Exactly two months after the World Health Organization (WHO) downgraded Monkeypox (mpox) from a Public Health Emergency of International Concern, the Ministry of Health detected the first case of the virus yesterday in T&T.
According to the Ministry of Health (MoH), the patient is a middle-aged male with travel-related history. The MoH said in a media release that the patient was tested yesterday, and the sample was sent to the Caribbean Public Health Agency’s laboratory via the Trinidad Public Health Lab. Minister of Heath Terrence Deyalsingh spoke to CNC3 News last night, saying, “The patient is doing fine, clinically well.”
The relevant County Medical Officer of Health has initiated the local public health response.
Deyalsingh said, “The relevant County Medical Officer of Health has already begun the contact tracing. Once the contact tracing is finished between tonight (Tuesday night) and tomorrow (Wednesday), we start to administer vaccines.”
The MoH placed an indicative order with the Pan American Health Organization in July 2022, with 1,400 mpox vaccines arriving in the country on December 14, 2022. The MoH said an additional 1,400 vaccines were scheduled to arrive in the country in the near future.
In T&T, the National Immunization Technical Advisory Group reviewed the WHO’s interim guidelines at the end of 2022. It recommended that available vaccines be administered to those who are close contacts of confirmed positive cases that are 18 or older but not pregnant and/or breastfeeding and as a post-exposure preventative vaccination. The MoH added that only those who meet their criteria would be eligible, and a mass vaccination campaign would not be utilised.
Minister Deyalsingh added, “We are reserving vaccines, per WHO protocols, for close contact health care workers in case persons need to go to a health facility. It is not recommended to open it up to the wider public because its threat to the wider public is extremely low as opposed to COVID-19 if we use COVID-19 as a benchmark.”
Since January 1, 2022, through July 3, 2023, the WHO has received over 88,144 laboratory-confirmed cases and 1,084 probable cases, including 149 deaths across 112 countries. Globally, the United States of America is the most affected country, with over 30,000 confirmed cases.
On average, 95 cases are still reported weekly across the globe, with the Region of the Americas, where T&T is located, remaining the most affected WHO region. T&T now joins Puerto Rico, Dominican Republic, Jamaica, Cuba, Martinique, Aruba, the Bahamas, Curacao, Guyana, Barbados, Bermuda, Guadeloupe, and Saint Martin, where mpox cases have been reported in the Caribbean to the WHO.
Even with this latest development, the Minister of Health stressed, “Don’t panic but be careful. Be careful in having close physical contact, especially sexual contact. It is transmitted mainly by very close, intimate physical contact,” Deyalsingh said. “It is not like COVID-19, which you can get just sitting on a maxi-taxi next to somebody.”
Deyalsingh added, “There are no travel restrictions for airports, either in or out of Trinidad and Tobago or any other country for that matter. There is going to be no lockdown. There’s going to be no restrictions on anybody’s movement. Life goes on as normal, except for those persons who intend to have very close, intimate physical contact with anybody from those 112 countries that have seen mpox from 2022 to now.”
Geneticist Dr Nicole Ramlachan explained that a confirmed mpox case might not lead to the same fate as COVID-19.
“Monkeypox spread, contagiousness, and fatality rates are not really comparable to the pandemic proportions of COVID-19 nor the novel nature of the disease as Monkeypox has been infectious to humans for decades. It is not necessarily new to our immune systems, as was the case for the COVID-19 causative SARS-CoV-2 virus. A very selective approach called “Ring” vaccinations is available, usually only given as a “ring” of people around the first infected individual detected rather than vaccinating an entire population.
“Precautions should be taken, as with all new outbreaks, but there should be no need to panic. Continue practicing the usual precautionary measures during travel around large groups or known infections,” she said.
For those still wary of mpox, the Ministry of Health said, “Common signs and symptoms may include a skin rash or mucosal lesions which can last two to four weeks accompanied by fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes. Anyone experiencing these symptoms is advised to visit their nearest health facility.”
How does mpox spread?
Person-to-person transmission of mpox can occur through direct contact with infectious skin or other lesions, such as in the mouth or on the genitals, including
• Face-to-face (talking or breathing)
• Skin-to-skin (touching or vaginal/anal sex)
• Mouth-to-mouth (kissing)
• Mouth-to-skin (oral sex or kissing the skin)
• Respiratory droplets or short-range aerosols from prolonged close contact.