Southeast Asia ramps up mpox countermeasures amid optimism of containment
- Singapore, Malaysia, and other countries have stepped up surveillance measures and prepared their healthcare experts to contain mpox
The nature of the mpox virus would unlikely overwhelm Singapore’s capacities to contain it, said Dale Fisher, director at the National University of Singapore’s Centre for Infectious Disease Emergency Response.
“During Covid-19, it was necessary to create makeshift community isolation facilities and repurpose existing healthcare infrastructure for example, but I can’t see this being necessary for mpox,” Fisher said.
However, one Singapore-based infectious diseases specialist stressed that children were more vulnerable to the new strain of the virus, warning that the virulence of mpox might be greater than anticipated.
“The spread may potentially be fast and furious, with the speed similar to a hand, foot and mouth disease outbreak in a childcare facility,” said Leong Hoe Nam, a specialist at Mount Elizabeth Novena Hospital, though adding that Covid-like lockdowns were unlikely to curb mpox.
Last week, Singapore’s Health Minister Ong Ye Kung described the situation as “very worrying” and expected Singapore to be among the “first places to find cases because of our flight connections”.
“I would say, in general, this is a very worrying situation, especially for the African continent. But I think we should work on the basis that mpox will arrive in Asia,” he told reporters.
The patient was a 33-year-old Filipino man who had no travel history outside the country, the health department said.
This came shortly after Sweden became the first country outside Africa to report a case of the clade 1b variant, while Pakistan has also reported its first case of mpox though it has not confirmed the strain of the virus.
In Malaysia, all travellers from countries that have reported having mpox are required to monitor their health for 21 days after their arrival in the country, while those with a history of risky activities and symptoms like rashes must be examined at a health facility and avoid contact with other people.
Medical practitioners have to notify suspected and confirmed cases of mpox immediately to the nearest district health office to ensure the implementation of prevention and control measures, the Malaysian health ministry said in a statement.
The local authorities are also making moves to ensure that premises that provide services involving close contact with customers, such as spas or massage parlours, practise personal hygiene and keep their environment clean.
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“If an employee or customer experiences symptoms, they should immediately seek medical attention,” the statement said.
In Indonesia, foreign visitors must declare their medical records and recent travel history by filling in forms at entry gates, its health ministry’s acting director general of disease prevention and control said.
“Visitors with illnesses are advised not to continue their trip [to Indonesia],” Yudhi Pramono said on Sunday, according to a report by the daily online news site Jakarta Globe.
In Singapore, the health ministry said that as of July 27, there had been 10 mpox infections detected in the city state, while a total of 32 cases were reported in the country last year. All cases were of the milder clade 2 strain.
While the immediate public health risk to the country is low, precautionary measures have been put in place, according to the health ministry. Travellers visiting Singapore are required to report mpox-related symptoms, such as fever or rash, and their travel history.
“Singapore’s healthcare system has the capability to effectively diagnose and manage mpox infections. We have informed all medical practitioners and healthcare institutions to be vigilant in detecting and reporting all mpox cases, including those suspected of clade I infections,” the ministry said in a statement on Friday.
Infectious disease experts told This Week in Asia the mpox situation was less threatening compared with the Covid-19 period, with existing efforts aimed at containing its spread as countries geared up testing, prevention and treating capabilities.
“The 2022 to 2023 [mpox] public health emergency was a good wake-up call for the world to ramp up vaccination strategies, diagnostic capabilities and community engagement,” said Paul Tambyah, president of the International Society for Infectious Diseases.
He pointed out that countries across the region, from Laos to Indonesia, have been able to detect mpox, which was “an indication that we will be able to recognise the disease and assess its spread”.
Leong from Mount Elizabeth Novena Hospital said that he expected a “slow burn of this disease” and not a sudden surge as seen during the Covid-19 pandemic, which “buys time for countries to get prepared”.
Vaccinations would play a vital role in the containment of the virus, Leong said.
Misinformation is a great modern-day enemy
Danish biotech firm Bavarian Nordic, which is one of the few firms that have an mpox vaccine, has said that it can manufacture 10 million doses of the Jynneos vaccine by the end of 2025 and is prepared to supply up to 2 million doses this year.
The stigma associated with mpox, however, might also deter some from coming forward for testing and treatment, Tambyah said.
Ultimately, public officials should engage effectively with the community to combat any misinformation about the virus.
“Misinformation is a great modern-day enemy. In countering any outbreak, engagement of the community is critical to ensure implementation of advice,” said Fisher from NUS.
“The public should only trust recognised authorities such as public health agencies and ministries of health, and other known official reliable and science-based sources.”
