RJ and SP monitor on the run with monkey cups – 19/06/2022 – Equilíbrio e Saúde

Rio de Janeiro and São Paulo have been monitoring the health status of passengers who were on flights where cases of monkey pox were identified. The procedure has been performed by the Municipal Department of Health of Rio de Janeiro and the São Paulo State Department of Health, according to the agencies’ press offices.

Brazil has already registered seven cases of the disease. The last of them was confirmed by the Ministry of Health on Friday (17).

Of the seven confirmed cases in the country, four are from São Paulo, two from Rio Grande do Sul and one from Rio de Janeiro. A further nine cases are being investigated. The first case in Brazil was registered on June 8.

In the capital, Rio de Janeiro, the municipal health department says it is launching an investigation into passengers who were on the same plane as the patient with a confirmed case of monkey pox. Travel data were provided by Anvisa (National Health Surveillance Agency).

The first case of monkey pox in Rio was confirmed on Tuesday (14). He is a 38-year-old man, resident in London, who arrived in Brazil on June 11 and sought care at the Instituto Evandro Chagas the day after landing. The samples were analyzed by the Instituto Carlos Chagas Filho, from the UFRJ (Federal University of Rio de Janeiro).

The municipal secretary has also collaborated with the state health department in Rio de Janeiro to carry out the monitoring of people who had contact with the patient.

Currently, there are already five people being monitored by the health authorities in Rio for having had close contact with him. It is observed if they develop symptoms of the disease – if they do, diagnostic tests will be done. However, these five are not passengers on the plane, the secretariats say.

According to the Ministry of Local Government, the monitoring procedures to be followed for passengers have not yet been determined.

In São Paulo, the state Department of Health says it has contacted all passengers on planes who had confirmed cases. As in Rio de Janeiro, passenger data was provided by Anvisa.

The Danish Health and Medicines Authority, on the other hand, explains that it is responsible for collecting information in ports and airports, both for monkey pox (the English name for monkeypox) and for other diseases. Anvisa says that it passes on passenger and crew information to the country’s health authorities, such as the local secretariats, and these define how to follow up on these people.

THAT Sheet contacted the Ministry of Health to comment on this protocol in case of flights with the diagnosis monkey pox, but received no response before the publication of the report.

Possibilities for transfer

Monitoring passengers on flights with confirmed cases of monkey pox still raises some uncertainty. This is because the transmission of the virus mainly occurs through contact with wounds in infected humans. Another common way is through materials, such as clothing, that have been in contact with these wounds.

However, the pathogen can also be transmitted through respiratory secretions, but requires close and prolonged contact. The CDC (US Centers for Disease Control) says, for example, that passing a person with the disease into a supermarket should not cause transmission, for example.

Precisely because it has a lower chance of infection through the respiratory tract, the chances of infection on aircraft are small. The CDC explains that “in cases where people with monkey cups have traveled by air, there have been no known cases of monkey cups in people sitting around them, even on long international flights.”

Still, surveillance measures are important, especially in the first moments of an outbreak like what is happening now, says Raquel Stucchi, a specialist in infectious diseases and a professor at Unicamp (State University of Campinas).

“This energy that is being spent on investigating passengers, the moment the first cases emerge in the country, I think is justified,” he says.

Stucchi says one measure that can be taken in these situations is the adoption of a questionnaire or app in which passengers indicate daily whether they have developed symptoms common to monkey pox, such as fever or bladder-shaped lesions.

From measures to monitor these first flights, it is possible to determine whether this initiative should really be taken in other similar cases, the infection doctor continues.

Clarissa Damaso, a virologist at the UFRJ (Federal University of Rio de Janeiro) and one of the researchers who make up the working group to fight monkey poop organized at the university, says that an important aspect is to define monitoring protocols that must be followed in all coincidence .

“Although the probability [de transmissão] is low does not mean it is impossible. That’s because you have a transmission by skin contact, it’s the main road, and there’s also a face-to-face transmission, which inside the plane would be more complicated unless the person knew the passenger next door very well, ”says Damaso.

The virologist exemplifies that it is possible in an airplane to have contact with the skin of an infected person, for example by shaking hands or touching the body, and then have a greater chance of infection.

However, if it is noted that the person infected with monkey pox had not developed the lesions at the time of flight, the chances of transmission decrease. Therefore, Damaso says that it is possible to have different monitoring mechanisms depending on the symptoms of the infected passenger.

In any case, an already known measure that can prevent the transmission of monkey cups through the airways is the use of masks. The CDC recommends that the infected person use the equipment in close contact with other people.

Similar guidance is given by Stucchi. “The use of masks prevents this respiratory transmission, which can rarely happen,” concludes the infection doctor.

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