Nepal Reports Third Case of Monkeypox, Raises Public Health Concerns

Nepal has confirmed its third case of monkeypox (Mpox), heightening concerns about the potential spread of the virus.

The latest case involves a 44-year-old migrant worker from Sindhuli district who returned from Saudi Arabia and tested positive on December 29. The patient, who sought medical attention upon arrival on December 28, marks the second reported Mpox case among returnees from Saudi Arabia within nine days. Previously, a 36-year-old man from Tanahun district tested positive on December 20.

Nepal’s first Mpox case, confirmed in June 2023, involved a 60-year-old foreign national. Of the current cases, one patient has recovered, while another remains in stable condition under treatment at Sukraraj Tropical and Infectious Disease Hospital (STIDH) in Teku, according to Dr. Prakash Budhathoki, spokesperson for the Ministry of Health and Population.

Public health experts have expressed concerns about the risk of community transmission, given the high volume of international travellers entering Nepal daily.

Dr. Sher Bahadur Pun, Chief of the Clinical Research Unit at STIDH, described Mpox as a zoonotic disease caused by the Monkeypox virus, part of the orthopoxvirus family that includes the smallpox-causing Variola virus.

Symptoms of Mpox include fever, headache, muscle aches, swollen lymph nodes, pus-filled blisters, and exhaustion. Although milder than smallpox, Mpox poses a significant public health concern.

Dr. Pun cautioned that symptom similarity with smallpox can delay diagnosis and treatment. He noted that some infected individuals, including asymptomatic carriers, might unknowingly transmit the virus, especially given the influx of travellers from affected regions.

The World Health Organization (WHO) states that Mpox primarily spreads through close physical contact, including sexual activity, as well as exposure to an infected person’s lesions, bodily fluids, respiratory droplets, or contaminated materials.

Although no specific treatment exists, symptomatic care is provided. Vaccines are available but are limited to regions with widespread infections, said Dr. Pun.

The Epidemiology and Disease Control Division (EDCD) has assured the public that the risk of an epidemic remains low. Director Dr. Yadu Chandra Ghimire emphasized that confirmed cases are limited to travellers and migrant workers returning from affected countries.

While Mpox is less contagious than COVID-19, the EDCD is monitoring passengers at international airports, operating health desks, and raising awareness about transmission. Symptomatic individuals are isolated and treated, and families of returnees from affected countries are advised to exercise caution.

Large-scale public awareness campaigns are deemed unnecessary at this stage to avoid panic. However, if Mpox cases rise in neighboring India, Nepal plans to enhance border surveillance and establish health desks at entry points, Dr. Ghimire said.

Minister for Health and Population Pradip Paudel reaffirmed the government’s commitment to curbing Mpox transmission. Following an emergency meeting with Tribhuvan International Airport officials, the Ministry is intensifying efforts to prevent the spread of the virus.

The government is also working with the Nepali Embassy in Saudi Arabia to raise awareness among Nepali communities abroad, given the association between cases and returnees from Saudi Arabia.

Public health experts urge individuals displaying symptoms to self-isolate, maintain hygiene, and seek medical care promptly to minimize the risk of transmission.