Singapore & Monkeypox
Monkeypox - Singapore
16 May 2019
On 9 May 2019, the Ministry of Health (MOH) in Singapore notified WHO of one laboratory-confirmed case of monkeypox. The case-patient is a 38 year old Nigerian man who arrived in Singapore on 28 April 2019 and attended a workshop from 29-30 April. Prior to his travel to Singapore, he had worked in the Delta state in Nigeria, and had attended a wedding on 21 April 2019 in a village in Ebonyi State, Nigeria.
The patient developed fever, muscle aches, chills and skin rash on 30 April. He reported that he had remained in his hotel room most of the time between 1 and 7 May. He was transferred to a public hospital by ambulance on 7 May and referred to the National Centre for Infectious Diseases (NCID) on the same day, where he was isolated for further management. Skin lesion samples were taken on 8 May and tested positive for monkeypox virus by the National Public Health Laboratory on the same day. He is currently in a stable condition.
Public health response -- [Remember, Singapore had the best response to SARS, their policies adopted by the WHO (World Health Organization)
Based on investigations thus far, authorities in Singapore have traced and contacted a total of 23 close contacts, including 18 participants and trainers who attended the same workshop, one staff at the workshop venue, and four hotel staff who had close contact with the affected individual. Healthcare workers who were in contact with the patient had used personal protection equipment. MOH’s investigation and contact tracing operations are ongoing.
One of the 18 workshop participants had left Singapore before the patient was diagnosed. This contact is a Nigerian national who travelled by air to Nigeria on 5 May. The Nigerian national IHR focal point has been provided with details of the contact for follow up action, as necessary. Potential sources of exposure and possible epidemiological links within Nigeria are currently being investigated.
Close contacts of the affected individual were referred to NCID for further assessment and offered post-exposure prophylaxis with smallpox vaccination, which can prevent disease or reduce the severity of symptoms. As of 15 May 2019, 14 persons were vaccinated. As a precautionary measure, close contacts have been quarantined either at home or designated government quarantine facility and monitored for 21 days from their date of exposure to the confirmed case. If anyone develops symptoms, they will be treated at NCID. All other contacts, who have a low risk of being infected, have been placed under active surveillance, and will be contacted twice daily to monitor their health status.
Singapore MOH released a press statement on 9 May 2019, providing information about the situation, advice for the public, and measures being taken to minimize the risk of any potential onward transmission of the disease.
WHO risk assessment
Monkeypox is a sylvatic zoonosis with incidental human infections that occur sporadically in parts of Central and West Africa. It is caused by the monkeypox virus (MPXV) and belongs to the Orthopoxvirus family. The disease is self-limiting, with symptoms usually resolving spontaneously within 14-21 days. There is currently no vaccine specifically for monkeypox. The animal reservoir remains unknown, although it is likely to include rodents. Direct contact with affected live or dead animals through hunting and consumption of bush meat are presumed drivers of human infection.
This is the first diagnosed case of monkeypox infection in Singapore. The patient was a traveller arriving from Nigeria, where a multistate monkeypox outbreak has been ongoing since September 2017.
Given that authorities in Singapore have promptly initiated appropriate public health measures, including isolation of the primary case, contact tracing and quarantine, surveillance and risk communication, the risk of onward spread in the country is low.
WHO advice
Residents and travelers to endemic areas/countries should avoid contact with sick, dead or live animals that could harbor MPXV (rodents, marsupials, and primates) and should refrain from eating or handling bush meat. Hand hygiene using soap and water, or alcohol-based sanitizer should be emphasized. Any illness during travel or upon return should be reported to a health professional, including information about all recent travel and immunization history. There is no specific treatment or vaccine for the MPXV infection.
Timely contact tracing, surveillance measures and raising awareness of imported emerging diseases among health care providers are essential to prevent secondary cases and effectively manage monkeypox cases and outbreaks.
Health-care workers caring for patients with suspected or confirmed MPXV infection should implement standard, contact and droplet infection control precautions. Samples taken from people and animals with suspected MPXV infection should be handled by trained staff working in suitably equipped laboratories.
WHO does not recommend any restriction for travel to, or trade with, Singapore or Nigeria based on available information at this time.
For more information on Monkeypox:
WHO factsheet on monkeypox, 6 June 2018
WHO disease outbreak news, monkeypox, Nigeria, 21 December
Weekly epidemiological record (WER) no.11, 16 March 2018, Emergence of monkeypox in West Africa and Central Africa 1970-2017
Nigeria CDC, An Update of Monkeypox Outbreak in Nigeria
MOH Singapore press release
~
Singapore reports first local monkeypox case
7.6.22
SINGAPORE, July 7 — Singapore yesterday (July 6) reported its first local monkeypox infection. The patient is a 45-year-old Malaysian man who lives here, the Ministry of Health (MoH) said in a press statement last night.
The man tested positive for monkeypox yesterday and is warded at the National Centre for Infectious Diseases (NCID) where he is in a stable condition. MoH stressed that the man’s infection is not linked to the imported case it had announced last month.
The Malaysian man first developed lower abdomen skin lesions last week on June 30, and then experienced fatigue and swollen lymph nodes on July 2. On Monday this week, the man developed fever and a sore throat and sought medical attention where initial tests for other possible medical conditions were done.
When these tests turned out negative, he was taken to NCID on July 6, where he was isolated for further assessment. Three close contacts have since been identified by the authorities — the man’s two housemates and one social contact.
“All close contacts will be placed on quarantine for 21 days from their last contact with the case. Contact tracing is ongoing,” MoH said. It noted that monkeypox is “typically a self-limiting illness where patients recover within two to four weeks”.
It warned, however, that a small percentage of those infected can fall seriously ill or even die.
“Those particularly vulnerable to complications are young children, pregnant women or immunocompromised individuals. Given that transmission requires close physical or prolonged contact, the risk to the general public remains low."
The ministry added that it will continue to monitor the monkeypox situation here closely and calibrate the country’s preparedness and response measures as needed. “Members of the public are encouraged to exercise personal responsibility by monitoring their personal health and maintaining good hygiene, especially during travel.
"They should also avoid close contact with other individuals known or suspected to be ill with monkeypox infection.” ― TODAY
Comments
Post a Comment