The 2022–2023 mpox outbreak in India is a part of the ongoing outbreak of human mpox caused by the West African clade of the

monkeypox virus ''Monkeypox virus'' (MPV, MPXV, or hMPXV) is a species of double-stranded DNA virus that causes monkeypox in humans and other mammals. Monkeypox virus is a zoonotic virus belonging to the '' orthopoxvirus'' genus, making it closely related to th ...

. The outbreak was first reported in

India India, officially the Republic of India ( Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the ...

on 14 July 2022 when

Kerala Kerala ( ; ) is a state on the Malabar Coast of India. It was formed on 1 November 1956, following the passage of the States Reorganisation Act, by combining Malayalam-speaking regions of the erstwhile regions of Cochin, Malabar, South C ...

's State Health Minister

Veena George Veena George (born 3 August 1976) is an Indian politician and former journalist who has served as the Minister for Health and Family Welfare of Kerala since 2021. She represents Aranmula State Assembly Constituency in the Kerala Legislative Asse ...

announced a suspected imported case which was confirmed hours later by the

NIV Niv may refer to: * Niv, a personal name; for people with the name, see * Niv Art Movies, a film production company of India * Niv Art Centre, in New Delhi, India NIV may refer to: * The New International Version, a translation of the Bible into ...

. India was the tenth country to report a mpox case in

Asia Asia (, ) is one of the world's most notable geographical regions, which is either considered a continent in its own right or a subcontinent of Eurasia, which shares the continental landmass of Afro-Eurasia with Africa. Asia covers an ...

and the first in

South Asia South Asia is the southern subregion of Asia, which is defined in both geographical and ethno-cultural terms. The region consists of the countries of Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka.;;;;; ...

. Currently, India has reported more than 30 cases of mpox. On 24 July, the first locally transmitted case was reported in

Delhi Delhi, officially the National Capital Territory (NCT) of Delhi, is a city and a union territory of India containing New Delhi, the capital of India. Straddling the Yamuna river, primarily its western or right bank, Delhi shares borders wi ...

. The individual, a middle-aged male who had no recent history of travelling abroad, was isolated in the Lok Nayak Hospital,

New Delhi New Delhi (, , ''Naī Dillī'') is the Capital city, capital of India and a part of the NCT Delhi, National Capital Territory of Delhi (NCT). New Delhi is the seat of all three branches of the government of India, hosting the Rashtrapati B ...

Background

Transmission

A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as

Nigeria Nigeria ( ), , ig, Naìjíríyà, yo, Nàìjíríà, pcm, Naijá , ff, Naajeeriya, kcg, Naijeriya officially the Federal Republic of Nigeria, is a country in West Africa. It is situated between the Sahel to the north and the Gulf of G ...

, the

Democratic Republic of the Congo The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...

as well as

central Central is an adjective usually referring to being in the center of some place or (mathematical) object. Central may also refer to: Directions and generalised locations * Central Africa, a region in the centre of Africa continent, also known a ...

and

western Africa West Africa or Western Africa is the westernmost region of Africa. The United Nations defines Western Africa as the 16 countries of Benin, Burkina Faso, Cape Verde, The Gambia, Ghana, Guinea, Guinea-Bissau, Ivory Coast, Liberia, Mali, Mauri ...

. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with

lesion A lesion is any damage or abnormal change in the tissue of an organism, usually caused by disease or trauma. ''Lesion'' is derived from the Latin "injury". Lesions may occur in plants as well as animals. Types There is no designated classif ...

s on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced

proctitis Proctitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum. Signs and symptoms A common symptom is a continual urge to have a bowel movement—the rectum could feel full or have const ...

, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis,

gonorrhea Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium '' Neisseria gonorrhoeae''. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with ...

chlamydia Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium '' Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several w ...

, and

herpes Herpes simplex is a viral infection caused by the herpes simplex virus. Infections are categorized based on the part of the body infected. Oral herpes involves the face or mouth. It may result in small blisters in groups often called cold ...

History

Arrival

On 14 July, a suspected mpox case was reported in the South-Indian state of

by the State health minister

. The patient was reportedly in close contact with a person who tested positive for mpox abroad in the

United Arab Emirates The United Arab Emirates (UAE; ar, اَلْإِمَارَات الْعَرَبِيَة الْمُتَحِدَة ), or simply the Emirates ( ar, الِْإمَارَات ), is a country in Western Asia ( The Middle East). It is located at ...

, and arrived in

from UAE four days prior to the announcement. Hours later, minister

announced that the patient was confirmed to be infected with the mpox disease by the

Pune Pune (; ; also known as Poona, ( the official name from 1818 until 1978) is one of the most important industrial and educational hubs of India, with an estimated population of 7.4 million As of 2021, Pune Metropolitan Region is the largest i ...

