The Ministry of Health has released the first version of guidelines on monkeypox. A letter to the heads of executive authorities of subjects in the field of health care and federal health care institutions (available to MV) was sent on June 28. The authenticity of the document was confirmed by a source at the federal medical center.
“MV” sent a request to the Ministry of Health with a request to inform them when the recommendations will be published and to clarify who is recommended for vaccination and whether it is planned to vaccinate their contacts.
Main source of infection
Previously, animals were the source of monkeypox infection. In the current outbreak, the main source of infection is humans, the document states. The intensive spread of the disease in 2022 in many non-endemic countries speaks in favor of this.
Transmission of the virus from person to person is carried out by contact and airborne droplets. However, the presence of viral DNA in the seminal fluid has been established approximately 5-7 days before the onset of symptoms. This may determine the ability to transmit the infection through sexual contact, the document states.
A person infected with monkeypox is dangerous from the moment symptoms appear until the scabs completely disappear. The recommendations indicate that this period takes about three weeks on average.
Confirmation of infection
It is carried out using the polymerase chain reaction (PCR) method. Confirmation of infection is determined by identifying the DNA of the pathogen.
For PCR testing, the contents of skin areas, an oropharyngeal swab, and blood are used.
The recommendations indicate that only two sets of reagents for research are registered in Russia: “VECTOR-MPCRV-OSPA” and “VECTOR-MPCRV-Opa”, produced by the State Research Center “Vector”.
Antiviral drugs for the treatment of monkeypox are not registered in Russia, as indicated in the recommendations.
Symptomatic medications are indicated, among which paracetamol and ibuprofen are indicated as antipyretics. NSAIDs should be avoided in the presence of ulcers, bleeding and dehydration.
To treat skin rashes, gentian violet can be used together with nystatin, fucorcin; for children, aqueous solutions of aniline dyes can be applied.
If your eyes are inflamed, you should not use ointments or drops containing steroids.
The document does not contain special instructions on vaccination and the population that requires immunization. The Ministry of Health indicates: vaccination is carried out in accordance with the indications for the use of vaccines. Three drugs are registered in Russia: “Live smallpox vaccine”, “OspaVir” and the oral vaccine “TEOvac”.
Preparations for post-exposure prophylaxis are not registered in Russia.
Smallpox vaccination before 1980 provides approximately 85% protection against monkeypox.
Obstetric tactics for infection of pregnant women
Infection with monkeypox is not an indication for premature delivery. The timing and method of delivery are determined individually.
In probable and confirmed cases, delivery should take place in an isolated room with negative pressure. During vaginal birth, there is a high risk of infection with monkeypox virus, in which case cesarean section is recommended.