Rio de Janeiro and São Paulo are monitoring the health status of passengers who were on the flights they were on Monkeypox cases identified. The procedure was carried out by the Rio de Janeiro Municipal Health Department and the São Paulo State Health Department, according to the agencies’ press offices.
Brazil has already recorded seven cases of the disease. The last of them was confirmed by the Ministry of Health this Friday (17).
Of the seven confirmed cases in the country, four are from São Paulo, two from Rio Grande do Sul and one from Rio de Janeiro. Nine other cases are under investigation. The first case in Brazil was recorded on June 8.
In the capital of Rio de Janeiro, the municipal health department said it was starting a survey of passengers who were on the same flight as the patient with a confirmed case of monkeypox. Traveler data was provided by Anvisa (National Health Surveillance Agency).
The first case of monkeypox in Rio was confirmed on Tuesday (14). He is a 38-year-old man, residing in London, who arrived in Brazil on June 11 and was treated at the Instituto Evandro Chagas the day after his disembarkation. The samples were analyzed by the Instituto Carlos Chagas Filho, of UFRJ (Federal University of Rio de Janeiro).
The Municipal Secretariat also counts on the collaboration of the Department of Health of the State of Rio de Janeiro to carry out people monitoring who had contact with the patient.
Currently, five people are already being followed by the Rio health authorities for having had close contact with him. We observe if they develop symptoms of illness – if they do, diagnostic tests will be performed. However, all five are not passengers of the plane, specify the secretariats.
According to the municipal ministry, the control procedures to be followed for passengers are not yet defined.
In São Paulo, the state Health Department said it contacted all passengers on flights who had confirmed cases. As in Rio de Janeiro, passenger data was provided by Anvisa.
The Health Surveillance Agency, in turn, explains that it is responsible for collecting information at ports and airports, both for monkeypox (English name for monkeypox) and for other diseases. Anvisa says it passes passenger and crew information to health authorities in the country, such as local secretariats, and these define how to track those people.
A Sheet contacted the Department of Health to comment on this protocol in cases of flights with a diagnosis of monkeypox, but received no response until the report was released.
Chances of transmission
Monitor passengers on flights with confirmed cases of monkeypox still generates some uncertainties. This because the transmission of the virus mainly by contact with the wounds of infected people. Another common way is to use materials, such as clothing, that have come into contact with these wounds.
However, the pathogen can also be transmitted through respiratory secretions, but requires close and prolonged contact. The CDC (US Centers for Disease Control), for example, stipulates that passing someone with the disease in a supermarket should not cause transmission, for example.
Precisely because it has less chance of infection through the respiratory tract, the possibilities of transmission on airplanes are low. The CDC explains that “in cases where people with monkeypox have traveled by air, no known cases of monkeypox have occurred in people seated around them, even on long international flights.”
Nevertheless, monitoring measures are important, especially in the first moments of the epidemic like what is happening nowexplains Raquel Stucchi, specialist in infectious diseases and professor at Unicamp (State University of Campinas).
“This energy that is spent investigating passengers, at this time when the first cases are appearing in the country, I think it is justified,” he says.
Stucchi says that, in these situations, one measure that can be taken is the adoption of a questionnaire or app in which passengers report daily whether they have developed symptoms common to monkeypox, such as fever or blister-like lesions.
From the surveillance measures of these first flights, it is possible to determine if this initiative should really be taken for other similar cases, continues the infectiologist.
Clarissa Damaso, a virologist at UFRJ (Federal University of Rio de Janeiro) and one of the researchers who make up the working group to combat monkeypox organized at the university, says that an important aspect is to define monitoring protocols to be observed in all cases.
“Even if the probability [de transmissão] is weak, does not mean that it is impossible. That’s because there’s skin-to-skin transmission, that’s the main route, and there’s also face-to-face transmission which inside the plane would be more complicated, unless the no one knows the passenger next to him very well,” says Damaso.
The virologist illustrates that it is possible to have contact in an airplane with the skin of an infected person, for example by shaking hands or touching the body, and then to have a greater risk of infection.
However, if it is found that the person infected with monkeypox had not developed the lesions at the time of the flight, the chances of transmission diminish. Therefore, Damaso says it is possible to have different surveillance mechanisms depending on the symptoms of the infected passenger.
In any case, an already known measure that can prevent the transmission of monkeypox through the respiratory tract is the use of masks. The CDC recommends that the infected person use the equipment in close contact with other people.
Similar advice is given by Stucchi. “The use of masks prevents this respiratory transmission which can rarely occur”, concludes the infectiologist.