News Releases

UWI Faculty of Medical Sciences advises the public about Monkeypox

For Release Upon Receipt - June 15, 2022

St. Augustine


The UWI St. Augustine, Trinidad & Tobago. Wednesday 15th June, 2022 – The following media advisory is issued on behalf of The Faculty of Medical Sciences, The University of the West Indies (The UWI) St. Augustine Campus and contains pertinent information for the public about Monkeypox. 

As at June 15, 2022 in Trinidad and Tobago, there are no confirmed cases of the disease nor are there any known hosts, which harbor the monkeypox virus. However, we are a highly mobile society that travel to and from countries where the disease has been identified. This places our population at a moderate risk. (Refer to the map below) 

In the local context, it is important that guidelines for patients, veterinarians and other health care professionals and animal handlers must be developed to track any potentially infected cases. “All healthcare professionals ;  medical doctors , veterinarians , nurses and allied health care professionals should be on high alert to recognise and  report suspect cases of this disease to the Ministry of Health,” urged Dr. Karla Georges, Director of The UWI School Veterinary Medicine (UWI-SVM). “Early detection of cases will assist in limiting the spread to the community,” she added. 

With respect to importation of rodents into Trinidad and Tobago, a permit must be obtained from persons desirous of importing wildlife and must submit the relevant form “INTEND TO IMPORT WILD FLORA AND FAUNA” available from the Wildlife Section, Forestry Division, Farm Road, St. Joseph. The virus can spread through any kind of sustained skin-to-skin contact, face-to-face contact, or mouth-to-skin contact with an infected person who has a lesion. It can also spread through contact with body fluids, contaminated bed sheets, towels and clothing, or respiratory droplets if a person has a lesion in their mouth. The virus has an incubation period from 6 to 13 days but clinical manifestations of infection can occur from 5 to 21 days. 

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Source: WHO Multi-country monkeypox outbreak: situation update (June 10) 

What is monkeypox?

Monkeypox is a rare disease that is caused by infection with an agent called the monkeypox virus. It is a viral zoonosis where the virus is transmitted from animals to humans. The monkeypox virus belongs to a family of viruses that includes a related infectious disease smallpox. 

Monkeypox is regularly found (endemic) in West and Central Africa and if detected outside of that region, would usually be linked to travel to that region. However, the rapid spread of the disease to numerous non-endemic countries (across Europe North and South America and Western Pacific) with travel history to Europe and North America has made this a public health concern, for which the WHO cannot rule out a pandemic risk. The first cases outside of the endemic areas were reported in early May 2022 and by June 8, 2022, it had spread across 28 countries resulting in 1285 confirmed cases and rising. 

In the Americas, confirmed cases of monkeypox have been reported in Canada, the United States, Mexico, and Argentina while suspected cases have been reported in French Guiana. Authorities have noted that the majority of reported cases had no established travel links to any of the endemic countries and were identified through visits to their primary health care and/or sexual health service facilities. 

The majority of monkeypox infections are mild or asymptomatic. However, since January 2022, deaths have only been reported in endemic countries. In symptomatic individuals, monkeypox causes a systemic illness including fevers, chills, and myalgias, with skin lesions that resemble the rash seen in the images below. The skin lesions heal and become dry and crusted after 2-3 weeks after which the person is no longer infectious. It is important to understand if the lesions have not all dried and become crusted over that a person will be able to infect others with this virus. The treatment of most cases involves supportive care with antiviral medicines being reserved only for severe infections.

Photograph: (Twitter) accessed from https://www.wionews.com/world/monkeypox-outbreak-in-the-uk-two-treated-for-rare-viral-infection-in-north-wales-390754 (Accessed June 9, 2022). 

Do we have any local habitats/reservoirs that carry it?

Although the name is ‘monkeypox’ the most likely natural reservoir are rodents rather than monkeys. In Trinidad and Tobago, the virus has not been identified in these animal populations.

According to the World Health Organization (WHO, 2022) ‘those who are most at risk are those who have had close physical contact with someone with monkeypox, while they are symptomatic (showing symptoms)’. 

Are local sources being monitored? 

Monkeypox is being monitored by the Ministry of Health locally and the WHO globally. Although most cases of ‘monkeypox’ are not typically fatal, since January 2022 there have been 72 deaths in the endemic countries. Due to the increasing numbers across different countries and the public health concern associated with infections, the WHO will meet shortly to assess whether the continuing outbreak represents a Public Health Emergency of International Concern.

If any individual experiences any of the stated signs or symptoms, they should make an immediate report to the public health authorities or the office of the County Medical Officer of Health in the respective districts.  Each individual must take personal responsibility to self monitor.  

