2022 monkeypox outbreak in the Philippines

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2022 monkeypox outbreak in the Philippines
DiseaseHuman monkeypox
Virus strainMonkeypox virus (MPV), clade II,[1] 2017–2019 outbreak subclade[2]
LocationPhilippines
First reportedJuly 28, 2022[a]
DateJuly 28, 2022 – ongoing (1 year, 5 months, and 15 days)
Confirmed cases4
Recovered4
Deaths
0

The 2022 monkeypox outbreak in the Philippines is a part of the larger global outbreak of human monkeypox caused by the West African clade of the monkeypox virus. The outbreak was first reported in the Philippines when a suspected case was confirmed on July 28, 2022 according to the Department of Health.[3]

Background

These paragraphs are an excerpt from Monkeypox and 2022 monkeypox outbreak.

Monkeypox is an infectious viral disease that can occur in humans and some other animals.[4] Symptoms include fever, swollen lymph nodes, and a rash that forms blisters and then crusts over.[4] The time from exposure to onset of symptoms ranges from five to twenty-one days.[5][6] The duration of symptoms is typically two to four weeks.[6] There may be mild symptoms, and it may occur without any symptoms being known.[5][7] The classic presentation of fever and muscle pains, followed by swollen glands, with lesions all at the same stage, has not been found to be common to all outbreaks.[4][8] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.[9]

The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus.[10] The variola virus, the causative agent of smallpox, is also in this genus.[11] Of the two types in humans, clade II (formerly West African clade)[12] causes a less severe disease than the Central African (Congo basin) type.[13] It may spread from infected animals by handling infected meat or via bites or scratches.[14] Human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route.[4][14] People can spread the virus from the onset of symptoms until all the lesions have scabbed and fallen off; with some evidence of spread for more than a week after lesions have crusted.[13] Diagnosis can be confirmed by testing a lesion for the virus's DNA.[15]

There is no known cure.[16] A study in 1988 found that the smallpox vaccine was around 85% protective in preventing infection in close contacts and in lessening the severity of the disease.[17] A newer smallpox and monkeypox vaccine based on modified vaccinia Ankara has been approved, but with limited availability.[5] Other measures include regular hand washing and avoiding sick people and animals.[18] Antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin and the smallpox vaccine may be used during outbreaks.[19][20] The illness is usually mild and most of those infected will recover within a few weeks without treatment.[20] Estimates of the risk of death vary from 1% to 10%, although few deaths as a consequence of monkeypox have been recorded since 2017.[21]

History

table

Arrival

The first case of human monkeypox in the Philippines was confirmed on July 28, 2022. The case involved a 31-year-old Filipino national who arrived from abroad to the Philippines on July 19, 2022. He also had prior travel to countries with documented monkeypox cases. The individual's monkeypox infection was confirmed through a reverse transcription–polymerase chain reaction (RT-PCR) test at the Research Institute for Tropical Medicine in Muntinlupa which yielded a positive result on July 28, 2022.[22] The patient had already recovered at the time of the health department's announcement but is undergoing isolation at home. Ten other people, including three people from the individual's household were identified as close contacts.[23]

On August 6, 2022, the patient was discharged after undergoing the 21-day quarantine isolation to which no other person was infected according to the Department of Health (DOH). Other close contacts tested negative too though they are still required to complete their 21 days of quarantine.[24]

Further cases

On August 19, 2022, the DOH announced the detection of two more cases; those of a 34-year-old and a 29-year-old both of which has a history of travel abroad. The 34-year-old patient is undergoing home isolation and the 29-year-old patient is in isolation at a health facility. Contract tracing was conducted for both with the latter having 17 identified contacts.[25] The PCR test conducted for both individuals returned positive results on August 18 and 19 respectively.[26]

All three cases at that time are unrelated to each other as they entered the Philippines from different countries and the DOH considered these cases as "imported" cases. They have exhibited typical symptoms associated with monkeypox like lessions on their faces and other parts of their bodies.[27]

DOH Technical Advisory Group (TAG) member Dr. Edsel Salvana says he expects more cases to be detected but allayed concerns of a local transmission or the disease becoming endemic in the country. He points out that monkeypox is less contagious than COVID-19 and that protocols in place for the COVID-19 pandemic is also mitigating the spread of monkeypox.[28]

On August 22, the DOH announced that the country has detected its fourth case that of a 25-year-old Filipino who have no travel history outside the country. The individual's PCR Test returned a positive result on August 19. The health department also stated that the fourth case is not related to the previous three.[29] The following day the health department's Western Visayas regional office, released further details regarding the patient confined in a hospital; a male who works in Iloilo City and resides in Iloilo province.[30][31][32] Iloilo City mayor Jerry Treñas in an interview with local radio stations said that the indicidual worked in a fast food chain in the city and added that he had a relative who recently came in from abroad.[33]

The DOH also asked the Western Visayas regional office to investigate the photos of the patient shared on social media as early as August 22 deeming such act as an unauthorized disclosure of private and confidential information.[32][34]

The second case was deemed recovered on August 31[35] while the third case was considered the same on September 8. The fourth case was discharged from the hospital on September 15[36] and is deemed to have recovered.[37]

