ludhiana as the world health organisation who has declared monkeypox a global public health emergency of international concern the district health department has asked hospitals to keep a watch on suspected patients and report the suspected cases if any the department has also issued an advisory to the ground staff to keep surveillance on returnees from highrisk countriescivil surgeon dr hatinder kaur said they have received an advisory from the department to keep a check on monkeypox symptoms and the staff have been apprised of it she indicated that they have to keep suspected persons returnees from specific countries under surveillance even as they are not to be tested for the disease the senior health officer said under integrated disease surveillance project idsp they normally carry out surveillance dr ramanpreet of idsp said only suspected persons are to be kept under surveillance if they had contact with cases or have symptoms she added that they have shared the advisory with all the government and the private health facilities on whether they have testing facility for monkeypox in ludhiana she said the samples of suspected cases have to be transported to the national institute of virology in pune for confirmation the health department officials said as per the union ministry of health and family welfare guidelines for management of monkeypox a suspected case is a person of any age having history of travel to affected countries within the last 21 days presenting with an unexplained acute rash and one or more of the following signs or symptoms including swollen lymph nodes fever headache body aches profound weakness they added that the confirmed case is a case which is laboratory confirmed for monkeypox virus by detection of unique sequences of viral dna either by polymerase chain reaction pcr andor sequencinghealth department officials said special watch is being kept on the suspected patients from european countries the united states of america usa canada among others they added that in punjab surveillance of suspected patients is being ensured at amritsar and mohali international airports where travellers from these countries arrive experts advise caution though it is not fatal as compared with covid virus it can spread therefore people must take precautions and maintain distance from suspected patients residents are already aware about covid and can take steps to prevent getting infected with monkeypox virus said punjab ima secretary dr sunil katyalmonkeypox is usually a selflimited disease with the symptoms lasting from 2 to 4 weeks severe cases occur more commonly among children and are related to the extent of virus exposure patient health status and nature of complications the extent to which asymptomatic infection occurs is unknown the case fatality ratio of monkeypox has historically ranged from 0 to 11 in the general population and has been higher among young children in recent times the case fatality ratio has been around 36