Rio de Janeiro and São Paulo have been monitoring the health of passengers on flights where monkeypox cases were found. According to the agency’s press office, the procedure is carried out by the Rio de Janeiro Municipal Health Department and the Sao Paulo State Health Department.
Brazil has recorded seven cases of the disease. The Ministry of Health confirmed the last of them on Friday (17th).
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. Brazil’s first case was registered on June 8.
In Rio de Janeiro’s capital, the city’s health authority said it was starting an investigation into passengers who were on the same flight as the patient with the confirmed monkeypox case. Traveler data provided by Anvisa (National Health Surveillance Agency).
The first case of monkeypox in Rio de Janeiro was confirmed on Tuesday (14th). He is a 38-year-old London resident who arrived in Brazil on June 11 and sought treatment at the Instituto Evandro Chagas the day after disembarking. Samples were analyzed by Instituto Carlos Chagas Filho from UFRJ (Federal University of Rio de Janeiro).
The city secretary also worked with the Rio de Janeiro state health department to monitor people who had come into contact with the patient.
Currently, Rio health authorities have monitored five people who had been in close contact with him. Watch them for symptoms of the disease – if they do, diagnostic tests will be done. However, the secretariat said none of the five were passengers on the plane.
The monitoring procedures passengers must follow have not been established, according to the city.
In São Paulo, the state health authority said it had contacted all passengers on flights with confirmed cases. Like Rio de Janeiro, passenger data is provided by Anvisa.
The health monitoring agency, in turn, explained that it is responsible for collecting information on monkeypox (the English name for monkeypox) and other diseases at ports and airports. Anvisa said it would pass information on passengers and crew to the country’s health authorities, such as the local secretariat, who determined how to follow up with those individuals.
This sheet The Ministry of Health was contacted for comment on the protocol when the flight was diagnosed with monkeypox, but no response was received before the report was published.
There is still some uncertainty about the monitoring of passengers on flights with confirmed monkeypox cases. This is because the spread of the virus occurs mainly through contact with the wound of an infected person. Another common method is through materials that have been in contact with these wounds, such as clothing.
However, pathogens can also be transmitted through respiratory secretions, but require close and prolonged contact. For example, the CDC (Center for Disease Control) states that passing someone with the disease in a supermarket, for example, should not lead to transmission.
Precisely because it has a lower chance of contracting it through the respiratory tract, it is less likely to be spread on an airplane. The CDC explains, “In cases where monkeypox patients travel by air, there have been no known cases of monkeypox among people sitting around them, even on long-haul international flights.”
Even so, surveillance measures are still important, especially in the initial stages of an outbreak like the current one, said Raquel Stucchi, an infectious disease expert and professor at Unicamp (Campinas State University).
“At the moment of the first cases in the country, the energy spent on investigating passengers, I think it’s justified,” he said.
In these cases, Stucchi said, one thing that can be done is to employ a questionnaire or app in which passengers each day indicate if they are experiencing any of the symptoms common to monkeypox, such as fever or vesicular lesions.
The epidemiologist went on to say that, based on measures to monitor these first flights, it may be possible to determine whether the move should really be taken for other similar cases.
Clarissa Damaso, a virologist at UFRJ (Federal University of Rio de Janeiro) and one of the researchers in the anti-monkeypox working group organized by the university, said an important aspect was defining the surveillance protocols that should be followed in all cases.
“Even if the probability [de transmissão] Low does not mean impossible. That’s because you transmit through skin-to-skin contact, which is the main way, and there’s also a face-to-face transmission that’s more complicated inside the plane, unless the person knows the passengers next to him very well,” Damaso said.
Virologists exemplify that it is possible to touch the skin of an infected person on a plane, for example by shaking hands or touching the body, giving a greater chance of infection.
However, if you notice that people infected with monkeypox don’t develop skin lesions while flying, the chance of transmission goes down. Therefore, Damaso said, there could be different monitoring mechanisms depending on the symptoms of an infected passenger.
Regardless, a known measure to prevent the spread of monkeypox through the respiratory tract is the use of masks. The CDC recommends that infected people use the device in close contact with others.
Stucchi gave similar guidance. “The use of masks can prevent this rare respiratory transmission,” concluded the epidemiologist.