplets or short-range aerosols from pro­longed close con­tact.