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.
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.
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.
“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.
According to MOH’s news release published on 22 Aug, Singapore has seen 13 mpox cases this year.
Thankfully, all mpox infections in Singapore have been the milder Clade II infections. At present, there have been no mpox Clade I cases detected in Singapore.
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.
“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.
Over in Thailand, authorities there have confirmed that a patient has been infected with mpox Clade 1b — Asia’s first known case of the deadlier strain.
The 66-year-old European man, who had recently travelled to Africa, arrived in Bangkok on Aug 14 and was sent to hospital with mpox symptoms.
The man had also transited in a Middle Eastern country, before flying to Thailand, reported Reuters.
Thai authorities said they are still monitoring 43 people in the country who have been in close contact with the patient. They have shown no symptom so far.
Precautions to take against mpox infections
MOH says precautionary mpox screening will now take place at Changi and Seletar airports, as well as the sea checkpoints. This will take place for those arriving on flights from places that may be exposed to the risk of mpox outbreaks.
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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