Ministry issues advisories on Mpox and Oropouche

(CNS): The Ministry of Health and Wellness has issued advisories on both Monkeypox, now referred to as Mpox, and the Oropouche virus, though there have been no confirmed cases of either disease in the Cayman Islands. On 14 August, in response to a surge of cases in the Democratic Republic of Congo (DRC) and onward transmission into neighbouring countries, the World Health Organization (WHO) declared that the current outbreak of Mpox is a Public Health Emergency of International Concern (PHEIC).

Since the start of 2024, there have been at least 15,000 cases and 511 deaths in the DRC. While Mpox is endemic in the DRC, this outbreak impacted provinces that were previously unaffected, and the number of cases is already more than the total number of cases in 2023. Over the past month, more than 100 cases have been reported in the nearby countries of Burundi, Kenya, Rwanda and Uganda, none of which are known to have had cases previously.

“The Mpox virus is transmitted from person to person by direct contact with Mpox rash and/or scabs, as well as bodily fluids or respiratory droplets from a person with Mpox,” Chief Medical Officer Dr Nick Gent explained. “Transmission can also occur via sexual contact, contact with contaminated items, such as towels and bedding, as well as vertically from a pregnant mother to her baby.”

Mpox symptoms are typically fever, headache, low energy, and muscle ache. Following fever, a mild to severe rash can develop, most commonly on the hands and feet but also in the genital and perianal areas. The rash goes through different stages before forming a scab.

Ministry officials have met with representatives from Health City Cayman Islands, Doctors Hospital, Faith Hospital and the Health Services Authority, including HSA’s General Practice, Urgent Care, Public Health Department and the Cayman Islands Molecular Biology Laboratory (CIMBL).

“Given that this is a dynamic situation, the ministry will continue to meet regularly with these key stakeholders in order to coordinate actions and overall preparedness,” Dr Gent said. Those at the meeting agreed on infection control issues, the need for immediate isolation, the urgency of informing public health officials, and rapid testing protocols. “The CIMBL has the capability to test locally for Mpox,” the CMO noted.

While there is a vaccine for Mpox, the global supply is limited and needs to be directed to the current outbreak in Africa. Given that the current risk of incursion and community spread in the Cayman Islands is quite low, Mpox immunisation is currently not an appropriate measure.

The ministry has prepared guidance for clinicians regarding suspected Mpox cases. Given the infectiousness of this virus, isolation of individuals and close contacts is an essential measure, so in-home quarantine measures will form part of the public health response. However, the HSA has identified a new suite of clinical rooms that include individual care rooms that would be suitable for any cases that need hospitalisation.

Meanwhile, the Pan American Health Organisation (PAHO) has issued a warning that the risk of transmission of Oropouche Virus in Central and South America and the Caribbean is now of significant concern.

There is no specific treatment or vaccine available for Oropouche Virus disease. It is transmitted to humans by the bite of a midge (small fly) and certain mosquitoes. Currently, there is no evidence of human-to-human transmission. The disease symptoms are typically fever, headache, joint stiffness, pain and chills. Due to the similar symptoms, it can often be confused with dengue. The symptoms usually persist for five to seven days. Severe cases of illness are rare.

Oropouche was first detected in 1955 in Trinidad and Tobago. Outbreaks have occurred since in Central and South America. Over the last few months, an increase in cases has been reported across some countries in South America and in Cuba, including countries that have not previously reported cases. Two deaths have been reported in Brazil, reportedly due to Oropouche infections. This is the first time that deaths have been attributed to OROV disease.

“Locally, we have been developing the capacity to be able to test for Oropouche Virus at the Cayman Islands Molecular Biology Laboratory (CIMBL) at the Health Services Authority,” Medical Officer of Health Dr Samuel Williams explained. The test is currently being validated and health providers will be notified when it is available for use.

Anyone who has a fever and either muscle or joint pain is encouraged to contact their GP for advice and testing, especially if they have recently travelled to an endemic area. Those who are travelling through affected areas are encouraged to use insect repellent and take precautions to prevent bites. 

Locally, all residents are encouraged to always protect themselves from mosquito bites by using mosquito repellent, especially during peak times of mosquito activity (dusk and dawn), wearing light, long-sleeved shirts and long trousers to prevent bites, and taking steps to keep mosquitoes out of your home by using air conditioning and window and door screens.

Residents are advised to empty and clean, turn over, cover, or throw out items that hold water, such as tyres, buckets, planters, toys, pools, birdbaths, flowerpots and trash containers, once a week, which will destroy mosquito breeding sites. They should check inside and outside the home, the ministry said, noting that mosquitoes lay eggs near water.

If the mosquito situation in your area is of concern, call the Mosquito Research and Control Unit at 949-2557.

Queries and requests for additional information should be directed to 
nick.gent@gov.ky or rachel.corbett@gov.ky.