Monkeypox in Jamaica: A call for greater awareness of vaccination, treatment protocols and sampling methods

Correspondence Author:

Kevoyne Hakeem Chambers
Institution: Medical student, Jiangsu University, China
Email: [email protected]

Copyright: This is an open-access article under the terms of the Creative Commons Attribution License which permits use, distribution, and reproduction in any medium, provided the original work is properly cited.

©2023 The Authors. Caribbean Medical Journal published by Trinidad & Tobago Medical Association

Monkeypox is a disease caused by the monkeypox virus which itself is a part of the orthopoxvirus species belonging to the Poxviridae family.¹ The monkeypox virus is a zoonotic pathogen, meaning it can be transmitted from animals to humans, it can also be transmitted from human to human via direct contact with the monkeypox rash and scabs, in addition, transmission can also occur placentally potentially leading to congenital monkeypox.²  Monkeypox is not a novel virus it was first identified in humans in 1970 in 5 Central and West African countries.³ Monkeypox was then introduced to the western hemisphere on May 24, 2003, in the United States of America.⁴ Recently there has been a resurgence of monkeypox cases and in May 2022 those cases rose exponentially outside countries where the disease is endemic. Later that year on July 23, 2022, the World Health Organization (WHO) declared the current monkeypox outbreak a Public Health Emergency of International Concern.⁵

Monkeypox usually presents with fever, chills, headache, and lymphadenopathy with a classical maculopapular rash occurring three days after the onset of prodromal symptoms. This can make distinguishing monkeypox from smallpox, other orthopoxvirus and even varicella zoster virus very difficult.⁶ Proper collection and transport of samples is extremely crucial because confirmation of monkeypox depends on the quality and type of the sample.¹. Recent studies have shown that the clade 3 B.1 strain responsible for the 2022 outbreak may have possibly enhanced human-to-human transmission.⁷ Therefore, a healthcare system that is ill-equipped to offer fast and reliable testing of specimens, up to date with the latest treatment and vaccination protocols, might find itself overburden with cases if this suspicion is true. From what we experienced with the recent COVID-19 pandemic, a rapid spike in cases can put a heavy strain on any healthcare system.

Jamaica and by extension the Caribbean is densely surrounded by countries with a large number of monkeypox cases.⁸ Jamaica like other Caribbean countries relies heavily on tourism with millions of tourists visiting the country each year. A potentially more contagious strain of the monkeypox virus can lead to a potential spike in monkeypox cases in the country.

To effectively protect the Jamaican population from another potential epidemic, healthcare workers need to be educated on the latest guidelines for detecting and diagnosing monkeypox. The Pan American Health Organization (PAHO) with The WHO has published interim laboratory and diagnostic guidelines as well as infection prevention and control guidance for the management of monkeypox to aid in the rapid detection of monkeypox.^9,10 Hospitals should perform internal audits to ensure healthcare workers are up to date on the latest guidelines on monkeypox. There should also be a safe and effective method of identifying potential monkeypox cases, testing and managing patients. Hospitals should have vaccines on hand as well as antivirals that are effective against smallpox since they may also provide symptom relief for patients with monkeypox. By implementing these strategies, we can decrease the impact of a potential outbreak on the Jamaican population and as a result, decrease the economic burden on our healthcare system.

References

1. Monkeypox (no date) World Health Organization. World Health Organization. Available at: https://www.who.int/health-topics/monkeypox#tab=tab_1 (Accessed: January 10, 2023).
2. Al-Tameemi, K., Nassour, R. and Hamad, A. (2022) Monkeypox: Facts about the disease, Bulletin of Pharmaceutical Sciences. Assiut. Assiut University, Faculty of Pharmacy. Available at: https://bpsa.journals.ekb.eg/article_271837.html (Accessed: January 10, 2023).
3. Breman, J.G. et al. (1980) Human Monkeypox, 1970-79, Bulletin of the World Health Organization. U.S. National Library of Medicine. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2395797/ (Accessed: January 10, 2023).
4. Ligon, B.L. (2004) Monkeypox: A review of the history and emergence in the Western Hemisphere, Seminars in pediatric infectious diseases. U.S. National Library of Medicine. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129998/ (Accessed: January 10, 2023).
5. Jennifer B. Nuzzo, D.P.H. (2022) The WHO declaration of Monkeypox as a Global Public Health emergency, JAMA. JAMA Network. Available at: https://jamanetwork.com/journals/jama/fullarticle/2794922 (Accessed: January 11, 2023).
6. Factsheet for Health Professionals on mpox (monkeypox) (2022) European Centre for Disease Prevention and Control. Available at: https://www.ecdc.europa.eu/en/all-topics-z/monkeypox/factsheet-health-professionals (Accessed: January 11, 2023).
7. Isidro, J. et al. (2022) “Phylogenomic characterization and signs of microevolution in the 2022 multi-country outbreak of Monkeypox virus,” Nature Medicine, 28(8), pp. 1569–1572. Available at: https://doi.org/10.1038/s41591-022-01907-y.
8. Multi-country outbreak of mpox, External Situation Report #13 – 5 january 2023 (2023) World Health Organization. World Health Organization. Available at: https://www.who.int/publications/m/item/multi-country-outbreak-of-mpox–external-situation-report–13—5-january-2023 (Accessed: January 11, 2023).
9. Laboratory guidelines for the detection and diagnosis of Monkeypox virus infection: 2 September, 2022 (2022) PAHO/WHO | Pan American Health Organization. Available at: https://www.paho.org/en/documents/laboratory-guidelines-detection-and-diagnosis-monkeypox-virus-infection-2-september-2022 (Accessed: January 11, 2023).
10. Interim guidance: Infection prevention and control for the management of Mpox in people in situations of vulnerability such as prisons and other custodial facilities. 1 December 2022 (2022) IRIS PAHO Home. Pan American Health Organization. Available at: https://iris.paho.org/handle/10665.2/56880 (Accessed: January 11, 2023).