The death of the 22-year-old man, who came from the UAE to Thrissur on July 22 and passed away on July 30, has now been confirmed as the first monkeypox casualty in India, said Kerala health authorities on Monday, August 1. NIV in Pune has confirmed that his samples were positive for the monkeypox virus.

22-year-old Hafeez passed away on Saturday, July 30, and health authorities swung into action and started preparing a detailed contact list of him after his arrival at the Kozhikode airport. It has been found out that four of his friends and his family members were also there, to receive him at the airport. The next day, he was out playing football with his friends. On July 27, he collapsed and was taken to a local clinic, and from there he was moved to a hospital, where he was undergoing treatment and passed away on Saturday.

The health department has already started getting in touch with all those who came in contact with the deceased. Health minister Veena George said they have identified 20 persons who had high-risk contact with the patient. "The primary contacts include members of his immediate family, a house help, the four friends who accompanied him from Karipur airport and nine others with whom he had close contact during a football game," said Veena George. 

The minister said the person had boarded the flight from UAE on July 21 and reached Karipur on July 22. "The flight had around 165 passengers and 15 of them are from Thrissur district alone. But the patient did not have close contact with all of them," she said.

According to the relatives of the deceased man, they were informed on July 30 — the same day the patient died — that his samples taken in UAE had also tested positive. Kerala Health Minister Veena George on Sunday said the health department will examine the reasons behind the death of the man. The patient was young and did not suffer from any other illness or health problems, and therefore, the health department was looking into the cause of his death, she said.

Veena George said they will also be examining why there was a delay in his hospitalisation after he arrived from the UAE on July 21. "This particular variant of monkeypox is not as highly virulent or contagious like COVID-19, but it does spread. Comparatively, the mortality rate of this variant is low. Therefore, we will examine why the 22-year-old man died in this particular case as he had no other illness or health problems," the minister had said.

Since this variant of monkeypox does spread, all necessary measures have to be taken to prevent the same, she added. 

According to the WHO, monkeypox is a viral zoonosis — a virus transmitted to humans from animals — with symptoms similar to smallpox although clinically less severe. Monkeypox typically manifests itself with fever, rash and swollen lymph nodes and may lead to a range of medical complications. It is usually a self-limited disease with symptoms lasting for two to four weeks.

Also read: Is monkeypox as deadly as COVID-19?

The 'Guidelines on Management of Monkeypox Disease' issued by the Union government, stated that human-to-human transmission occurs primarily through large respiratory droplets generally requiring prolonged close contact. It can also be transmitted through direct contact with body fluids or lesions, and indirect contact with lesion material such as through contaminated clothing or linen of an infected person. Animal-to-human transmission may occur by bite or scratch of infected animals or through bush meat preparation.

The incubation period is usually from six to 13 days and the case fatality rate of monkeypox has historically ranged up to 11 per cent in the general population and higher among children. In recent times, the case fatality rate has been around three to six per cent. 

The symptoms include lesions which usually begin within one to three days from the onset of fever, lasting for around two to four weeks and are often described as painful until the healing phase when they become itchy. A notable predilection for palm and soles is characteristic of monkeypox, the guidelines stated.