On July 23, 2022, Monkeypox has declared a Public Health Emergency of International Concern (PHEIC). Seventy-five countries reported monkeypox disease outbreaks, with 16,016 confirmed cases of Monkeypox. There has been an exponential increase since July 2022. Generally, Monkeypox was only reported as endemic in a few Central and Southern African countries in 1970. However, now most cases of Monkeypox reported outside Africa are related to international travel to countries where the disease is common or through imported animals. Has Monkeypox entered Indonesia? How is this monkeypox spread? Is there a way to prevent Monkeypox?
To answer these questions, Cenderawasih University’s One Health Collaboration Center (OHCC) conducted a One Health Seminar entitled “Beware of Monkeypox Disease (Monkeypox)” on Friday, September 16, 2022, from 1 pm to 3 pm (Indonesia Eastern Time). The One Health Seminar was held offline in the Public Health Department Uncen and online via Zoom Meeting. Participants were Public Health students, the Kalimantan Health Office, and the NTB Health Office.
The One Health Seminar was officially opened by the Dean of the Faculty of Public Health, Cenderawasih University, Dr. Semuel Piter Irab, SKM., M.P.H. Furthermore, welcome and thanks were delivered by Dr. Inriyanti Assa, SP., M.Sc. as Uncen’s OHCC Coordinator. At this seminar, Dr. Dolfinus Yufu Bouway, SKM., M.Kes (Epid), and dr. Aaron Rumainum, M. Kes. present as the seminar speaker hosted by I Dewa Gede Airlangga Subratha, SKM. as moderator.
In the first session, the topic brought on by Dr. Dolfinus Yufu Bouway, SKM., M.Kes (Epid) is the Prevention and Control of Emerging and Re-emerging Infectious Diseases. He emphasized several risk factors for spreading long-standing infectious diseases, which may return, including human life habits, changes in the environment or animal habitats, and increased mobility of people between locales, regions, and countries (international travel). “Regarding Monkeypox, based on data and information on August 20, 2022, in Indonesia, there was only one case, while in developing countries, it has reached 14,000. The journey of disease transmission, where humans as carriers of the disease will not be able to enter Jayapura if we do not prioritize the prevention of this disease (Monkeypox),” explained Dr. Dolfinus Yufu Bouway. Next, Dr. Dolfinus added that the way to overcome the problems caused by these risk factors is by applying the One Health concept to break the chain of disease transmission and improve public health status. The three components of One Health are human, animal, and environmental Health. Things that can be applied are designing and implementing programs, policies, legislation, and research in various health sectors. For example, the One Health information network in the USAID network team such as SEAOHUN, INDOHUN, and OHCC Uncen continues to provide the latest information about infectious diseases. Then a map of emerging and re-emerging infectious diseases globally was shown, in which he explained that the spread of the disease on these five continents was evenly distributed. “We are now friends with the disease.” said Dr. Dolfinus. COVID-19 has not yet been completely handled in Indonesia, including Papua. Humans have been confronted again with a new disease, Monkeypox. He advised the participants to know health principles such as monkeypox prevention as a first step.
In the second session, dr. Aaron Rumainum, M. Kes. explained a topic entitled consolidating the Monkeypox Disease Mitigation Strategy at various Levels. dr.’s explanation Aaron said there were seven discussion points on the monkeypox mitigation strategy in Indonesia. Starting the presentation, dr. Aaron explained the history of Monkeypox, the concept of infection, and how the disease is transmitted. In the Epidemiology section, based on an overview of global case data at WHO, people who are at risk of contracting and transmitting Monkeypox are described as 99% of men with an average age of 36 years, 98% of sexual orientation (gay and bisexual groups), 41% of HIV positive patients, and 319 cases of health workers.
Meanwhile, reports on the development of cases in Indonesia, dr. Aaron added that in July, reports of suspected disease cases had been checked in four regions: Central Java, West Java, DKI Jakarta, and West Kalimantan. Then the checking results obtained negative. But on August 20, the Ministry of Health confirmed one case in Jakarta with a positive PCR result.
So that, at the clinical management stage, dr. Aaron told the patient who was confirmed positive for Monkeypox was carried out independently, given supportive treatment (vitamins), and monitored via telemedicine. There are four essential points in the clinical management of Monkeypox, including nutrition and fluids, comorbid management, vaccines, and the drug Tecorivimat. Then the preparedness phase formed two formations: preparedness at the entrance (airport) and preparedness in areas with a detailed description of the scope of work. “We have learned from handling COVID-19, so Indonesia and the city of Jayapura should be ready to face this disease with the guard at the entrance to the country and in the country’s territory. There are four things that we can prepare, such as human resources, costs, tools and materials, and handling guidelines,” said dr. Aaron. At this Precautionary stage, added dr. Aaron, health workers, must focus and be vigilant with people who have symptoms of Monkeypox disease (fever, rash, swollen lymph nodes, headache). If a suspect is confirmed positive for PCR, close contact tracing with the patient is immediately carried out. Then the vigilance in other sectors is zoonotic surveillance in coordination with the Department of Agriculture and the Service of the Environment. In the next stage, a risk assessment is implemented to determine the level of risk based on the likelihood of an event and the consequences of the impact of an event. The final phase of mitigation is recording and reporting cases for 24 hours.
At the end of the seminar, it was seen that Uncen students and seminar participants who were in the Zoom Meeting room were very enthusiastic about asking about the Monkeypox prevention system in Papua health workers. This action indicates that people now realize there is a danger of other infectious diseases besides COVID-19, which is still happening today.