“Clinics should monitor suspected cases of monkeypox to stop local spread”


With the recent designation of monkeypox as a second-degree infectious disease in a four-tier system, the medical community should establish a surveillance system to detect monkeypox cases early and quickly secure third-party smallpox vaccines and treatments. generation, said an expert.


In particular, he said infectious disease, urology and dermatology clinics should use the system to monitor patients with suspected monkeypox.


Shin Sang-yup, an infectious disease specialist at the Korea Medical Institute, released a report on the institute’s website on Wednesday, explaining the characteristics of monkeypox and measures to prevent local outbreaks.


According to Shin, the symptoms of monkeypox are similar to those of chickenpox, and patients and doctors may mistake it for chickenpox and delay diagnosis.


In monkeypox, fever and headaches begin one to three days before the rashes, and enlarged lymph nodes often appear in the neck, armpits, and groin. When the rashes appear, they begin on the face and spread “by centrifugation” to the arms, legs, palms and soles of the feet.


However, if the infection was caused by sexual contact, Shin noted that rashes could appear in the genital area. In some cases, the itching is severe but uncharacteristic, he said.


Monkeypox rashes begin as round red spots and progress to blisters, pustules, and scabs. He added that rashes in the same part of the body usually show the same stages of progression.


Although Korea has first- and second-generation smallpox vaccines in stock to respond to biological terrorist attacks and national public health risks, it is difficult to use them in the monkeypox outbreak due to “several limitations “, did he declare.


“Scheduled vaccines are not licensed for monkeypox, and they could cause serious adverse reactions that could lead to death. So many people are banned from getting vaccinated,” Shin said.


First-generation smallpox vaccines, in particular, have been stored frozen and dried for decades, and some question their effectiveness, he said.


Transmit from person to person. According to Shin, given the safety and cost-effectiveness of smallpox vaccines, inoculating the entire Korean population would not be appropriate or possible.


“Ring vaccination” is the most convenient and effective measure.


Ring vaccination refers to the vaccination of a selective “ring” group of people epidemiologically related to monkeypox patients and those who have had close contact with them.


As the Korean government pushes to introduce Bavarian Nordic’s third-generation smallpox vaccine, Shin said he should decide on the target and scope of vaccination.


According to Shin, Bavarian Nordic’s third-generation smallpox vaccine won FDA approval for monkeypox in 2019. The new vaccine has improved safety and efficacy over older vaccines, and it can be inoculated to almost everyone.


Shin said the nation also urgently needed treatment for monkeypox.


Tecovirimat (TPOXX) has received FDA, EMA and Canadian approval to treat smallpox, and EMA clearance to treat monkeypox. Treatment is expensive, but Korea should secure them enough to prepare for outbreaks of smallpox and monkeypox, just like other countries are doing, he advised.


Finally, he stressed that the medical community should set up a surveillance system to detect cases of monkeypox early. Monkeypox has a long incubation period and is difficult to detect through the airport quarantine procedure, so it is important to spot local patients early.


Primary medical institutions cannot diagnose monkeypox, and patients with suspected monkeypox should be referred to the Korea Disease Control and Prevention Agency for testing and quarantine.


However, with the exception of several tertiary hospitals, Shin said many hospitals find it difficult to make this procedure safe and smooth.


Thus, he said infectious disease, urology and dermatology clinics should set up a monitoring system.


The government should consider establishing an aggressive quarantine system so that when a suspected case of monkeypox is discovered, the doctor immediately reports it to the quarantine authorities, and the authorities can initiate epidemiological investigations as well as testing and quarantining patients, he added.