Discontinuation of small pox vaccine might have helped in resurgence of monkeypox cases: Doctors

New Delhi: The discontinuation of the small pox vaccine might have helped in the resurgence of monkeypox cases, which should not be confused with the novel coronavirus, doctors at the Sir Ganga Ram Hospital here said.

An editorial written by researchers from the Institute of Clinical Microbiology and Immunology at the hospital, which was published in the current edition of the Indian Journal of Medical Microbiology, suggests that authorities should launch a programme for inoculating those aged below 45 years with the small pox vaccine since it provides 85 per cent protection.

India's monkeypox tally of cases currently stands at 14, with Delhi accounting for nine of those.

"The waning immunity in humans due to the discontinuation of the small pox vaccine has established the scope for the resurgence of monkeypox, demonstrated by the re-emergence of the outbreak after an absence of 30-40 years," said Dr Chand Wattal, corresponding author and chairperson, Institute of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital.

The senior doctor said many of the monkeypox patients are below 40 years of age with a median age of 31 years.

"Since the small pox vaccine provides 85 per cent cross-protection, a programme for vaccination of the unvaccinated needs to be considered and a roadmap should be framed now, especially for people below 45 years of age. A high-risk person's burden needs to be considered and the possible drug -- Tecovirimat -- could be stockpiled," he said.

Monkeypox is zoonotic -- an infectious disease that has jumped from animals to humans -- followed by human-to-human spread with an average mortality of 3 to 6 per cent, according to the World Health Organization (WHO).

Noting that experts agree that the infection can occur through respiratory droplets from a close contact, Dr Sanghamitra Datta, author and senior consultant, Institute of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, said monkeypox cannot be transmitted over distances like COVID-19.

"Small pox has no known animal reservoir and has only human-to-human transmission with a high mortality rate of 30 per cent. Lymphadenopathy is distinct in monkeypox, which is not there in small pox. Most experts agree that though the infection can occur through respiratory droplets from a close contact, it does not seem to be transmitted over the distances like the Sars-CoV-2 virus," she added.

Wattal said even though the number of cases is low currently, cases with no history of international travel to affected areas can be a warning sign.

"The health authorities need to be vigilant. The Kerala mode of containment and contact tracing is praiseworthy and the prompt diagnosis made by NIV, Pune by achieving the gold standard of having cultured and sequenced the virus in a shortest possible time is encouraging by way of capacity building and the rapid response ecosystem having come of age in India," he added.

Wattal concurred with Datta and said monkeypox cannot be equated to Covid in any way, "but our learning from the pandemic can help".

The editorial was published when there were nine cases of the infection in the country.

The size of the outbreak clusters is growing each day, as is the geographical spread across international borders, the doctors said.