Monkeypox Disease – Global Public Health Emergency Declared & Local Updates

The World Health Organisation (WHO) has determined that the outbreak of Monkeypox in more than 75 countries constitutes a Public Health Emergency of International Concern.  The Emergency Committee Report and temporary recommendations are available here.  The WHO website also contains regularly updated information and reports on the global trends of the Monkeypox outbreak, which can be accessed here.

The IMO’s Circular Letter “Multi-country Monkeypox outbreak in non-endemic countries” No.4575 is available here. This contains information and guidance on Monkeypox disease based on recommendations developed by the World Health Organization (WHO).

Additional information in the Circular ICS(22)18 issued by the International Chamber of Shipping is available here.

Monkeypox symptoms usually start within three weeks of exposure to the virus. It generally starts with flu-like symptoms, including fever, aches and pains and distinctive swollen lymph nodes. They will usually develop a rash one to four days later.  Monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts two to four weeks.  

Ship operators are advised to stay alert to the developing situation and the areas affected by Monkeypox where vessels may be proceeding. Ship personnel should be informed about Monkeypox through messages, posters, videos, and message boards, and promote the importance of personal protective measures and risk-reducing behaviour, particularly before shoreside visits.  

Key messages for ship personnel should include information on the following:

• Symptoms: Monkeypox presents with fever, headache, muscle aches, exhaustion and an extensive characteristic rash that looks like pimples or blisters. The febrile stage is followed by the skin eruption stage, lasting for 2 to 4 weeks. Lesions evolve from macules (lesions with a flat base) to papules (raised firm painful lesions) to vesicles (filled with clear fluid) to pustules (filled with pus), followed by scabs or crusts.  

• Transmission: Monkeypox virus can spread from person-to-person through: 

o direct contact with the infectious rash, scabs, or body fluids,
o respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing or sex, and
o touching items (such as clothing, towels or bed linens) that previously touched the infectious rash or body fluids. 
o It is also possible for people to get Monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.
 

• Prevention: Good hygiene measures should be followed at all times. Self-protection steps include avoiding skin-to-skin or face-to-face contact with anyone with symptoms, practicing safer sex, cleaning hands with water and soap or alcohol-based hand rub, and respiratory etiquette. Contact with animals that can spread Monkeypox virus must be avoided, especially look out for rodents on board and primates in Central and West Africa.  

• Reporting: Any rash-like illnesses should be immediately reported to a medic, including information about all recent travel, sexual history, and smallpox immunization history. The person who is ill should be isolated to limit transmission.

Additional information on Monkeypox disease can be accessed at the European Centre for Disease Prevention and Control and US Centers for Disease Control and Prevention.

Local Updates 

Some correspondents have reported on local measures relevant to shipping.

Brazil – Brazmar have advised that the National Health Surveillance Agency (ANVISA) has stated that several measures applied in relation to the COVID 19 outbreak are similarly applicable to management of the Monkeypox. This includes the use of masks, respiratory etiquette, physical distancing, and cleaning of surfaces. For maritime vessels arriving in the country, it is mandatory to present health documents: the Maritime Health Declaration, which allows the sanitary control of vessels, and the Medical Logbook, containing the records of health occurrences on board related to the last 30 (thirty) days from the moment of the request for authorization to operate in Brazilian ports. 

Mongla Port, Bangladesh – precautionary measures include shore passes for crew/officers only to be granted in emergencies and requirements for signed off crew to have a health check-up. In addition, information regarding Monkeypox symptomatic patients on board should be reported to Mongla Port Control Room (Phone no: 02478846166) and Port Health Office (Contact No: 01914-466764) immediately. In such case ship’s movement/cargo operation will be subjected to the report of PHO inspection. For more details from GAC click here.