Understanding AIIMS Delhi’s Guidelines on Managing Suspected Monkeypox Cases
With the resurgence of Monkeypox cases and the recent declaration by the World Health Organization (WHO) labeling it a global health emergency, it’s crucial to stay informed and vigilant. The All India Institute of Medical Sciences (AIIMS) in New Delhi has taken proactive steps by issuing detailed guidelines to manage and treat suspected cases of Monkeypox, or Mpox as it’s now known. These guidelines are essential for healthcare providers to ensure effective management of the disease and to prevent its spread.
In this blog, we will explore the 10 key points issued by AIIMS Delhi, delving into the implications of each step and understanding why these measures are vital for public health safety.
1. Immediate Assessment of Suspected Patients
AIIMS has emphasized that any patient presenting with fever, rash, or a history of contact with confirmed Monkeypox cases should be flagged for immediate assessment. This first step is crucial because Monkeypox, though similar to smallpox, can easily be mistaken for other viral infections, especially in its early stages. Immediate assessment allows for the timely identification and isolation of cases, which is vital to controlling the spread of the virus.
The importance of early detection cannot be overstated. Early symptoms of Monkeypox, such as fever and rash, are nonspecific and can resemble those of other diseases like chickenpox, measles, or even certain allergic reactions. However, the history of contact with a confirmed case, combined with these symptoms, should raise a high index of suspicion. By flagging such cases, AIIMS is ensuring that no potential Monkeypox case goes unnoticed, thereby reducing the risk of an outbreak.
2. Identification of Key Symptoms
The AIIMS guidelines instruct medical staff to be vigilant in identifying the key symptoms of Monkeypox, which include fever, headache, muscle aches, back pain, swollen lymph nodes, chills, exhaustion, and the characteristic skin lesions. These symptoms provide critical clues for diagnosing Monkeypox, especially in the absence of laboratory confirmation.
The characteristic skin lesions are perhaps the most distinctive feature of Monkeypox. These lesions typically begin on the face and then spread to other parts of the body. They progress through several stages—from macules to papules, vesicles, pustules, and finally scabs—before falling off. Swollen lymph nodes are another hallmark of Monkeypox, which can help differentiate it from smallpox, as smallpox does not typically cause lymphadenopathy.
Identifying these symptoms early and accurately is essential for prompt isolation and treatment, preventing further transmission.
3. Immediate Isolation of Suspected Cases
According to AIIMS, any patient suspected of having Monkeypox should be placed in a designated isolation area immediately. This is a critical step in preventing the virus from spreading to other patients and healthcare workers.
Isolation is a cornerstone of infection control in infectious diseases. By isolating suspected cases, AIIMS is effectively reducing the risk of nosocomial (hospital-acquired) transmission. Monkeypox can be transmitted through respiratory droplets, body fluids, and contact with contaminated surfaces, making isolation an essential preventive measure.
Moreover, isolation protects not only the general hospital population but also vulnerable patients who might suffer severe outcomes if infected. It also limits the exposure of healthcare workers, who are at high risk due to their close contact with patients.
4. Designated Isolation Beds
AIIMS has specifically notified four beds—numbers 33, 34, 35, and 36 in the AB-7 ward—for isolating Monkeypox patients. This designation ensures that the hospital is prepared to manage cases effectively without compromising the care of other patients.
Designating specific beds for Monkeypox patients is part of an organized approach to managing the disease. These beds are likely equipped with the necessary facilities to monitor patients closely, manage symptoms, and prevent cross-infection. By having dedicated isolation beds, AIIMS can streamline the care process, ensuring that patients receive the appropriate treatment without delay.
Furthermore, the designation of these beds in a specific ward allows for better infection control practices. It enables the hospital to implement stringent sanitation and sterilization protocols in these areas, further reducing the risk of the virus spreading within the facility.
5. Allotment of Beds Based on Emergency Chief Medical Officer’s Recommendation
The allocation of these designated beds will be done based on the recommendation of the Emergency Chief Medical Officer (CMO) and the treatment will be overseen by the medicine department. This step ensures that the decision to isolate and treat a patient in these designated areas is made by a senior medical professional, ensuring that resources are utilized effectively.
The involvement of the Emergency CMO in the decision-making process adds an additional layer of oversight. This ensures that only those patients who genuinely require isolation in these dedicated beds are admitted, preventing unnecessary use of limited resources. The medicine department’s role in overseeing treatment ensures that patients receive the best possible care tailored to their condition.
