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JEDDAH: Health officials in Europe and the Americas are sounding the alarm over the spread of monkeypox, with many declaring the outbreak a public health emergency.

In Saudi Arabia, on the other hand, where only three cases have been confirmed, the response has been more muted.

Saudi experts say the Kingdom’s restrained approach has several reasons, including the presence of well-established surveillance, detection and prevention measures resulting from its handling of previous infectious disease outbreaks, and the extremely low rate of transmission seen in the country. the region.

“We know that, particularly in the Gulf region and in Saudi Arabia, there have been many efforts to document the increase in cases and to implement rigorous methods to detect them, ensuring that the right preventive measures and cures are in place to prevent the spread of monkeypox, as well as to treat it immediately from a medical point of view,” Dr. Nawaf Albali, a Saudi doctor, told Arab News.

“Countries need to implement appropriate border control and surveillance standards and increase screening, increase diagnostic capabilities within and across borders.”

Once a relatively rare disease, monkeypox has been present in a handful of West and Central African countries since the 1970s, with occasional outbreaks not exceeding 100 cases over the past four decades.

People with the condition tend to develop a rash that may be on or near the genitals or anus, and other areas such as the hands, feet, chest, face, or throat. stuffy.

The rash will go through several stages, including scabs, before it heals. It may initially look like pimples or blisters, and may be painful or itchy.

Other symptoms may include fever, chills, swollen lymph nodes, exhaustion, muscle aches, back pain, headache, sore throat, stuffy nose, or cough.

These symptoms usually begin within three weeks of exposure to monkeypox virus and typically last for two to four weeks.

Authorities have detected dozens of cases in Europe, North America and beyond since May, surpassing the 28,000 mark globally.

Symptoms of the self-limiting disease usually last two to four weeks. (Shutterstock)

The World Health Organization declared monkeypox a global health emergency on July 23. To date, there have been at least 75 suspected monkeypox deaths in Africa, mostly in Nigeria and Congo.

On July 29, Brazil and Spain both reported monkeypox-related deaths, the first reported outside of Africa. Spain reported a second death the next day and India reported the first on August 1.

Only three cases of monkeypox have been detected in Saudi Arabia, among passengers returning from Europe.

Regionally, the United Arab Emirates has 16 confirmed cases and Qatar has two, indicating a much slower spread compared to other parts of the world.

Monkeypox is transmitted when a person comes into contact with the eponymous virus from an animal, human or contaminated material.

It is often spread through skin-to-skin contact, and many, but not all, cases have been caused by physical contact between men.

“The way it spreads is either through skin-to-skin contact or through contact with certain bodily fluids, for example sweat, or through exposure to sensitive parts of the body like the genitals or private parts,” Albali said. .

“That kind of contact and that kind of intimate contact is not that common (in the Gulf). That’s not to say they aren’t there, but they aren’t as common.

Health officials in Europe and the Americas are sounding the alarm over the spread of monkeypox. (AFP)

Dr Abdulaziz Al-Angari, assistant professor of epidemiology at King Saud bin Abdulaziz University of Health Sciences in Riyadh, said that although the WHO has declared monkeypox a public health emergency of international concern , it is not yet a pandemic.

“The rate of infection is slow and limited given the transmission routes of the virus,” he told Arab News.

To calculate an odds ratio (a statistic that quantifies the strength of the association between two events), a sufficient number of cases must be considered. To date, there have been too few cases in the Kingdom to draw conclusions.

“More detailed information on the cases, such as investigations (demographics, history, practices, travel information, etc.) is needed,” Al-Angari said.

Saudi Arabia and several other countries have taken the necessary steps to collect this data in real time and prevent the spread – lessons learned from previous viral outbreaks.

In 2012, the first case of Middle East respiratory syndrome caused by the MERS coronavirus was identified in Saudi Arabia.

Studies have shown that humans are infected through direct or indirect contact with infected camels, but the exact route of transmission remains unclear.

The experience prompted the Kingdom to develop detection and containment strategies and infrastructure, which came into action in 2020 when COVID-19 emerged.

Registered pharmacist Sapna Patel demonstrates preparing a dose of monkeypox vaccine at a pop-up vaccination clinic. (AFP)

The Ministry of Health launched a command and control center and accelerated the establishment of the Saudi Center for Disease Control and Prevention.

“Our experience with MERS-CoV has been painful and unique to our region, and between 2013 and 2015, health authorities understood the extent of disease prevention, lockdowns, market closures and certain commercial activities. related to camels,” Albali said.

“So we understand the effectiveness of early intervention in disease control. We have developed this kind of capacity and sense of urgency in the global health system. »

Reiterating the importance of early detection and documentation of cases, Al-Angari said, “Global health systems have developed critically after the recent pandemic in data collection, surveillance and monitoring systems. .

“With this, contact tracing is essential to prevent the virus from being introduced into new populations in the near future.

“Although it may not be necessary now, the use of systems such as the Tawakkalna app could be considered at some point.”

The Saudi Data and Artificial Intelligence Authority has developed Tawakkalna to support the government’s efforts to deal with COVID-19 by managing the process of granting exit permits during the lockdown phase, which has helped limit the spread of the virus.

In June, the app received the 2022 United Nations Public Service Award for Institutional Resilience and Innovative Responses to the Pandemic.

The Kingdom understands the effectiveness of early intervention in disease control, according to Dr. Abdulaziz Al-Angari, assistant professor of epidemiology at KSAU-HS. (Provided)

As travel demand soars after the easing of COVID-19 restrictions, Al-Angari stressed the importance of monitoring entry points.

“Since the virus (monkeypox) is transmitted from human to human, all necessary arrangements must be implemented,” he said.

“The activation of thermal cameras is necessary at all times, not just for this disease but for all future diseases, and random health screening of people who have regular contact with animals is important to prevent zoonotic diseases.”

Just like in the early days of COVID-19, infrared cameras placed in airport arrival halls are an integral part of the syndromic surveillance process – a process of collecting, analyzing and interpreting health-related data to provide early warning of health threats.

“Once a camera detects any of the symptoms of the disease (such as an elevated body temperature), the case is isolated at the airport, and as part of Saudi Arabia’s preventive measures, other people who might have been exposed to the case must also be tested,” Albali said.

“This is how the cases were detected, and an investigation was subsequently launched, with no further cases detected to date.”

Beyond surveillance, according to Albali, health authorities need to provide enough information and guidance to travelers to countries considered monkeypox hotspots.

“The main lesson learned from the COVID-19 pandemic is increased community awareness of the virus and how to protect themselves,” he said.

“The same rule of thumb now applies to this current outbreak, even though it has barely marked our shores in Saudi Arabia, and with the health authorities’ transparent communication strategy, the level of awareness will continue to rise and protect further. the community from future epidemics.

A rollout of the monkeypox vaccine has been launched in the United States, United Kingdom, Denmark, Spain, Germany, France and Canada, among others.

However, it is unlikely to be distributed in Saudi Arabia unless it is needed to protect the most vulnerable, such as children, the elderly and the immunocompromised.

“Vaccines can be implemented,” Al-Angari said. “However, I don’t see it coming soon because it’s not a current threat, at least (not) in this region.”

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