Mpox

Mpox is a viral disease that is caused by infection with monkeypox virus.

Prior to 2022, mpox primarily occurred in parts of Central and West Africa where it is endemic. Almost all mpox cases occurring outside of Africa were linked to international travel to endemic regions or through imported animals.

In May 2022, multiple cases of mpox were reported concurrently in multiple countries outside of Africa not historically known to be endemic to mpox. On 23 July 22, the World Health Organization (WHO) declared the ongoing outbreak of mpox to be a Public Health Emergency of International Concern (PHEIC)*.

Click here for the latest WHO update on the mpox situation.

*Reference: https://www.who.int/news/item/23-07-2022-second-meeting-of-the-international-health-regulations-(2005)-(ihr)-emergency-committee-regarding-the-multi-country-outbreak-of-monkeypox

Please refer to the  MOH Weekly Infectious Diseases Bulletin for the numbers of confirmed mpox cases in Singapore.

Mpox can spread through exposure to respiratory droplets or direct physical contact with the blood, body fluid or lesion material from infected individual or contaminated materials. The virus can also spread from animals to humans, e.g. through bite or scratch from an infected animal, bush meat preparation, or direct contact with the blood, body fluids, or skin or mucosal lesions of infected animals.

In the 2022 outbreak, available data suggests that the mode of transmission is predominantly via close physical or prolonged contact, such as face to face and skin to skin contact including sexual contact. Most cases have been identified in individuals who reported intimate contact (including sexual contact) with infected people. Cases have also been reported where infection was attributed to household transmission. Regardless of sexual orientation, persons engaging in high risk sexual behaviours, such as having multiple or casual sexual partners are most at risk of infection in the context of the current outbreak.

Food (other than bushmeat) has never been identified as being associated with human cases of mpox. Currently, there is also no evidence that food or food packaging is a likely source or route of transmission of the virus. As such, the risk of mpox transmission through food is low. Please refer to SFA's website [https://www.sfa.gov.sg/monkeypox-and-food-safety] for more information.

Mpox is typically a self-limiting and mild illness. However, serious complications or death can occur in vulnerable persons (e.g. pregnant women, young children or immunocompromised individuals).

Symptoms may include:

Mpox is typically a self-limiting illness and most mpox patients usually recover within two to four weeks, although serious illness and complications may occur especially in vulnerable persons (e.g. young children, pregnant women or immunocompromised individuals). Treatment is typically symptomatic and supportive.

The MVA-BN (JYNNEOS), a third-generation smallpox vaccine, is currently available as Post Exposure Prophylaxis (PEP) for persons who have been identified to be close contacts of confirmed mpox cases, as well as Pre-Exposure Prophylaxis (PrEP) for persons at higher risk of being infected with mpox based on epidemiological factors in the 2022 outbreak. While JYNNEOS is estimated to provide over 80% protection against mpox, current data remains limited in concluding the level and duration of protection conferred by vaccination, and persons are advised to continue adhering to the recommended precautions against the disease.

In line with international recommendations, mass population-wide vaccination is currently not recommended as a preventive strategy for mpox, as the risk to the general public remains low with disease transmission predominantly via close physical or prolonged contact.

Members of the public are strongly advised to maintain vigilance and take the following precautions:

• Monitor your health and maintain a high standard of personal hygiene, including frequent hand washing after going to the toilet, or when hands are soiled
• Avoid contact with persons who are unwell and objects that may have become contaminated with infectious fluids such as soiled clothing, bedding, or towels
• Avoid high-risk sexual activity, such as having multiple sex partners or casual sex
• When travelling, avoid contact with wild animals that could harbour the virus, and consumption of bush meat
• Seek medical attention immediately if you develop symptoms such as sudden onset of high fever, swollen lymph nodes and rash, and inform your doctor of any recent travel or exposure history