IDI Monkey Cacar Task Force Susun Alur Implementation Of Monkey Cacar Patients In Indonesia

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JAKARTA - The Monkeypox Task Force (Monkey Case) of the Executive Board of the Indonesian Doctors Association (PB IDI) has prepared recommendations for the flow of management of monkeypox patients in Indonesia, starting from screening, triage and clinical assessment, to testing. Head of the Monkeypox Task Force PB IDI Hanny Nilasari said that during the screening process, people with acute rashes need to be wary of if they have more than one other symptom such as acute onsen fever, lymph nomination (soft lymph gland swelling), headache, myalgia (must pain), back pain, and asthenia (physical weakness). "Clinical examinations must be carried out accurately that there is no suspicion of skin eruptions because others, for example, are due to variicella zosters, Laboratory simplex viruses (HSV), syfilis, disseminatic gonokocal infections, hand-to-shoulder diseases,tes, scabies, chikungu., dengue fever, and so on," said Hanny during a media briefing that was followed online in Jakarta, Antara, Wednesday, September 21. As for the characteristic of the acute rash of monkeypox, it is the existence of spots or rashes that then turn into lumps on the surface of the skin, then rolling, pusting, before finally rioting. "The main relaxation is on the face or gender, the amount varies and this can involve a mucosa membrane so it is necessary to carry out an accurate examination. In addition, lesi is also present in conjunctivations or corneas, as well as genital disorders or genitals," said Hanny. "And generally all lesi are in the same stage, spreading centrifugeally or spread to the palms and palms of the feet," he continued. If during screening it is found that the acute rash suffered by the patient is typical of monkeypox, Hanny said it is necessary to identify the severity. In addition, it is also necessary to see if the patient is a high risk group. "For high-risk populations, what we recommend are those classified as children, pregnant women, immunosuppress people such as uncontrolled illness and HIV, as well as people who have chronic skin conditions," added Hanny. The signs of severity can be seen if the patient experiences more than one symptom ranging from vomiting nausea, lack of oral intake, dehydration, disfagencies due to cervical lymph nopathy, visual impairment, eye pain, pneumonia, looking confused, sepsis, and hepatomegali (massive organ liver). The severity can also be seen if there is an increase in hepar enzymes, an increase in lekosits, a decrease in platelets, and a decrease in albumins. In addition, the more the number of lesions also indicates that the patient's condition is getting worse. "Then we will do testing of the lesi, including the absorption of exudat lesi, the roof of more than one skin disorder. The swab may dry or what has been placed in the virus transport media and the technique is an amplification test for nucleic acids such as RT or conventional PCR," said Hanny. If a patient has mild or no complications of monkeypox, it is advisable to self-isolate at home and separate from other house members. Then, perform symptomatic treatment, meet nutrition, skin care, and be monitored daily by medical personnel. However, if a patient has severe monkeypox or with complications, it is necessary to isolate him in a hospital or health facility to get more optimal treatment and be given antiviral. Patients can be said to have recovered if all skin lesions have reached the crucial phase, peeling, and growing a new layer. If it has reached this phase, the patient no longer needs to do a PCR examination. "The criteria for completing isolation are declared to end, namely having no fever and no symptoms of respiration, and no new lessons in 48 hours. All skin lesions reach the crustous, peeling, and growing new layers. Generally it lasts 2-4 weeks since the prodromal symptoms appear," concluded Hanny.