According to WHO (2022) a suspected case is defined as:

A person of any age presenting in a monkeypox with an unexplained acute rash

AND                                       

One or more of the following signs or symptoms, since 15 March 2022: 

  • Rash with blisters on face, hands, feet, body, eye, mouth, or genitals
  • Headaches
  • Acute onset of fever (>38.5oC),
  • Swollen lymph nodes (Lymphadenopathy)
  • Muscle and body aches  (Myalgia)
  • Back pain
  • Profound weakness (Asthenia)
  • Low Energy

What are the preventive measures? 

The disease has been identified in a number of different animals including squirrels, rats, dormice, monkeys and others. The animal reservoir has not yet been identified but as we said above, rodents are strongly suspected at this time. People living in rural areas where the disease is endemic have a greater risk of becoming infected. 

Vaccines used for a related illness, smallpox, in the previous generations have also provided protection against monkeypox. However, when smallpox was eradicated in 1980 vaccination against its agent (viarola virus) was discontinued. The immunity from those who received smallpox vaccine in 1970’s can decrease with time. Other ways to control and prevent the spread of the monkeypox are: 

  • Avoid contact with humans and animals that are potentially infected
  • Avoid skin-to-skin contact (including sexual contact), face-to-face contact, or mouth-to-skin contact
  • Wash hands with soap and water regularly or sanitize often with an alcohol-based hand sanitizer
  •  Isolating infected patients and animals
  • Avoid contact with any material that was exposed to humans and animals afflicted with monkeypox
  • Clean objects, surfaces, bedding, towels and clothes regularly
  • Use personal protective equipment (PPE) when caring for patients and their samples
  • Wear a mask if close contact is avoidable and especially when handing bedding, towels and clothes
  • Thoroughly cook all meat before consumption
  •  Place regulations and restrictions on animal trade e.g., quarantine imported animals from countries where the disease is endemic for at least 30 days 

Notes to Editor

For further information, please see the following websites:

Centers for Disease Control: 

https://www.cdc.gov/poxvirus/monkeypox/index.html

https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.htm 

Department of Agriculture | Monkeypox [Internet]. Center for Food Security and Public Health:Iowa State University College of Veterinary Medicine.  Available from: https://www.cfsph.iastate.edu/diseaseinfo/disease/?disease=monkeypox

Institute of Environment and Sustainability at University of California Los Angeles:

Using Remote Sensing to Map the Principal Carrier of Monkeypox Virus in the Congo Basin [Internet]. Institute of the Environment and Sustainability at UCLA. 2022. Available from: https://www.ioes.ucla.edu/news/using-remote-sensing-map-principal-carrier-monkeypox-virus-congo-basin/

World Health Organisation:

https://www.who.int/health-topics/monkeypox

https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON392

https://www.who.int/multi-media/details/monkeypox--what-you-need-to-know

About The UWI 

The UWI has been and continues to be a pivotal force in every aspect of Caribbean development; residing at the centre of all efforts to improve the well-being of people across the region. 

From a university college of London in Jamaica with 33 medical students in 1948, The UWI is today an internationally respected, global university with near 50,000 students and five campuses: Mona in Jamaica, St. Augustine in Trinidad and Tobago, Cave Hill in Barbados, Five Islands in Antigua and Barbuda and its Open Campus, and 10 global centres in partnership with universities in North America, Latin America, Asia, Africa and Europe. 

The UWI offers over 800 certificate, diploma, undergraduate and postgraduate degree options in Culture, Creative and Performing Arts, Food and Agriculture, Engineering, Humanities and Education, Law, Medical Sciences, Science and Technology, Social Sciences, and Sport. As the Caribbean’s leading university, it possesses the largest pool of Caribbean intellect and expertise committed to confronting the critical issues of our region and wider world. 

Ranked among the top universities in the world, by the most reputable ranking agency, Times Higher Education, The UWI is the only Caribbean-based university to make the prestigious lists. In 2020, it earned ‘Triple 1st’ rankings—topping the Caribbean; and in the top in the tables for Latin America and the Caribbean, and global Golden Age universities (between 50 and 80 years old).  The UWI is also featured among the top universities on THE’s Impact Rankings for its response to the world’s biggest concerns, outlined in the 17 United Nations Sustainable Development Goals (SDGs), including Good Health and Wellbeing; Gender Equality and Climate Action. 

For more, visit www.uwi.edu. 

(Please note that the proper name of the university is The University of the West Indies, inclusive of the “The”, hence The UWI.)

 

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