PHL response to monkeypox in place should be updated regularly—expert
While the first case of monkeypox has already been recorded in the Philippines, the public should not panic too much as the Department of Health (DOH) has already issued a memorandum as early as May this year on how to respond to this new public health emergency. of international scope (USPPI).
During the webinar titled “Monkeypox, nandito na. Are we ready?” by the University of the Philippines in partnership with UP Manila NIH National Telehealth Center and in cooperation with UP Philippine General Hospital, Dr. Regina Berba, Chairperson, Infection Control Unit, UP Philippine General Hospital, said that it was needed -date and relevant response to monkeypox.
“It is necessary for all countries in the world to get involved and have this global solidarity to prevent this from turning into something much worse,” she said.
She said if the country is to identify the targets for the response, it should identify cases effectively, reduce new cases, reduce confusion, reduce stigma and protect health workers.
“It is important for our responses at the institutional, collective and individual level, because we do not want to lose our patients. We want them to come to us and be diagnosed as efficiently as possible and hope to achieve all the identified goals,” she said.
How to treat suspicious patients?
Dr Berba said there should be a pathway on how suspected patients can be brought to specific areas of a hospital where they can be treated. She cited that at PGH they have already posted informational posters about monkeypox and where clinics are located, and have informed their large infectious disease community of healthcare workers, all of whom may be asked to manage patients who are suspected or probable cases.
Patients presenting with a rash can also be taken to the SAGIP clinic at the HGP, to the dermatology clinic or to the emergency room. There is also a need to create a pathway and make the facility safe and efficient for patients, such as setting up the facility before the first patient arrives, obtaining all diagnostic needs like kits and PPE, as well that setting up a messaging network that will bring diagnostic samples to the Institute for Research in Tropical Medicine (RITM), and networking with the local Epidemiology Bureau (EB) and the Regional Epidemiological Surveillance Unit (RESU) .
In terms of the facility’s response, Dr Berba said it comes down to two areas: identifying an isolation area for suspected monkeypox cases, which should be a self-contained, dedicated facility where monkeypox cases should not not be mixed with other patients; and have a process in place to refer suspected cases for monkeypox testing or transfer them to designated referral centres.
“Even before a suspected case is identified in the facility, the infection prevention and control unit [IPCU] should already coordinate with local epidemiological surveillance units, whether municipal, municipal or regional, to determine the procedures to be followed in the event that a case of monkeypox is identified in the establishment. This process should be worked on, written down and modified accordingly,” she said.
At UP-PGH, Dr. Berba said he created a tentative pathway for monkeypox cases, a sort of flowchart or more of a checklist where there are questions with a corresponding action depending on the answer to questions.
Initially, Dr. Berba said they would admit patients who answered “Yes” to the questions, but she learned from Dr. Franco Felizarta, an infectious disease specialist and part of the UP Medical Alumni Association in America (UPMASA), that not all cases of monkeypox may have to be admitted because they may not be sick and will therefore be discharged.
“The journey needs to be smooth, people need to know what to do, what to expect and how to take care of themselves once the patient arrives,” she added.
This involves determining whether the suspect is monkeypox or not such as the appearance of a rash, the other links like travel history in the last 21 days, were there multiple sex partners in the last 21 days and other epidemiological links. A checklist should also be handy, a fully completed Monkeypox Case Investigation (CIF) form which resembles the Covid-19 tracking form, then sample collection and instructions on proper sample collection.
However, Dr Berba reiterated that not all rashes are monkeypox, so there is dengue fever, syphilis, chickenpox, herpes, measles, other skin lesions or even skin reactions. non-infectious hypersensitivity.