Find out how suspected cases of monkeypox are monitored in the DF

To arrive at this diagnosis, multiple servers were involved, from notification of possible cases to referral for genetic sequencing and treatment.

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

When a person presents to public health units with a fever and rash, a question is collected by a medical professional. After data collection and clinical examination, epidemiological surveillance is communicated on the suspicion of monkeypox infection.

According to Joint Technical Note No. 3 of 2022, from the Ministry of Health, this communication must be made within 24 hours, in addition to immediately informing the patient that it is a suspected case.

“The guidelines for the prevention and control of monkeypox in DF health services cover professionals in the public and private sectors, civilian and military and at all levels of care (primary, outpatient clinics, practices, clinics, hospitals, laboratories, among others )”, indicates the document, which can be read in full on the website of the Ministry of Health.

Notification

Upon identification of a suspected case of monkeypox in the health department, the Department of Health begins identification and tracing of possible contacts. The aim is to establish the necessary measures to prevent the spread of the virus to other people.

“Epidemiological surveillance detects, notifies and investigates suspected cases and their contacts for the risk of viral dissemination and for the interruption of chains of transmission in the event of epidemics”, explains the director of epidemiological surveillance, Fabiano dos Anjos Martins . “In this way, we will better understand the epidemiology of the disease to support the implementation of public health actions in the Federal District,” he adds.

The epidemiologist points out that possible contacts are also being monitored to identify early and timely signs and symptoms so that chains of transmission are quickly interrupted.


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Investigation

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

One of the main purposes of the investigation is to identify the likely source of infection and detect new cases. For this, it is also necessary to collect information on the movements, exposures and contacts that the patient has had in the probable period of exposure to the virus. This interval can be up to 21 days before the appearance of signs and symptoms, 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 Epidemiological Surveillance and Immunization Nuclei (NVEPI) of the regions, depending on the place of residence of the suspected case.

“Based on a close relationship with epidemiological surveillance, primary care is able to act as early as possible,” adds primary health care coordinator Fernando Erick Damasceno. The DF has 611 Family Health Teams, with 6,992 professionals working in 675 Basic Health Units (UBS).


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The director of epidemiological surveillance, Fabiano dos Anjos, stresses that suspected patients are advised to maintain isolation at home until the lesions are completely resolved. If their general condition worsens, they must seek treatment after prior contact with their referral health facility.

“It can be UPA or UBS, the important thing is to avoid traveling a lot so as not to run the risk of spreading the disease,” says Martins. He also points out that, so far, the DF has 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 isolation at home. The samples taken by epidemiology are sent to the Central Public Health Laboratory (Lacen).

Confirmation of the diagnosis is done by molecular tests (RT-PCR – like those for covid-19), which detect specific sequences of the virus in patient samples. “As our Lacen does not have genetic sequencing, this test is sent to the Ministry of Health, which sends the samples for testing to Rio de Janeiro,” Martins explains.


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With regard to patient care, he clarified that clinical advice is aimed at relieving symptoms, managing possible complications and preventing long-term sequelae. Patients should receive hydration and food to maintain adequate nutritional status.

UPA

In addition to primary care units (UBS), urgent care units (UPA) are ready to receive patients suspected of monkeypox. The network is uniform when it comes to alerting for new cases.

“The Technical Note of the Department of Health is very complete, it has already been disseminated and is in practice in the emergency services of the units”, explains the director of health care at the Iges-DF, Nestor Miranda Júnior.


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According to him, the 24-hour UPAs and the hospitals of the Base de Brasília and the Regional de Santa Maria are ready. “We have the necessary PPE and are fully capable of receiving and handling identified and suspected cases of monkeypox,” he said.


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*With information from the Brasilia Agency

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