Monkeypox outbreak, will it affect surgery services? - Correspondence.

Dear Editor,

Since March 2020, when the World Health Organization (WHO) declared COVID-19 a pandemic, international health has been in crisis and therefore surgical care has been seriously affected [1]. Since June 2021, surgical services have been progressively reactivated internationally. However, reports on the appearance of Monkeypox (MPX) in Europe and the Americas raise alarms that affectations in the treatment of surgical pathologies may occur again.

Monkeypox is a double-stranded DNA virus, a member of the Orthopoxvirus genus and the Poxviridae family, the causal agent is the monkeypox virus. Monkeypox was detected for the first time in humans in 1970, in the Republic of Congo and in America the first case was recorded in the United States of America (U.S.A) in 2003 [2].

On May 15, 2022, the World Health Organization (WHO) received notification of four confirmed cases of Monkeypox disease (MPX) in the United Kingdom, followed by other countries such as Portugal and Sweden. Due to the increase in confirmed cases, on June 23, 2022, the WHO holds a meeting of the Emergency Committee of the International Health Regulations with the aim of taking concrete measures to contain and manage the outbreak [3].

As of June 7, 2022, in the region of the Americas there were 1185 confirmed cases, 71 probable cases, and 30 suspected cases (Fig. 1 ). In South America there were 178 confirmed cases, of which 142 were in Brazil. In Colombia, there are currently five confirmed cases (Fig. 2 ) [4].

Fig. 1

Confirmed, probable and suspected monkeypox cases by Region of the American. Data sources: https://shiny.pahobra.org/monkeypox/.

Fig. 2

Confirmed, probable and suspected monkeypox cases by South America. Data sources: https://shiny.pahobra.org/monkeypox/.

The clinical-surgical specialties play an important role in the partial or definitive treatment of multiple pathologies prevalent at an international level, an example is cancer, which is currently the leading cause of death in the world. The arrival of the MPX is imminent and taking into account our experience with COVID-19, we must act quickly and in a synchronized manner, the current health system and more especially the surgical services would not support a cessation of activities, since it would not only have consequences as an increase in morbidity and mortality, but also for the national economy and the survival of the surgeon.

Therefore, it is important to carry out a rapid and effective preparation in the emergency and surgical services in the recognition of these patients, being clear about their symptoms, forms of diagnosis and therapy. Therefore, we suggest some important recommendations from admission to the emergency room, during surgery, hospitalization and hospital discharge (Fig. 3 ), following the recommendations given by the WHO and Tsagkaris et al. [5].

Fig. 3

Monkeypox Surgical Safety recommendations, adapted from the World Health Organization (WHO) Surgical Safety Checklist and Tsagkaris et al. [5].

We believe that the current MPX outbreak should not be a cause for the closure of surgical services, as a positive outcome of the COVID-19 pandemic, the health service was strengthened, increasing hospital capacity, intensive care unit beds (ICU), and a higher percentage of qualified health personnel, in addition to multiple laboratories available at an international and national level with the capacity to perform molecular tests for the timely diagnosis of this disease [6].

Additionally, some studies carried out in our country showed low levels of contagion secondary to the performance of surgical procedures in times of COVID-19 [7], consequently to a rapid diagnosis and conduct plan, in addition to the proper use of personal protection elements, systematization of activities and updated training for health personnel. These pillars mentioned above we consider should be replicated for the outbreak by MPX. Likewise, it is of the utmost importance to keep the technological measures in place active, such as telemedicine, with the aim of reducing contagion during medical consultations and optimizing health services. Finally, we are sure that Latin America, and more specifically Colombia, is prepared to deal with this type of emergency.

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Author contribution

All authors equally contributed to the analysis and writing of the manuscript.

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Guarantor

Gonzalo Andrés Domínguez Alvarado, Médico, Especialista Epidemiologia, Docente, Universidad Autónoma de Bucaramanga, Grupo de innovación e investigación Quirúrgica (GIIQ), Capitulo Futuros cirujanos (ASCOL), Floridablanca, Santander, Colombia. gdominguez@unab.edu.co.

Provenance and peer review

Not commissioned, internally peer-reviewed.

Declaration of competing interest

None.