Monkeypox, Ministry of Health Circular: Travel to countries where outbreaks have been confirmed is not recommended

Following the declaration of a Public Health Emergency of International Concern (PHEIC) regarding the spread of smallpox virus by the World Health Organization (WHO) On August 14th, The Ministry of Health sets the line of conduct in Italy in black and white (Here is the dedicated site). This is through a circular that has been awaited for days, signed by the head of the Department of Prevention, Research and Health Emergencies, Maria Rosaria Campitello, and the director, Francesco Vaia, according to what was reported by the newspaper Adnkronos.

The Ministry’s indicators come in implementation of the recommendations of the World Health Organization issued following the meeting of the Emergency Committee concerned with the International Health Regulations, whose report was issued today (You can find it here.). The European Centre for Disease Prevention and Control did the same on 16 August, with its indicators for “containing any potential outbreak in the EU/EEA” (Here is the document).

Trips

One of the first “recommendations” to the country’s health facilities relates to travel. “It is advisable that Raising awareness among travelers to countries with confirmed outbreaks“From the Mpox clade I virus regarding the risk of contracting the disease, and providing them with relevant information to protect themselves and others before, during and after the trip,” the Ministry of Health document states.

Furthermore, “it is advisable to Advice against“For travelers”Participation in events and gatherings in countries with confirmed outbreaks of Mpox clade I virus.

Red Lights for Doctors and Healthcare Workers

Another line of work is to raise awareness among doctors and health care workers about The “red lights” that should make people suspect they are dealing with a possible case of Mpox. And protect employees themselves from potential risks.

“It is recommended to raise awareness among physicians and healthcare workers about potential travel-associated Mpox cases caused by Mpxv subtype 1, including Possibility of different clinical symptoms, and transmission of the disease through sexual and non-sexual means and different groups affected compared to the previous Mpox clade II epidemic. Strengthening protection measures for healthcare workers and caregivers is recommended.”

Situation in Italy: No cases of type 1 reported

But what is the situation in our country?Here is the in-depth analysis.)? In Italy, As of August 8, “no cases of Clade I have been reported.”the family to which the new variant of the so-called monkeypox virus, Mpox, belongs, the Ministry of Health reported in a circular from the Department of Prevention, Research and Health Emergencies (former Directorate General of Health Prevention), which has an update on the Mpox disease.

Confirmed cases since 2022

“From May 20, 2022 (date of the first report of the first case of smallpox in Italy) to August 8, 2024, a total of 1,056 confirmed cases of smallpox have been reported – the Ministry reports – most of which occurred in the summer of 2022. From January 1 to August 8, 2024, 65 confirmed cases were reported from 12 regions. All cases date back to infections that occurred in 2023 and in the first months of the current year, there are no new cases dating back to August,” the publication said.

Monitoring and contact tracing

The circular also included a chapter on monitoring and contact tracing, and “the importance of immediately reporting new smallpox cases via Primal platform And combine the reports with the sequence result of the clade to which the virus belongs. “It is important Always delve into all the information in the gallery, Especially after the discovery of Mpxv clade I”. In these cases in particular, “information necessary for contact tracing purposes” should be quickly emailed to the Ministry’s Contact Tracing Coordination.

In this regard, we reiterate the “necessity of contact tracing (including with regard to contacts in transport)”, according to the circular of August 2, 2022. Reference should also be made to the same circular on Indications for isolation of cases.

In line with the recommendations of the ECDC and the European Centre for Disease Prevention and Control, the Ministry of Health explains that it has created a page dedicated to Mpox on its institutional portal, containing epidemiological data (monthly bulletin), an information sheet on the virus, and various contents including information on the vaccination strategy with a map of the centres where vaccination can be carried out, answers to the most frequently asked questions and a section dedicated to “fake news”.

Diagnostic laboratories

The last note concerns laboratories: “It is recommended that autonomous regions/provinces: Unifying the laboratory diagnostic network and alerting laboratories to the importance of having diagnostic capacity For Mpxv with special reference to the definition of the clade”.

Specific indicators for laboratories will be issued “through a dedicated technical document.” Carried out in collaboration with the Higher Institute of Health (ISS), where the National Reference Laboratory for Smallpox is designated, in agreement with the Lazzaro Spallanzani National Institute for Infectious Diseases, part of the European Reference Laboratories Consortium designated by the European Commission. , Adnkronos always reports.

Initiatives at the international level: Gavi Alliance

Meanwhile, international initiatives to combat the new health emergency are also multiplying. Gavi, the Vaccine Alliance Dedicated to improving access to vaccines in developing countries (Here is the interview with CEO Sanya Nishtar.), is closely monitoring the Mpox situation as of 2022.

Thus, “considerations regarding epox have contributed to both Designing new innovative health security mechanisms for GaviThe organization says it aims to address systemic gaps revealed during the COVID-19 vaccine response, as well as Gavi’s next five-year strategy.

“When Gavi, in 2023, began the evaluation process for the Vaccine Investment Programme (VIS) 2026-2030, Smallpox vaccines included. In the first quarter of 2024 Hold special sessions of the VIS Steering Committee To ensure that this approach takes into account developments in the Democratic Republic of the Congo, where the epidemic spread rapidly, mainly affected children (in terms of morbidity and mortality) and led to a high mortality rate.

New Strategy

Therefore, in June 2024, the Gavi Board of Directors approved the following actions related to Mpox:
– In the next five-year strategy starting from 2026 Gavi It will create a global stockpile of smallpox vaccines, similar to those for cholera, Ebola, meningitis and yellow fever.The establishment of the stockpile is subject to the availability of the WHO Emergency Use List or
To prequalify the recommended vaccine, subject to fundraising for Gavi’s next strategic period. A key objective will be to ensure that the design of the stockpile is supported by a robust assessment of long-term public health needs.
Meanwhile, Javi QIt will support the response to epidemics in the Democratic Republic of the Congo and neighbouring countries..
– In parallel, Gavi will make significant investments in: Training program, With the aim of improving future vaccination efforts against the disease, including the design of a global stockpile.