Kerala man who came from UAE dies of suspected monkeypox, probe ordered

22-yr-old had tested positive before coming to India, says minister; NIV report awaited to ascertain cause of death

The death of a man from Punnayur in Thrissur district of Kerala on Saturday could be the first case of a monkeypox casualty in India, the state’s health minister, Veena George, said on Sunday. The 22-year-old had tested positive in another country, the minister added.

A report from the National Institute of Virology (NIV) in Alappuzha was expected either late Sunday night or early on Monday. The youth had landed in Kerala on July 22 from the United Arab Emirates. Out of the four monkeypox cases reported so far in India, three were from Kerala.

“He had conducted tests a day before coming to India. According to the report, he is monkeypox positive,” George told the media. The state government has constituted a high-level committee with members from the medical education department. “It has been asked to submit a detailed report as death due to monkeypox is unlikely,” she added.

According to the World Health Organization’s (WHO) official data published on July 22, around 16,016 monkeypox cases were confirmed between January 1 and July 22. However, only five deaths were reported although the cases were spread across 75 countries. Spain and Brazil had reported the first cases of deaths outside Africa on Friday. The deaths reported in Africa were from Nigeria (three) and Central African Republic (two).

While the NIV report is awaited, the state government has started taking precautionary measures. People who were in close contact with the deceased were asked to quarantine themselves. After coming in contact with the infected person, the incubation period is around 21 days. Panchayat authorities in Punnayur have also called for a meeting of all the health workers on Monday. According to media reports, besides viral fever the patient did not have any visible symptoms of monkeypox or any other illness or health problem.

The minister said that since this variant of monkeypox is not contagious like Covid-19 and has a lower mortality rate, the reasons for the death have to be examined. The local media reported that the youth had interacted with people and even played football after reaching home. He was shifted to a private hospital on July 26 and was later on life support. Health authorities in Kerala are looking at reasons for the delay in reporting and have made a route map of the person. His burial was also done in accordance with monkeypox guidelines.

“Until a detailed investigation is done, one cannot call it a monkeypox death. The number of deaths reported due to monkeypox are relatively few, in comparison to the several thousands of cases known so far. The reported cases will be an underestimation,” Rajeev Jayadevan, vice-chairman, research cell, Indian Medical Association, Kerala, told Business Standard.

On July 23, WHO had declared the outbreak a public health emergency of international concern and issued temporary recommendations concerning it.

Kerala had seen the first three cases of Covid-19 too, when medical students who had returned from Wuhan got infected on January 30, 2020. The first case of Covid death in India was reported in Karnataka in March 2020. On May 19, 2018, Kerala had also reported the first case of Nipah virus in South India.

Health authorities have said that there is no reason to panic as monkeypox is not as severe as Covid or Nipah.