India till now has reported nine Monkeypox cases and one death owing to the viral zoonosis infection. Centre has stepped up vigil and issued revised guidelines as the threat of a Global Public Health Emergency looms of the country recovering from a severe spell of Covid-19 pandemic.
In the latest update of Monkeypox virus cases in India, an analysis conducted by the Indian Council of Medical Research (ICMR) and National Institute of Virology (NIV) it has been revealed that the first two Monkeypox cases diagnosed in India which was a duo that had returned from the UAE- were infected with the virus strain A. 2.
Notably the strain A. 2, is different from the strain causing the worrying outbreak of Monkeypox cases in Europe.
The foreign returnees from the United Arab Emirates presented with fever, myalgia, and vesicular lesions on the genital area with cervical lymphadenopathy. The oropharyngeal and nasopharyngeal swab, EDTA blood, serum, urine, lesion samples from multiple sites were collected from both the cases on the ninth post onset day of illness.
The clinical specimens of both the cases were tested with real-time PCR for orthopoxvirus, monkeypox virus (MPXV).
” The complete genome sequences obtained from skin lesions of cases 1 and 2 showed similarity of 99.91 and 99.96 per cent respectively with MPXV_USA_2022_FL001 West African clade. Phylogenetic analysis revealed that the two cases were infected with monkeypox virus strain A. 2 which belong to hMPXV-1A lineage of clade 3 (West African clade),” the study by the NIV under the ICMR found.
The West African clade is found to be circulating in the current ongoing outbreaks of 2022 in non-endemic countries. It is which is less severe than Congo lineage reported earlier,” Dr Yadav said.
Here is everything you need to know about the A. 2 strain of Monkeypox virus
- The A. 2 strain, which was detected in the US last year, has not been linked to major clusters. The current outbreak is being driven by the B. 1 strain of monkeypox virus
- The West African and Central African (Congo Basin) are the two known clades of the monkeypox virus, of which Congo basin strain causes more severe illness, 0– 11% mortality and increased transmissibility.
- The study found that the two cases were infected with monkeypox virus strain A. 2 which belong to hMPXV-1A lineage of clade 3 (West African clade). Of the two known clades- West African and Central African– the West African clade is found to be less severe than Central African lineage
According to the study, people with no history of sexual contact can also contract the virus. In the first case, the person had a history of similar lesions amongst his friends and contact with a suspected Monkeypox case.
- Symptoms of patients infected with A. 2 strain
-The 35-year-old man had developed low-grade fever and myalgia on July 5. He developed multiple vesicular rashes in the oral cavity and lips followed by single lesion on the genital organ. He also had rashes on both hands.
-The 31-year-old man had developed dysuria and genital swelling on July 8. He travelled from Dubai to his hometown in Kerala on July 13. He visited a government hospital locally and on the suspicion as monkeypox case, he was isolated on July 16.
-The study said the infection starts with a febrile illness with average incubation of 5– 13 days with lymphadenopathy, myalgia, and headache, followed by deep-seated umbilicated vesicular or pustular rashes.
-The rash primarily starts from the face (oral), genital or perianal region and then distributed in centrifugal manner to other parts of the body and progresses over time to scab.