Govt guidelines on monkeypox stress on surveillance, rapid identification, isolation
New Delhi, May 31: Amid increasing cases of monkeypox being reported in non-endemic countries, the government on Tuesday issued guidelines directing district surveillance units to consider even one such case as an outbreak and initiating a detailed investigation through the Integrated Disease Surveillance Programme.
In the 'Guidelines on Management of Monkeypox Disease' issued to states and union territories, the health ministry stressed on surveillance and rapid identification of new cases as the key public health measures for outbreak containment, mandating the need to reduce the risk of human-to-human transmission.
It stated that India needs to be prepared in view of the increasing reports of cases in non-endemic countries even as no case of monkeypox virus has been reported in the country till date.
The guidelines proposed a surveillance strategy to rapidly identify cases and clusters of infections and the sources of infections as soon as possible in order to isolate cases to prevent further transmission, provide optimal clinical care, identify and manage contacts and protect frontline health workers and effective control and preventive measures based on the identified routes of transmission.
According to the guidelines, a confirmed case is laboratory confirmed for monkeypox virus by detection of unique sequences of viral DNA either by polymerase chain reaction (PCR) and/or sequencing.
All the clinical specimens should be transported to the apex laboratory of ICMR-NIV (Pune) routed through the Integrated Disease Surveillance Programme (IDSP) network of the respective district or state.
The guidelines explain the Infection Prevention and Control (IPC) measures, IPC at home, patient isolation and ambulance transfer strategies, additional precautions that needs to be taken care of and duration of isolation procedures.
Contacts should be monitored at least daily for the onset of signs or symptoms for a period of 21 days (as per case definition) from the last contact with a patient or their contaminated materials during the infectious period.
Raising awareness of risk factors under risk communication and preventive measures, the guidelines further explain in detail about raising awareness and educating people about the measures for monkeypox virus like avoiding contact with any material of the sick person, isolation of infected patient from others, practising good hand hygiene and using appropriate personal protective equipment (PPE) when caring for patients.
Monkeypox has been reported as endemic in several other central and western African countries such as Cameroon, Central African Republic, Cote d'Ivoire, Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. However, cases have been also reported in certain non-endemic countries like the US, the UK, Belgium, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, Australia, Canada, Austria, Israel and Switzerland.
The health ministry said it continues to maintain a close watch over the evolving situation.
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Real Madrid fines Valverde and Tchouaméni half a million euros each for altercation
Barcelona (AP): Real Madrid slapped players Federico Valverde and Aurélien Tchouaméni with half-a-million-euro ($588,000) fines on Friday for their altercation during practice.
The massive fines came a day after the midfielders tussled when the team trained. Valverde said in a post on social media on Thursday that no punches were thrown. But Valverde knocked his head on a table and he suffered a small cut that required a brief hospital visit.
On social media, Valverde initially called it a “meaningless fight” with a teammate and said “everything has been blown out of proportion."
His employers, however, considered it a significant enough breach of team discipline to nail both Valverde and Tchouaméni with fines that bite even the bank account of a top soccer player. The half-a-million euro penalties reflect the reputational damage the club was enduring in a chaotic end to a disappointing season.
In a statement, the 15-time European champion said its disciplinary action was concluded after both players expressed to the club “their complete remorse for what happened and apologized to one another.”
Madrid added they also apologized to their teammates, the coaching staff and club supporters, as well as showing their willingness to accept whatever disciplinary action the club deemed “opportune.”
Tchouaméni was back training with Madrid on Friday, two days before they play at Barcelona in a clasico. Madrid has to win otherwise Barcelona will be crowned La Liga champion.
After being notified of the fine, he posted a public apology to the club and its fans on social media.
“What happened this week in training is unacceptable,” Tchouaméni wrote. "I say this while thinking about the example we are expected to set for young people, whether in football or at school.
“Above all, I am sorry for the image we projected of the club.”
Valverde was not at practice due to the head knock.
Both players are set to play in the World Cup next month, with Tchouaméni playing for France and Valverde for Uruguay.
Chaotic end to a poor season
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The run-in between the players, who for seasons have played side by side in Madrid's midfield, came after they argued this week in previous training sessions. But tempers boiled over on Thursday. Spanish media was rife with reports that the players previously disagreed over the club's decision to let coach Xabi Alonso go after just months on the job.
It was not the only altercation involving Madrid players during training this week. Álvaro Carreras confirmed he was in a “minor” incident with a teammate. Spanish media said he and fellow defender Antonio Rüdiger got into a scuffle.
Álvaro Arbeloa, the coach who was promoted from Madrid's reserve team when Alonso was fired in January, will face tough questions on what went wrong inside the changing room when he gives a press conference on Saturday ahead of the clasico at Camp Nou.
Madrid is facing a second consecutive campaign without a major trophy amid rumors in the Spanish media that club president Florentino Pérez is considering bringing back Jose Mourinho to straighten out his underperforming team.
