- Experts in Epidemiology, Laboratory, Health Promotion, Risk Communication, Pharmacovigilance, Dermatology, Internal Medicine and Infectious Diseases participated in its preparation.
- The work is aimed at the first contact medical personnel of the care units of the public or private sector.
- The document contains three main changes from the first medical guideline for the care of monkeypox.
One of the constants within Medicine is that nothing is permanent. Everything can be changed, especially knowledge because new things that need to be known frequently appear. With this in mind, the Ministry of Health (SSa) presented the Updated medical guide for the approach to cases of monkeypox in Mexico.
The work was prepared by experts from different institutions in the Health sector. While The consultation and orientation document is designed for first-contact medical personnel in care units of the public or private sector.
At the launch of the second edition of the guide, the Undersecretary for Prevention and Health Promotion, Hugo Lopez-Gatell Ramirezexplained that it is a technical instrument that will contribute to improving the clinical management of patients and strengthening prevention.
He added that it was built from the contributions of those who have been affected by this disease —as happened in the 80s with HIV—, essential to deal with this type of infectious disease or any public health problem.
Objectives of the new medical document
This guide is scientifically based and facilitates timely access to people most at risk. In addition, it contributes to address the phobia that exists towards the community of sexual diversity.
The official pointed out that the monkeypox transitioned from a zoonotic disease to little attention by public health communitiesto be an international public health emergency due to its current form of transmission between humans.
The guide has contact information for accompaniment and linking people. Includes more information on differential diagnoses and treatment; as well as communication to avoid stigma and discrimination. pic.twitter.com/y8vIkPMr3s
– HEALTH Mexico (@SSalud_mx) November 22, 2022
He highlighted the need to continue building messages on prevention and health promotion aimed at the most affected population and called on community leaders to help strengthen dissemination.
Changes in the updated medical guide for the approach to monkeypox
The director of Comprehensive Care of the National Center for the Prevention and Control of HIV and AIDS (Censida), Nicole Finkelstein Mizrahi, pointed out that the updated medical guide for cases of monkeypox was prepared by a technical group of experts in Epidemiology, Laboratory, Health Promotion, Risk Communication, Pharmacovigilance, Dermatology, Internal Medicine and Infectious Diseasesfrom the institutions of the Health sector, who were based on scientific evidence from international bibliography.
He reported that in the second updated version three main changes stand out in the general structure: contact information for monitoring and linking people; more information on differential diagnoses and treatment; pain management, recommendations to avoid infections due to injuries, complications and alarm data; as well as communication to avoid stigma and discrimination.
He pointed out that the update on the treatment -outpatient or hospital- guides health professionals to provide it according to the needs of each patient, whether due to drug interactions, dose adjustment in special populations or comorbidities. Likewise, it requires the management of fever, pruritus, pain, genital ulcerated lesions, oral lesions, patient nutrition, proctitis due to monkeypox and ocular affection.
Regarding differential diagnoses and treatment, Finkelstein Mizrahi said that the three antiviral agents that have been used internationally are mentioned and detailed, but, like any biomedical measure, they require review and analysis for eventual authorization by the Federal Commission for Protection against Sanitary Risks (Cofepris).
The holder of the General Directorate of Health Promotion (DGPS), Ricardo Cortés Alcalá, explained that the viruela.salud.gob.mx page was created with the support of community leaders and civil society, thus eliminating institutionalization barriers; the information is focused on people and medical personnel, with the aim of being used as the epidemic evolves. This page is updated weekly to make it a useful tool for healthcare professionals and interested individuals.
Meanwhile, the director general of the National Center for Blood Transfusion (CNTS), Jorge Trejo Gómora, stressed that according to scientific evidence so far no case of monkeypox by blood transfusion has been confirmed and there is no recommendation to perform screening or screening tests on blood and its components.
He clarified that a complete study is applied to any donor to guarantee safety and reduce the risk of transmission of infections and all blood products undergo rigorous examinations in accordance with NOM-253-SSA1-2012.
He pointed out that a person with probable infection by monkeypox cannot donate blood in the following 21 days from the risk contact or onset of symptoms; for those who had confirmed disease with outpatient management, the recommendation is to wait 14 days after the symptoms disappear; if hospitalization was required, the waiting period to donate is three months.
The director of Strategies and Development of Healthy Environments of the DGPS, Arlette Saavedra Romero, pointed out that when the first cases of an unknown infectious disease occur, patients may suffer stigma and discrimination, due to fear and ignorance of the condition.
Therefore, it is essential to reinforce the training of health professionals so that they provide care with respect for privacy and the right to confidentiality.
Likewise, they should avoid requesting explicit contact information, providing information to family members about patient care at home, changing clothes, treatment of injuries, and follow-up.
The specialist of the National Institute of Medical Sciences and Nutrition “Salvador Zubirán”, Arturo Galindo Fraga, reported that the patients present clinical manifestations and complications such as proctitis; however, there is no specific treatment.
For now, the Updated medical guide for the approach to cases of monkeypox It can Consult for free at this link.
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