Should Singapore be worried about mpox infections?
On 14 August 2024, World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus declared the mpox outbreak an international public health emergency.
The Democratic Republic of Congo (DRC) in particular, had reported an increase in mpox cases and fatalities — with more than 15,600 cases and 537 deaths this year.
Dr Tedros called the rapid spread in African countries “very worrying”. He added:
On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives.
The infectious disease first originated in the DRC in 1970 and previously caused a global outbreak in 2022.
With reports of new mpox cases emerging in the Philippines and Thailand, should Singapore also be worried about infections here?
What is mpox and who is most at risk?
Singapore’s health ministry described mpox as “a viral disease caused by two distinct clades of the monkeypox virus, Clade I and II”.
The recent outbreak in the DRC is associated with Clade I infections, which are historically more severe.
In general, pregnant women, young children, and immunocompromised individuals are more at risk of developing, sometimes fatal, complications.
Image for illustration purposes only.
Regardless of the clades, symptoms of mpox infections usually begin within a week of exposure and are often as such:
- Skin rash
- Fever
- Headache
- Backache
- Muscle ache
- Sore throat
The recognisable rash begins as a flat sore and develops into a blister filled with liquid that can last two to four weeks.
Typically the rash begins on the face and spreads over the body, extending to the palms of the hands and soles of the feet.
As the rash heals, the lesions dry up, crust over and fall off.
Source: Marina Demidiuk on iSTock via CIDRAP University of Minnesota
Infected persons may also experience exhaustion or weakness, and swollen lymph nodes.
In some cases, severe complications may occur, such as infected skin, pneumonia, pain or difficulty swallowing, sepsis and more.
Individuals can contract mpox by touching those with the virus and coming into contact with skin lesions, body fluids, or respiratory secretions.
A WHO factsheet further outlines how person-to-person transmission can occur.
For instance, talking to an infected person or breathing the same air may lead to infection.
The same can be said about touching, kissing, and having intimate relations with an infected individual.
Source: San Diego County News Center
“The virus then enters the body through broken skin, mucosal surfaces… or via the respiratory tract,” said WHO.
Mpox is also transmissible via contaminated clothing and linens.
Additionally, the virus can spread from animals to humans through bites or scratches.
Mpox infections in Singapore
Singapore’s health minister Ong Ye Kung has noted the low immediate risk of mpox to Singapore as the country does not have any direct flights to affected African countries.
However, Singaporeans should be prepared to respond when — not if — it does arrive.
Mr Ong noted that the disease will eventually spread to the Middle East and Europe, where Singapore has flight connections to.
Source: @YeoEC1 on X via Changi Airport on Facebook. Image for illustration purposes only.
According to MOH’s latest weekly bulletin published on 15 Aug, Singapore has seen 12 mpox cases this year.
Only two cases were reported in the past week. Thankfully, all mpox infections in Singapore have been the milder Clade II infections.
That said, this is not the first time that Singapore is experiencing the virus.
On 21 June 2022, MOH confirmed one imported case of monkeypox infection in Singapore amid the global outbreak.
The patient — a 42-year-old male British flight attendant — was the first reported case in Southeast Asia.
What is the global situation now?
In the African continent alone, 12 of Africa’s 54 countries — including Cameroon, Kenya, Rwanda, and Uganda — had reported cases of mpox infections this year.
ABC News reported that 94% of the 18,910 cases were in Congo.
Since the WHO announced the international health emergency, there have only been a few suspected cases of the more deadly mpox strain outside of Africa.
Sweden, for example, confirmed a case on 15 Aug of an infected individual who had caught the Clade Ib type of mpox in Africa.
Source: Arlette Bashizi/Bloomberg.
“A case in Sweden most likely means dozens of undetected cases in Europe,” said Lawrence Gostin, a public health expert and professor at Georgetown Law in Washington to Reuters.
Countries in Southeast Asia have also reported cases of mpox infections.
On 19 Aug, a 33-year-old Filipino man was the first mpox case in the Philippines since December 2023.
He had no travel history outside of the Philippines.
The country’s health department has since confirmed the case as a mild Clade II variant, unlike the more severe variant spreading in Africa.
However, Thailand has reported a suspected case of the Clade I mpox on 21 Aug — a 66-year-old European man who had recently travelled to Africa.
The man had also transited in a Middle Eastern country, before flying to Thailand, reported Reuters.
Thai authorities are also monitoring 43 people in the country who have been identified as close contacts.
Officials are still waiting on test results to determine the strain.
Precautions to take against mpox infections
Even though Singapore has yet to report a case of the deadlier virus clade, the public should still practice vigilance and some precautions by observing good personal hygiene at all times.
These include washing your hands with soap, sanitising, and avoiding contact with persons who are unwell.
Singapore’s health ministry also advised against high-risk sexual activities such as having multiple sexual partners or partaking in casual sex.
Meanwhile, Singaporeans planning to travel should adopt stricter health precautions.
These include keeping up with vaccinations before your trip and avoiding raw or undercooked foods and milk products.
MOH also advises travellers to avoid feeding or touching stray or wild animals while overseas.
The full health advisory for all travellers can be accessed here.
Also read: ‘Mpox is not the new Covid’: WHO says transmissions of the virus can be controlled
‘Mpox is not the new Covid’: WHO says transmissions of the virus can be controlled
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Featured image by MS News and adapted from @JakeGagain on X.
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