By Henrylito D. Tacio
Just days after the World Health Organization (WHO) declared mpox a global health emergency, the Philippines reported its first case this year.
According to the Department of Health (DOH), the patient was a 33-year-old male who had no travel history outside the country.
The public health emergency of international concern (PHEIC) is the WHO’s highest form of alert. “A new form of the virus has triggered global concern as it seems to spread easily through routine close contact,” said a Reuters news report.
“(The) new Filipino mpox patient turned out to be clade II,” wrote Dr. Edsel Maurice Salvana, an infectious diseases doctor and professor at the University of the Philippines – Philippine General Hospital.
Clade II is the mpox virus from the 2022 PHEIC. “It is less deadly than clade I which is the one that the current PHEIC is targeting,” Dr. Salvana said. “You can think of clade I as similar to Delta in COVID-19 while Clade II is more like Omicron.
“Having said that, mpox is nowhere near as transmissible or deadly as COVID-19. This does not mean it isn’t concerning and it should still be closely monitored, but for now there does not seem to be any mpox clade I transmission locally,” he added.
According to Dr. Salvana, mpox clade I has already infected more than 15,600 people this year with 567 deaths so far. “Half of the cases and most of the deaths in the Democratic Republic of Congo where there is an ongoing large outbreak are in children less than 5 years old,” he reported. “So clade I is much more concerning.”
Dr. Salvana also reported that there is an mpox patient in Thailand with recent travel to Africa. The doctors there are testing to see if it is clade I. “Expect more cases of both clade I and clade II to be detected in the near future in our part of the world, but hopefully we can keep clade I out from the Philippines for as long as possible,” he said. “Differentiating clade I from clade II requires genomic sequencing so any mpox cases should be treated as potentially clade I until proven otherwise.”
Mpox is an illness caused by the monkeypox virus. It is a viral infection which can spread between people, mainly through close contact, and occasionally from the environment to people via things and surfaces that have been touched by a person with mpox. In settings where the monkeypox virus is present among some wild animals, it can also be transmitted from infected animals to people who have contact with them.
Let’s get to know more about mpox. Most of the information here was taken from the press releases and website of the United Nations health agency. As one doctor puts it: “Ligtas ang may alam.”
Mpox can cause a range of signs and symptoms. Common symptoms of mpox include a rash which may last for 2–4 weeks. This may start with, or be followed by, fever, headache, muscle aches, back pain, low energy and swollen glands (lymph nodes). The rash looks like blisters or sores, and can affect the face, palms of the hands, soles of the feet, groin, genital and/or anal regions. These lesions may also be found in the mouth, throat, anus, rectum or vagina, or on the eyes. The number of sores can range from one to several thousand. Some people develop inflammation inside the rectum (proctitis) that can cause severe pain, as well as inflammation of the genitals that may cause difficulties urinating.
In most cases, the symptoms of the mpox go away on their own within a few weeks with supportive care, such as medication for pain or fever. However, in some people, the illness can be severe or lead to complications and even death.
Severe disease due to mpox may include larger, more widespread lesions (especially in the mouth, eyes and genitals), secondary bacterial infections of the skin or blood, and lung infections. Complications can include severe bacterial infection from skin lesions, mpox affecting the brain (encephalitis), heart (myocarditis) or lungs (pneumonia), and eye problems.
People with severe mpox may require hospitalization, supportive care and antiviral medicines to reduce the severity of lesions and shorten the time to recovery.
Mpox spreads from person to person mainly through close contact with someone who has mpox. Close contact includes skin-to-skin (such as touching or sex) and mouth-to-mouth, or mouth-to-skin contact (such as kissing) and can also include being face-to-face with someone who has mpox (such as talking or breathing close to one another, which can generate infectious respiratory particles).
Mpox can also be spread from humans to animals. People who have confirmed or suspected mpox are advised to avoid close physical contact with animals, including such pets as cats and dogs as well as livestock and wildlife.
Once the animal is infected with the virus, man can be infected through physical contact with the animal that carries the virus. The virus can also be caught through eating contaminated meat which is not cooked thoroughly.
To protect yourself and others against mpox, know the signs and symptoms, how the virus spreads, what to do if you get ill, and the risk in your area or community.
If the virus is spreading in your area or in your community, have open conversations with those you come into close contact with about any symptoms you or they may have. Avoid close contact with anyone who has mpox, including sexual contact. Clean your hands frequently with soap and water or an alcohol-based hand rub.
If you think you might have mpox, you can act to protect others by seeking medical advice and isolating yourself from others until you have been evaluated and tested. If you have mpox, you should isolate yourself from others until all your lesions have crusted over, the scabs have fallen off and a new layer of skin has formed underneath. This will stop you from passing on the virus to others.
If someone has mpox, how would you care for the person? The care someone needs will depend on their symptoms and their risk of developing more severe disease. People with mpox should follow the advice of their health care provider. Symptoms typically last 2–4 weeks and usually go away on their own or with supportive care, such as medication for pain or fever (such as analgesics and antipyretics).
The WHO advises that anyone with mpox who is recovering at home to stay hydrated, eat well and get enough sleep. People who are self-isolating should take care of their mental health by doing things they find relaxing and enjoyable, staying connected to loved ones using technology, exercising if they feel well enough and can do so while isolating, and asking for support with their mental health if they need it.
People with mpox should avoid scratching their skin and take care of their rash by cleaning their hands before and after touching lesions and keeping skin dry and uncovered (unless they are unavoidably in a room with someone else, in which case they should cover it with clothing or a bandage until they are able to isolate again).
The rash can be kept clean with sterilized water or antiseptic. Saltwater rinses can be used for sores in the mouth, and warm baths with baking soda and Epsom salts can ease the discomfort of sores on the body. Paracetamol can be used to help manage the pain caused by lesions, if needed. If stronger pain medicine is needed, advice should be sought from a health care provider.
Fortunately, there is a vaccine available against mpox but it is not yet available in the Philippines. The UN health agency recommends several vaccines for use against mpox. However, mass vaccination, which rolled out during the COVID-19 global pandemic, is not currently recommended.
Only people who are at risk of exposure to mpox should be considered for vaccination, according to WHO. – ###
Photos taken from WHO press release.
