A technical note prepared by the Ministry of Health recommends that pregnant women, puerperal women and breastfeeding women maintain the use of masks due to the monkeypox outbreak, stay away from people with symptoms of the disease and use condoms in all sexual relations.
The document highlights “the rapid increase in the number of cases of MPX [monkeypox, nome em inglês da doença] in Brazil and in the world” associated “with transmission by direct contact and, eventually, by air”.
“Pregnant women have a clinical picture with similar characteristics to non-pregnant women, but they may have greater severity, being considered a risk group for unfavorable evolution”, says the technical note.
The ministry points out that pregnant women are in the risk group for monkeypox, as well as immunosuppressed and children under eight years old. Therefore, according to the document, laboratories should prioritize the diagnosis of these people, “since eye complications, encephalitis and death are more frequent”.
The Ministry of Health also advises that pregnant women with moderate or severe monkeypox should be hospitalized, “taking into account greater risk”.
Pregnant women who are showing signs of the disease, but had the diagnosis of monkeypox ruled out, should stay in home isolation for 21 days, without visits, and retake the exam if the symptoms do not disappear.
The technical note is signed by the secretary of Primary Health Care, Raphael Câmara, and by the director of the Department of Maternal and Child Health, Lana de Lourdes Aguiar Lima.
The Ministry of Health even convened the press this Monday (1st) to present the recommendations, but took it back shortly after, without explaining the reasons. The technical note has not yet been released by the folder.
THE Sheet found that the document was not discussed in the emergency committee installed last Friday (29) — formed by representatives of the ministry, state and municipal health secretariats, PAHO, Anvisa (National Health Surveillance Agency) and the National Institute of Health. Infectology Evandro Chagas.
Infectologist Raquel Stucchi, a professor at Unicamp (State University of Campinas), says that the chances of monkeypox infection via the respiratory tract are low compared to other diseases, such as Covid-19. Even so, she says that there is still a lack of information to measure the impact that this form of transmission represents in the cases of the current outbreak.
According to Stucchi, pregnant women —along with immunosuppressed patients and children—are part of the groups most at risk for the development of severe disease. “Therefore, in people who are at risk of more serious illness, care in relation to blocking transmission should be intensified at this time.”
One of these measures is precisely the use of masks. “The use of masks, thinking about the potential respiratory role, becomes interesting. Not only for pregnant women, but for children and immunosuppressed as well”, she says. She cites that closed environments, clusters and with closer contact between people are those with the greatest risk for this group.
The Ministry of Health’s note also states that “there are not enough data on the use of the immunizer in pregnant or breastfeeding women” and therefore no vaccine against monkeypox is approved for use in pregnancy. Also, according to the ministry, there is no “specific treatment protocol with antivirals in the pregnancy-puerperal cycle.”
Health Minister Marcelo Queiroga tried to avoid the issue at an event on breastfeeding, also on Monday, and said that mothers are not worried about the disease.
“The theme [do evento] is breastfeeding. Brazilian mothers aren’t too worried about monkeypox. They are worried about feeding their children. So let’s talk about breastfeeding. Too bad some subjects don’t interest people,” she said.
Earlier, the minister announced via social media that Brazil will receive the antiviral tecovirimat for severe cases of monkeypox from PAHO (Pan American Health Organization). THE SheetQueiroga stated that, at first, the donation will be enough for only 50 patients.
At this Monday’s event, the minister said that, like other countries, Brazil faces difficulties in purchasing antivirals and vaccines against monkeypox and said that he would like to bring “a word of tranquility to the Brazilian population.”
On Friday, the Ministry of Health announced the purchase of 50,000 doses of vaccine against the disease. The forecast is that about 20 thousand doses arrive in the country in September and the rest in October. The import will also be done via Opas.
“The vaccine issue: there is a shortage of vaccine all over the world. The US got 800,000 doses. The US is the richest country in the world. A country that has resources, has all the structure. Europe, 100,000. And here, for the Latin American region, 100 thousand. And these vaccines will be acquired via PAHO’s rotation mechanism”, he said.
“Other antiviral drugs whose use is off-label, they [Opas] They also don’t have a lot of availability. Yesterday I talked to Socorro [Gross, representante da Opas no Brasil]. We’ll get an initial amount. And, later, the pharmaceutical assistance department will look for medicines to meet those more serious situations.”
The announcement of the antiviral comes three days after the confirmation of the first death from the disease in Brazil – also the first outside the African continent in the current outbreak. According to the bulletin released this Sunday (31), Brazil has 1,369 confirmed cases of monkeypox in 16 states and the Federal District.
The ministry says the objective is to vaccinate health professionals who deal directly with biological samples – such as those who work in laboratories – as well as people who have had contact with those infected.
Collaborated with Samuel Fernandes, from São Paulo.