Learn how to spot suspected monkeypox cases in DF

Monkeypox, or monkeypox, has left the entire health network in the Federal District on alert. The first case of the disease was confirmed in DF on Saturday (2). To arrive at this diagnosis, many servers were involved, from notification of potential cases to transmission for genetic sequencing and treatment.

When a person goes to public health units with a fever and rash, a question is collected by a health professional. After data collection and clinical examination, epidemiological surveillance of suspected monkeypox infection is reported.

According to Joint Technical Note No. 3 of 2022 from the Department of Health, this communication should take place within 24 hours, in addition to informing the patient immediately that it is a suspected case.

“Guidelines for the prevention and control of monkeypox in DF health services include professionals from the public, private, civil and military sectors and at all levels of care (primary, outpatient, office, clinic, hospital, laboratory, among others),” says the document, which can be read Fully available on the Department of Health website.

Attention

From the identification of a suspected case of monkeypox in the health service, the Ministry of Health begins to identify and trace potential contacts. The goal is to put in place the necessary measures to prevent the spread of the virus to other people.

The director of epidemiological surveillance, Fabiano dos Anjos Martins, explains that “the epidemiological surveillance detects, reports and investigates suspected cases and their contacts for the risk of spreading the virus and interrupting transmission chains in the event of an outbreak.” “This way, we will better understand the epidemiology of the disease to support the implementation of public health measures in the Federal District,” he adds.

The epidemiologist stresses that potential contacts are also monitored in order to identify early and timely signs and symptoms so that chains of transmission are quickly interrupted.

Investigation

With information on suspected cases, the work of epidemiological surveillance involves investigating the situation, with data collection, such as telephone interviews, home visits, review of medical records, examinations, reports and other documents.

One of the main goals of the investigation is to identify the possible source of infection and to discover new cases. For this, it is also necessary to collect information about travel, exposures and contacts that the patient had in the likely period of exposure to the virus. This period is up to 21 days before signs and symptoms appear, taking into account the incubation period of the disease.

The epidemiological investigation will be carried out by the family health teams under the supervision of the nuclei of epidemiological surveillance and immunization (NVEPI) for the regions, according to the place of residence of the suspected case.

“Based on the close relationship with epidemiological surveillance, primary care is able to operate as soon as possible,” adds Primary Health Care Coordinator, Fernando Eric Damascino. DF 611 has a Family Health Team, with 6,992 professionals working in 675 Basic Health Units (UBS).

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The director of epidemiological surveillance, Fabiano dos Anjos, notes that suspected patients are advised to maintain home isolation until the pests are completely resolved. If there is a deterioration in the general condition, they should seek care after previous contact with their reference health unit.

“It could be a UPA or a UBS, the important thing is to avoid traveling a lot so you don’t run the risk of spreading the disease,” Martins says. It also highlights that, to date, DF has had no cases of community transmission of the disease.

According to the director, being in good general condition, with no indication of hospitalization, the patient must wait for the result of the examination in home isolation. Samples collected by epidemiology are sent to the Central Public Health Laboratory (Lacen).

The diagnosis is confirmed by molecular tests (RT-PCR – such as those for covid-19), which reveal a specific sequence of the virus in patient samples. “Because there is no genetic sequence in Lacen, this test is sent to the Ministry of Health, which sends the samples for testing in Rio de Janeiro,” explains Martins.

As for patient care, he explained, clinical guidance aims to relieve symptoms, manage potential complications, and prevent long-term consequences. Patients should have access to water and food to maintain proper nutritional status.

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In addition to primary care units (UBSs), emergency care units (UPAs) are ready to receive patients with suspected monkeypox. The network is unified regarding alerting of new cases.

“The technical note from the Department of Health is very complete, it has already been distributed and is in practice in the units’ emergency units,” explains Iges-DF’s Director of Health Care, Nestor Miranda Jr.

According to him, round-the-clock UPAs and hospitals in Base de Brasília and Regional de Santa Maria are ready. “We have the necessary PPE and are fully able to receive and manage identified and suspected cases of monkeypox,” he highlights.

*With information from the Brasilia Agency