Nurses in Guyana worried about potential Monkeypox outbreak

May 29, 2022 News

---

…as COVID-19 cases sees steep increase

By Davina Bagot

Kaieteur News – Amidst an already struggling health sector, care givers – nurses and patient care assistants in particular – are worried about a possible outbreak of the very contagious disease, Monkeypox.

Monkeypox, according to the Pan American Health Organization (PAHO), is a viral zoonosis caused by the monkeypox virus, which belongs to the Orthopoxvirus genus, which includes variola virus (which causes smallpox). There are two genetically distinct strains of the monkeypox virus: the Congo Basin (Central African) strain and the West African strain. Human infections with the West African strain appear to cause less severe disease compared to the Congo Basin strain.
It can spread from someone who is carrying the virus mainly through direct or indirect contact with the rash, bodily fluids (such as fluid, pus, or blood from skin lesions), and scabs. However, the virus can also be transmitted if clothing, bedspread, towels, or objects become contaminated from an infected person. PAHO has also said that Monkeypox can spread from someone who is pregnant to the fetus from the placenta, or from an infected parent to child during or after birth through skin-to-skin contact. It is not clear whether people who do not have symptoms can spread the disease.

Meanwhile, the Centers for Disease Control and Prevention (CDC) said on its website that Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘Monkeypox’. The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then, Monkeypox has been reported in humans in other central and western African countries.
As recent as May 25, PAHO said over the past two weeks, cases of the virus have been reported to the World Health Organization (WHO) from several non-endemic countries with no direct travel links to an endemic area.In humans, the symptoms of Monkeypox are said to be similar to, but milder than the symptoms of smallpox. CDC explained that it begins with fever, headache, muscle aches, and exhaustion. The main difference between symptoms of smallpox and Monkeypox is that Monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not. The incubation period (time from infection to symptoms) for Monkeypox is usually seven to14 days but can range from five to 21 days.
A person who has been infected can experience fever, headache, muscles aches, back aches, swollen nymph nodes, chills and exhaustion, as Monkeypox develops. The rash usually develops about one to three days, sometimes longer, after the symptoms listed above. The rash, according to CDC, often begins on the face before spreading to other parts of the body.
In Guyana, no cases have been reported to date, but health care professionals fear the worst. “We already saw what happened with COVID-19. They (government) left the country opened and the virus came and spread throughout the country. I believe that they should close down the country for a bit until we get a full understanding of this thing and it could give us some time to prepare too,” a Patient-care Assistant from Region Five told Kaieteur News earlier this week.
In Region Four, a nurse attached to the Georgetown Public Hospital Corporation said that while the disease remains fairly new to her, she understands that it can be transmitted through contact with an infected person. “It is new to me. I haven’t heard of it until recent but what I do know is that it shares similar signs and symptoms as of chicken pox. Because it can be transmitted through contact, the respiratory track (droplets) mucus membranes such as the eyes, nose, mouth. I think it’s safe to say that the government needs to insist on persons wearing their mask, sanitizing and maintain social distancing. Also it’s important to know that even before persons who are infected by this virus develop rashes, they are infectious. Honestly I think everyone should go in a body bag or cover themselves up, to prevent physical contact because the majority of persons are travelling in public transportation,” the nurse explained.
Another nurse, who works at an East Bank of Demerara health centre, said the new outbreak is worrying as Guyana is currently still struggling with strains from the global COVID-19 pandemic. According to the nurse, “Monkeypox come now but we in Guyana aren’t ready for that because you should know that we barely even have nurses. …Hardly any nurses left in the country. Everyday more and more of them either leaving the country or leaving the profession because they (government) don’t treat we nice here at all.”
In Region Three, one nurse said she was particularly worried about the government’s silence on the disease as many persons are still clueless as to what Monkeypox is.
In Region 10, a nurse said government should increase the salary for all health care workers, as they remain on the frontline to respond and treat infected persons. “We have our families to go home to and it’s frightening to think of what can happen if we infect our children and other relatives,” she said.
Health care professionals, she noted though, could not complain about the provision of Personal Protective Equipment (PPE) as these have been readily available to the Health Department. This she hopes would continue to be accessible.
A few other nurses who this newspaper spoke with said they do not know much about the virus and declined to comment.
PAHO has said that there are no specific treatments for Monkeypox as symptoms often resolve on their own without the need for treatment. “It is important to take care of the rash by letting it dry if possible or covering it with a moist dressing to protect the area if needed. Avoid touching any sores in the mouth or eyes. Mouth rinses and eye drops can be used as long as cortisone-containing products are avoided. An antiviral that was developed to treat smallpox (tecovirimat, commercialised as TPOXX) was also approved for the treatment of Monkeypox in January 2022,” PAHO explained on a dedicated Monkeypox page.
Importantly, it was also noted that vaccination against smallpox was demonstrated through several observational studies to be about 85 percent effective in preventing Monkeypox.
The World Health Organization (WHO) reported that as of May 21, last, 92 laboratory confirmed cases, and 28 suspected cases of Monkeypox were diagnosed in 12 Member States, including Canada, the United States of America, the United Kingdom, Portugal and Spain, with the three former states having the highest recorded cases so far of, 21 to 30 each.
“The situation is evolving and WHO expects there will be more cases of monkeypox identified as surveillance expands in non-endemic countries. Immediate actions focus on informing those who may be most at risk for Monkeypox infection with accurate information, in order to stop further spread. Current available evidence suggests that those who are most at risk are those who have had close physical contact with someone with Monkeypox, while they are symptomatic. WHO is also working to provide guidance to protect frontline health care providers and other health workers who may be at risk such as cleaners. WHO will be providing more technical recommendations in the coming days,” the health institution said.

---

---