This hierarchical approach to patient management not only optimizes resource use but also ensures that decisions are made with a comprehensive understanding of the patient’s clinical status and the overall situation in the hospital.
6. Coordination with Integrated Disease Surveillance Programme (IDSP)
AIIMS has instructed that the officials of the Integrated Disease Surveillance Programme (IDSP) should be contacted immediately when a suspected Monkeypox case is identified. The IDSP team is to be provided with the patient’s details, brief history, clinical findings, and contact details.
Coordination with the IDSP is vital for several reasons. The IDSP is responsible for monitoring and responding to infectious disease outbreaks across India. By notifying the IDSP of suspected cases, AIIMS is ensuring that the case is recorded in the national surveillance system, which helps in tracking the spread of the disease and identifying potential outbreaks.
Moreover, the IDSP can provide additional resources and support for managing cases, including contact tracing and public health interventions in the community. This coordination also facilitates the sharing of critical information with other healthcare facilities and public health authorities, ensuring a unified response to the Monkeypox threat.
7. Referral to Safdarjung Hospital
AIIMS has designated Safdarjung Hospital as the facility for managing and treating Monkeypox patients. Any patient suspected of having Monkeypox should be referred to Safdarjung Hospital for further evaluation and treatment.
Referring patients to Safdarjung Hospital ensures that they receive specialized care in a facility that is equipped to handle infectious diseases. Safdarjung Hospital has been chosen for its capabilities in managing such cases, including isolation facilities, trained staff, and the necessary medical infrastructure.
This referral system also helps in centralizing the treatment of Monkeypox, which allows for better management of resources and ensures that patients are treated by specialists with experience in handling such infections. It also helps in reducing the burden on AIIMS, allowing it to focus on other critical cases.
8. Dedicated Ambulance for Patient Transfer
To ensure the safe transfer of suspected Monkeypox patients, AIIMS has earmarked a dedicated ambulance for this purpose. The emergency staff is required to inform the ambulance coordinator to arrange for the transfer.
The use of a dedicated ambulance is a critical component of infection control. By using a vehicle specifically assigned for transporting Monkeypox patients, AIIMS is minimizing the risk of contaminating other ambulances and exposing other patients and staff to the virus.
This dedicated ambulance is likely equipped with the necessary protective measures, such as proper sanitation protocols and personal protective equipment (PPE) for the staff. The coordination with the ambulance service ensures that the transfer is done efficiently and safely, reducing the time patients spend in transit and the potential exposure of others.
9. Strict Infection Control Measures
AIIMS has mandated that all patients suspected of having Monkeypox must be handled with strict infection control measures. The staff must use personal protective equipment (PPE) when dealing with these cases, and proper documentation of the patients’ details, symptoms, and referral process must be maintained.
Strict infection control measures are essential in preventing the spread of Monkeypox within the hospital. PPE, such as gloves, masks, gowns, and face shields, is necessary to protect healthcare workers from exposure to the virus. The use of PPE also prevents the virus from spreading to other patients and surfaces within the hospital.
Proper documentation is another critical aspect of infection control. By maintaining accurate records of patients’ symptoms, contact history, and the referral process, AIIMS ensures that each case is tracked and managed appropriately. This documentation also serves as a vital tool for epidemiological studies and helps in understanding the spread and impact of the disease.
10. Comprehensive Monitoring and Response
The final guideline emphasizes the need for comprehensive monitoring and a prompt response to suspected Monkeypox cases. This includes not only the immediate isolation and treatment of patients but also ongoing surveillance, coordination with public health authorities, and continuous assessment of the situation.
Comprehensive monitoring ensures that any changes in the patient’s condition or the overall situation are detected early, allowing for timely interventions. It also involves monitoring the effectiveness of the infection control measures and making adjustments as needed.
A prompt and coordinated response is crucial in managing infectious diseases like Monkeypox. By working closely with public health authorities, AIIMS can ensure that all suspected cases are investigated thoroughly, contacts are traced, and appropriate measures are taken to prevent further spread.
Conclusion
The AIIMS Delhi guidelines for managing suspected Monkeypox cases are a crucial part of India’s strategy to control the spread of this re-emerging disease. By following these guidelines, healthcare providers can ensure that suspected cases are identified quickly, isolated effectively, and treated appropriately.
These measures not only protect the patients and healthcare workers but also play a vital role in preventing a wider outbreak. As the situation with Monkeypox evolves, it is essential to stay informed and adhere to the best practices outlined by leading health institutions like AIIMS.
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