Spread

No community transmission or locally transmitted cases were detected in India until on 24 July, Delhi reported their first case, and the patient had no history of travel from abroad. He recently attended a party in

Himachal Pradesh Himachal Pradesh (; ; "Snow-laden Mountain Province") is a state in the northern part of India. Situated in the Western Himalayas, it is one of the thirteen mountain states and is characterized by an extreme landscape featuring several peak ...

. Although community transmission of the disease in India wasn't confirmed by the government health officials.

Timeline

July 2022

14 July: A suspected mpox case was reported in

. State health minister

said that the patient was in close contact with a person who tested positive for mpox. The patient arrived in

from the

four days earlier, according to the health minister, and was admitted to a hospital in the state after the patient showed symptoms, and samples were sent to the National Institute of Virology (NIV). It was also reported that tests in local hospitals confirmed that the individual was affected with disease, but still samples were sent to the NIV for confirmation, as per the guideline given by the central government. 31 July: A 22-year-old man who had been in the

came back to India. During his stay in the UAE, he had been in contact with another man who also tested positive for the virus. He then tested positive for

mpox Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and some other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild ...

in the UAE but left the country following the test, he then arrived in his home-district in

Thrissur Thrissur (), formerly Trichur, also known by its historical name Thrissivaperur, is a city and the headquarters of the Thrissur district in Kerala, India. It is the third largest urban agglomeration in Kerala after Kochi and Kozhikode, and ...

on 22 July. At first, he didn't have much symptoms with others in contact with him saying he was actively playing 'football' and other daily activities. On 26 July, he was admitted to a hospital with a fever and the authorities announced a suspected case. On 31 July, he died in the hospital of an unknown cause. It was then reported he died of mpox.

Responses

Central government

After the outbreak was highlighted on mid-May, Union Health Minister

Mansukh Mandaviya Mansukh Laxmanbhai Mandaviya (born 1 June 1972) is an Indian politician currently serving as the Minister of Health and Family Welfare and Chemicals and Fertilizers of India. He is also a Rajya Sabha member from Gujarat. Early life Mansu ...

directed the National Centre for Disease Control (NCDC) and the Indian Council of Medical Research (ICMR) to keep a close watch and monitor the situation. The Union Health Ministry has also directed airport and other port health officers to be vigilant and have been instructed to isolate and send samples to the National Institute of Virology (NIV) in

of any sick passenger with a travel history to infected countries.

State and Union territory governments

Karnataka Karnataka (; ISO: , , also known as Karunāḍu) is a state in the southwestern region of India. It was formed on 1 November 1956, with the passage of the States Reorganisation Act. Originally known as Mysore State , it was renamed ''Kar ...

: Following the directions of the Union Health Ministry, Karnataka state government directed officials to set up mpox surveilience and set up a two-bed isolation ward in every

district A district is a type of administrative division that, in some countries, is managed by the local government. Across the world, areas known as "districts" vary greatly in size, spanning regions or county, counties, several municipality, municipa ...

hospital to isolate suspected or confirmed cases. *

Madhya Pradesh Madhya Pradesh (, ; meaning 'central province') is a state in central India. Its capital city, capital is Bhopal, and the largest city is Indore, with Jabalpur, Ujjain, Gwalior, Sagar, Madhya Pradesh, Sagar, and Rewa, India, Rewa being the othe ...

: The state health department issued an advisory about pox-related diseases (especially Smallpox and Mpox) on early June. Health Commissioner-and-Secretary Sudam Khade directed all district Chief Medical and Health Officers (CMHOs) to take necessary steps as per the advisory when needed. *

West Bengal West Bengal (, Bengali: ''Poshchim Bongo'', , abbr. WB) is a state in the eastern portion of India. It is situated along the Bay of Bengal, along with a population of over 91 million inhabitants within an area of . West Bengal is the four ...

: The

West Bengal state government The Government of West Bengal also known as the West Bengal Government, is the subnational government of the Indian state of West Bengal , created by the National Constitution as the state's legislative, executive and judicial authority. Th ...

issued an advisory on June. In the advisory, the State Health Department asked hospitals in the state to set up separate facilities to accommodate patients coming from abroad with symptoms and collect and sent samples of suspected patients to the

. *

Uttar Pradesh Uttar Pradesh (; , 'Northern Province') is a state in northern India. With over 200 million inhabitants, it is the most populated state in India as well as the most populous country subdivision in the world. It was established in 1950 ...

: On June, Uttar Pradesh Chief Medical Officer issued an advisory for and District Magistrates and other higher health officials of the state to remain alert. The advisory directed that information on patients with fever and rashes to be shared with the office of the CMO.

Others

Cases and statistics

Total Cases Graph

Notes

References

{{DEFAULTSORT:2022-2023 mpox outbreak in India

Mpox Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and some other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild ...