Delhi: Surveillance Teams Face Challenge Of Contact Tracing Monkeypox Patient

Already contending with a pandemic for nearly two-and-half years now, Delhi’s surveillance teams are staring at a new challenge – tracing the contacts of the city’s first monkeypox patient.

The 34-year-old man, who was diagnosed with the infection on Sunday, has no history of foreign travel, but visited Himachal Pradesh for three days on June 26.

The major challenge, Delhi’s surveillance officers said, is the nearly month-long gap between his return from the hill state, the first set of symptoms on July 5, his hospitalisation on July 22 and finally his diagnosis two days after that. He is likely to have interacted with umpteen people in this span, officials said, leaving tracking teams with a mountain to climb, apart from the possibility that several contacts may fly beneath their radars.

“The longer the gap between the infection being contracted, symptoms appearing and the infection getting confirmed, the trickier the contact tracing process becomes. In the west Delhi patient’s case, the incubation time was around 10 days and it took another 10 days for the infection to be diagnosed. In the first two days, we managed to isolate the patient’s immediate contacts, which does not require much effort. It’s tracking the other links that takes time,” the official said.

Officials explained that tracking contacts of patients works in “concentric circles”. This means that first the immediate contacts of the patient--family, friends, medical professionals who have treated them--are contacted and isolated. Then the next line of contacts, where they have met in the incubation period but for a relatively limited period or in a setup where contact is limited. This progression is maintained.

These contacts are advised isolation and their symptoms are observed for a seven-day period.

Another hurdle in the exercise, the official said, is that a patient is likely to forget a significant number of people they interacted with if there is a protracted gap between acquiring an infection and symptoms cropping up.

Fourteen people who came in touch with the west Delhi patient have so far been tracked and isolated. More are pending. The authorities are yet to track the source of infection.

The west Delhi patient started developing skin lesions around eight days after he first got a fever.

On July 21, Dr Richa Chaudhary, a dermatologist, diagnosed the patient with monkeypox and reported the case to the health officials.

Senior officials of the Delhi government’s health department said that surveillance teams from Himachal Pradesh are also helping the administration track the patient’s chain of contacts. Authorities in the neighbouring state have been asked to isolate and observe any confirmed contact for possible symptoms.

Health department officials said the Delhi government’s familiarity with contact tracing exercise, thanks to the pandemic, is likely to help their efforts, with several established surveillance systems now in place.

For instance, the department has a dedicated control room to track Covid-19 infections. District teams also support the department in this exercise.

“We currently do not have a dedicated control room for monkeypox because there is only one confirmed case in Delhi. The teams that worked for Covid contact tracing can be roped in for monkeypox too, because currently the load of Covid patients is also not too high,” said a health official.

ABOUT THE AUTHOR

Soumya Pillai covers environment and traffic in Delhi. A journalist for three years, she has grown up in and with Delhi, which is often reflected in the stories she does about life in the city. She also enjoys writing on social innovations.

Crime Patrol Dial 100 - Ep 727 - Full Episode - 6th March, 2018