DNA Explainer: Does India need to panic after the death of Kerala youth who tested positive for monkeypox in UAE?

India saw its first death from monkeypox as the Kerala government on Monday confirmed that the 22-year-old man, who died on July 30, tested positive for the virus. State Chief Minister Pinarayi Vijayan told reporters here that the samples sent to NIV (National Institute of Virology), Pune, had returned positive and had been a West African variant.

Vijayan said the man, who reached the State on July 22, had earlier tested positive for monkey pox on July 19 in the UAE.
"He was admitted to a private hospital at Thrissur on July 27 after his health deteriorated but his relatives informed the hospital authorities about the test result from UAE on July 30," State Health Minister Veena George said in a release.

The case is different from the three cases of monkeypox detected in Kerala earlier. One of those three earlier cases has been discharged from hospital and the other two were reported to be stable on Sunday. 

The one reported in Delhi was also different from the remaining cases since the patient had no history of foreign travel. All the cases in Kerala, including the one in which the infected person has died, were in individuals who arrived in the state from the Middle East. 

About the first death from monkeypox

The deceased is a 22-year-old named Hafeez from Thrissur, who dies in a private hospital on Saturday, days after he returned from the UAE. 

George said the man had been diagnosed with monkeypox while he was abroad, but his family had informed the hospital in Thrissur only on Saturday.

He had visited a hospital on July 26 after he developed a fever. He was moved to another hospital later, where he was put on life support, and where he died on Saturday afternoon.

Is monkeypox a fatal disease?

No, it is not. Just because the Kerala youth who died on Saturday had tested positive for the zoonotic virus, does not mean that he was killed by it. An analysis of his condition will conclude the exact reason for his death, which may have been caused by several other possible factors. 

Chief Minister said a detailed probe would be conducted by a high-level State medical board.

George had, on Sunday, said the patient was young and did not suffer from any other illness or health problems and, therefore, the Health Department was looking into the cause of his death.

"This particular variant of monkey pox is not as highly virulent or contagious like COVID-19, but it does spread. Comparatively, the mortality rate of this variant is low. Therefore, we will examine why the 22-year-old man died in this particular case as he had no other illness or health problems," the Minister had said.

How many overall deaths so far?

The global outbreak since May has left over 20,000 people infected from monkeypox virus across over 80 countries. However, most of the deaths have been reported in Africa, where monkeypox outbreaks have been reported for years. More than 75 people have died in Africa from the disease till date. 

Outside Africa, there have four deaths, counting the Kerala death. The first monkeypox-related death outside the African continent was reported in Brazil on Friday (July 29). 

On Friday, there was a death in Spain’s Valencia region, and on Saturday, a patient died in the Andalusia region of the country. The two deaths in Spain are Europe’s first monkeypox-related deaths.

In the Brazil death case, it must be noted that the patient also suffered from lymphoma and a weakened immune system. 

According to a Deutsche Welle report, both the patients in Spain had been hospitalised with infections that had attacked the brain in the days before their deaths, and that it is possible their deaths were linked to pre-existing conditions.

About Monkeypox

According to the WHO, monkeypox is a viral zoonosis -- a virus transmitted to humans from animals -- with symptoms similar to small pox although clinically less severe.

Monkeypox typically manifests itself with fever, rash and swollen lymph nodes and may lead to a range of medical complications. It is usually a self-limited disease with symptoms lasting for two to four weeks.

The 'Guidelines on Management of Monkeypox Disease' issued by the Centre, stated that human-to-human transmission occurs primarily through large respiratory droplets generally requiring prolonged close contact.

It can also be transmitted through direct contact with body fluids or lesions, and indirect contact with lesion material such as through contaminated clothing or linen of an infected person. Animal-to-human transmission may occur by bite or scratch of infected animals or through bush meat preparation.

The incubation period is usually from six to 13 days and the case fatality rate of monkeypox has historically ranged up to 11 per cent in the general population and higher among children. In recent times, the case fatality rate has been around three to six per cent.

The symptoms include lesions which usually begin within one to three days from the onset of fever, lasting for around two to four weeks and are often described as painful until the healing phase when they become itchy. A notable predilection for palm and soles is characteristic of monkeypox, the guidelines said.