Monkeypox outbreak

Monkeypox is a rare disease that is caused by infection with monkeypox virus. Its name is derived from its discovery in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research.

Since the first human case was reported in 1970, the vast majority of infections have been concentrated in the Democratic Republic of the Congo (DRC) and Nigeria. However, in recent months more cases are being reported in countries not normally associated with outbreaks.

Transmission

Monkeypox does not spread easily between people, but may occur through:

• contact with clothing or linens (such as bedding or towels) used by an infected person
• direct contact with monkeypox skin lesions or scabs
• coughing or sneezing of an individual with a monkeypox rash

The virus enters the body through broken skin (even if not visible), the respiratory tract, or the mucous membranes (eyes, nose, or mouth).

Spread of monkeypox may also occur when a person comes into close contact with an infected animal – rodents are believed to be the primary animal reservoir for transmission to humans.

The IMO has issued Circular Letter No.4575 “Multi-country monkeypox outbreak in non-endemic countries”, which comprises information and guidance on the monkeypox disease, based on recommendations developed by the World Health Organization (WHO).

Included in this circular letter is the recommendation to “avoid intimate or sexual contact with someone with a localized anogenital rash and/or oral ulcers”. It further advises: “During the early phase of this outbreak while information is still being collected, it would be prudent to limit the number of sex partners, keep hands clean with water and soap or alcohol-based gels, and maintain respiratory etiquette and hand hygiene.”

Symptoms

According to the United States CDC, the incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days.

The illness begins with:

• Fever
• Headache
• Muscle aches
• Backache
• Swollen lymph nodes
• Chills
• Exhaustion

Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a rash, often beginning on the face then spreading to other parts of the body.

Lesions progress through the following stages before falling off:

• Macules
• Papules
• Vesicles
• Pustules
• Scabs

The illness typically lasts for 2−4 weeks.

In Africa, monkeypox has been shown to cause death in as many as 1 in 10 persons who contract the disease. However, the United Kingdom guidance states that the illness is usually mild and most of those infected will recover within a few weeks without treatment.

Impact on shipping

As reported by maritime news agency ‘Splash 247’, Bangladesh introduced restrictions, with the port of Chittagong banning shore leave for all crew unless in the case of an emergency and requiring signed-off crew to undergo health checks.

Shipping agency GAC advises that according to Mongla Port Authority Emergency Circular No.03/2022 (2 June 2022), all ships arriving to Mongla Port shall exercise following precautionary measures:

• No officer/crew shall be granted shore pass unless emergency and with prior approval of the Port Health Officer (PHO).
• Signed off crew shall remain under health check up by PHO prior out pass from immigration office near MPA main jetty gate.
• Any information regarding Monkeypox symptomatic patient on board ship shall be informed to Mongla Port Control Room (Phone no: 02478846166) and Port Health Office (Contact No: 01914-466764) immediately. In such case ship’s movement/cargo operation will be subjected to the report of PHO inspection.