The Ministry of Health published the recommendations as well as the case definition for monkey pox on Tuesday. There are therefore type I and type II contact persons, which are defined according to the intensity of the contact. Type I are high-risk contacts “that have direct contact with skin lesions (all stages, including crusts) or mucous membranes in a symptomatic monkey case, its body fluids or potentially infectious material”.
Type I contacts are, according to this, sexual partners, persons who, for example, by cleaning in contaminated rooms risk inhaling drops of respiratory secretions or whirled up, virus-contaminated dust, household contacts or the like – for example consumption. night in the same room -, skin contact with common clothing, bedding or common household items, including objects in the workplace, persons with skin damage from common sharp objects (eg needles or blades) and travelers in planes, buses and trains traveling at least eight timer.
Contact tracking for Type I connectors
Type II contacts are short social contacts, work colleagues who do not share an office, short stays in the gym, sauna, bathroom or the like and persons with adequate personal protective equipment. This includes FFP2 or higher quality masks, long-sleeved protective coats, safety goggles and gloves.
For type I contacts, the experts in the health department recommend that the responsible health authority first registers by name by collecting telephone number, e-mail address, place of work, occupation and living conditions – in short, contact tracing.
Laboratory test for fever and rash
The responsible health authorities should also actively inform the type I contact persons about the symptoms and development of the disease. In addition, their state of health should be monitored by the authority for a period of 21 days after the last exposure in the form of daily telephone contact.
If symptoms such as fever, rash, etc. appear within 21 days of the last exposure, the competent authority should initiate a laboratory diagnostic test. The person should immediately isolate themselves until monkey pox infection can be ruled out.
Contact with immunosuppressed and pregnant women as well as children under the age of 12 should also be avoided in the workplace, just as close physical contact and contact with pets should be avoided. In addition, you must pay attention to hand hygiene and hygiene when coughing, sneezing and brushing your nose. Three points – contact tracking, information and self-control – are also recommended for Type II contacts.
risk of infection throughout the disease period
The Ministry of Health reiterated that people infected with monkey pox are themselves contagious throughout the two to four week period of illness. There is a pre-eruptive (or prodromal) and an eruptive phase. The former is initially caused by a sudden high fever (38.5 – 40.5 degrees Celsius), headache and muscle pain, fatigue and very often swelling of the lymph nodes – especially in the throat and throat and in the groin area – possibly. coughing, feeling uncomfortable and sometimes characterized by diarrhea.
The outbreak stage occurs after one to three days, the skin changes shape. First, there is a rash in the mouth and throat, face, hands and forearms, followed by spreading towards the center of the body. This then continues with the cup-typical so-called flowering stages from limited color changes in the skin to blisters and pustules to the crusts. The gender area can also be affected. Eventually the crusts will heal. Only when these have completely disappeared does the patient no longer be contagious.
In addition to the described clinical criteria, there are other parameters in the case definition, such as epidemiological: These include, for example, contact with potentially infected animals, travelers returning from West or Central African countries and / or contact with a probable or confirmed cases of monkey pox in humans.
And there are laboratory diagnostic criteria: These are evidence of the presence of an orthopoxvirus infection (eg, orthopoxvirus-specific positive PCR without sequencing) or evidence of monkeypox virus-specific nucleic acids in a clinical trial using PCR3 or sequencing.
“Suspected, probable and confirmed cases”
A distinction is also made between presumed, probable and confirmed cases. Suspected cases are persons who meet at least one of the epidemiological criteria, have a fever or rash of unknown origin and show two or more non-specific symptoms within 21 days of the last contact (in relation to the epidemiological criteria).
Likely cases are patients with rash of unknown cause, one or more other monkey copper symptoms and one of the following additional points: These include a positive laboratory test result for orthopedic virus infection, a relevant travel history, an epidemiological link to a confirmed or probable case, or multiple or anonymous sexual contacts within the last 21 days. Probable cases are also people with similar rashes. Finally, confirmed cases are those detected in a laboratory by either a monkey copper PCR test or by an orthopoxvirus-specific PCR test and confirmation by nucleotide sequencing.
WHO: 131 confirmed cases
The World Health Organization (WHO) still considers it possible to contain monkey pox, although it classifies the recent outbreak outside Africa as unusual. Further meetings will be scheduled to provide support and advice to the responsible authorities in various countries in the fight against the disease, the United Nations Health Organization said on Tuesday. Since a case outside Africa and thus the usual range was first reported on 7 May, 131 diseases have been confirmed and a further 106 suspected cases have been registered.