Last week, Rwanda announced a monkeypox preparedness plan worth Rwf10 billion, aimed at responding to the global outbreak in case it shows up in the country. So far, no case of the virus has been registered in Rwanda, but medics think it is time to prepare, since a number of countries around the world, including the neighbouring DR Congo, have reported cases. Monkeypox is a viral zoonotic infection, meaning that it can spread from animals to humans. It can also spread from humans to other humans and from the environment to humans. Monkeypox spreads from person-to-person through close contact with someone who has a monkeypox rash. Close contact can mean being face-to-face (such as talking, breathing or singing close to one another which can generate droplets or short-range aerosols); skin-to-skin (such as touching or sex); mouth-to-mouth (such as kissing). According to the World Health Organisation (WHO), in most cases, the symptoms of monkeypox go away on their own within a few weeks. However, in some people, an infection can lead to medical complications and even death. “Based on what we know from previous Monkeypox outbreaks, new-born babies, children and people with underlying immune deficiencies may be at higher risk of more serious symptoms and death from Monkeypox,” reads a statement from WHO. Since January 1, 2022, cases of monkeypox have been reported from at least 96 countries from different continents. By August 22, a total of 41,664 laboratory confirmed cases and 192 probable cases, including 12 deaths, had been reported to the WHO. According to WHO, the most common symptoms of monkeypox identified during the 2022 outbreak include fever, headache, muscle aches, back pain, low energy and swollen lymph nodes, followed or accompanied by the development of a rash which may last for two to three weeks. The rash can affect the face, palms of the hands, soles of the feet, groin, genital and/or anal regions. It may also be found in the mouth, throat, anus or vagina, or on the eyes. The number of sores can range from one to several thousand. Sores on the skin begin flat, then fill with liquid before they crust over, dry up and fall off, with a fresh layer of skin forming underneath. In this article, we look at some of the details in Rwanda’s preparedness plan, in the face of the lingering threat of the virus. Here are 6 things that you should know about the plan: 1. Scaling up diagnostic capacity The government plans to establish subnational molecular diagnosis capacity for monkeypox in priority districts. Here, besides bringing in equipment for doing the tests, Rwanda Biomedical Center (RBC) also plans to train laboratory personnel on safety procedures and infection prevention and control for specimen collection, labeling, transfer, among other processes. 2. Specific case management mechanisms. Under the plan, RBC expects to revise, approve and disseminate standard operating procedures (SOPs) for monkeypox; as well as establishing, training, and mentoring case management teams with clinicians experienced in patient management and infection prevention and control, is also a goal of the preparedness plan. 3. Feedback mechanism for communities RBC hopes to allocate a 24/7 staff for hotline services which can be used to receive reports from citizens regarding monkeypox. According to the plan, scientifically-informed messages are also expected to be translated and disseminated to the media, Community Health Workers (CHWs), local government institutions, religious leaders, among other people or organisations from which communities can get information regarding monkeypox. 4. Applicable epidemiological surveillance Other measures include training of health workers in case detection, reporting protocols, isolation of patients and management of cases to ensure early detection and response. 5. Tightening preventive measures at border areas There will be teams at various designated points of entry into the country, to screen people and report as well as isolate and refer any cases of those infected. Among other things, RBC hopes to conduct drills to review communication systems between health authorities at the various points of entry of the country and conveyance operators. 6. Acquisition of vaccines As part of the plan, RBC expects to make effort to acquire monkeypox vaccines from outside countries. In addition to this, the country Rwanda expects to have in place regulatory and ethical approvals for the importation and use of the vaccines before an inoculation exercise can be rolled out.