Related cases abroad

On September 5, 2022, the first ever case of monkeypox in Hong Kong was detected from a passenger who arrived from a flight from Manila.[38] The individual concerned is a 30-year old Hong Konger.[39]

Response

On May 24, 2022, the DOH expressed readiness to detect and contain monkeypox if it reaches the Philippines. It has classified monkeypox as a notifiable disease requiring health facilities in the country to report all patients under investigation and cases to its Epidemiology Bureau (EB) and Regional Epidemiology Surveillance Unit. It also announced that all suspected cases are to undergo reverse transcription–polymerase chain reaction (RT-PCR) tests for monkeypox.[40][41]

By June 20, 2022, the Research Institute for Tropical Medicine in Muntinlupa announced that it has optimized its real-time polymerase chain reaction (PCR) assay for the detection of monkeypox virus.[42]

As of July 2022, the RITM and the Philippine Genome Center in Quezon City are the only institutions in the Philippines capable of detecting monkeypox through RT-PCR tests.[43] The DOH has aimed to expand capacity and capability to other institutional hospitals as well. The Ninoy Aquino International Airport and several national airports ramped up their surveillance to detect the virus. In an explicit statement on August 2, 2022, DOH Officer in Charge Maria Rosario Vergeire said that borders and foreign entry are not to be shut down whilst not yet receiving recommendations from the World Health Organization (WHO).[44] Furthermore, it was affirmed that the opening of classes and universities will still resume on August 22 accordingly along with the cooperation of DepEd and local LGUs.[45][46]

The DOH has also entered negotiations with the United States government in a bid to secure monkeypox vaccines for a limited demographic.[47] Along with the WHO, the DOH has been proactively monitoring cases and revamping medical facilities in the country.[48]

Upon the detection of the first case, the Private Hospitals Association of the Philippines Inc. released a statement advising against home isolation for further suspected monkeypox cases.[49]

Notes

  1. ^ Date when the monkepox infection of the index case was confirmed through a positive test. The individual involved arrive in the country on July 19, 2022. The first case was announced publicly by the Department of Health on July 29, 2022. The patient was already tagged as recovered by the time of the announcement though still undergoing mandatory quarantine.

See also

References

  1. ^ "Monkeypox: experts give virus variants new names". World Health Organization. August 12, 2022.
  2. ^ Rambaut, Andrew (May 21, 2022). "Discussion of on-going MPXV genome sequencing". Virological.org. Archived from the original on May 23, 2022. Retrieved May 21, 2022.
  3. ^ "DOH Detects First Confirmed Case of Monkeypox in the Philippines". Department of Health. Retrieved August 3, 2022.
  4. ^ a b c d "Multi-country monkeypox outbreak: situation update". www.who.int. World Health Organization. June 4, 2022. Archived from the original on June 6, 2022. Retrieved June 7, 2022.
  5. ^ a b c "WHO Factsheet – Monkeypox". World Health Organization. May 19, 2022. Retrieved May 28, 2022.
  6. ^ a b "Signs and Symptoms Monkeypox". CDC. May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
  7. ^ Sutcliffe, Catherine G.; Rimone, Anne W.; Moss, William J. (2020). "32.2. Poxviruses". In Ryan, Edward T.; Hill, David R.; Solomon, Tom; Aronson, Naomi; Endy, Timothy P. (eds.). Hunter's Tropical Medicine and Emerging Infectious Diseases E-Book (Tenth ed.). Edinburgh: Elsevier. pp. 272–277. ISBN 978-0-323-55512-8.
  8. ^ Harris, Emily (May 27, 2022). "What to Know About Monkeypox". JAMA. 327 (23): 2278–2279. doi:10.1001/jama.2022.9499. PMID 35622356. S2CID 249096570.
  9. ^ "Multi-country monkeypox outbreak in non-endemic countries". World Health Organization. May 21, 2022. Retrieved May 25, 2022.
  10. ^ Taha, M. J., Abuawwad, M. T., Alrubasy, W. A., Sameer, S. K., Alsafi, T., Al-Bustanji, Y., ... & Nashwan, A. J. Ocular manifestations of recent viral pandemics: A literature. health, 13, 14.
  11. ^ Petersen, Brett W.; Damon, Inger K. (2020). "348. Smallpox, monkeypox and other poxvirus infections". In Goldman, Lee; Schafer, Andrew I. (eds.). Goldman-Cecil Medicine. Vol. 2 (26th ed.). Philadelphia: Elsevier. pp. 2180–2183. ISBN 978-0-323-53266-2.
  12. ^ "Monkeypox: experts give virus variants new names". World Health Organization. August 12, 2022.
  13. ^ a b Adler, Hugh; Gould, Susan; Hine, Paul; Snell, Luke B.; Wong, Waison; Houlihan, Catherine F.; et al. (May 24, 2022). "Clinical features and management of human monkeypox: a retrospective observational study in the UK". The Lancet. Infectious Diseases. 22 (8): S1473–3099(22)00228–6. doi:10.1016/S1473-3099(22)00228-6. PMC 9300470. PMID 35623380. S2CID 249057804.
  14. ^ a b "Transmission Monkeypox". CDC. May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
  15. ^ "2003 U.S. Outbreak Monkeypox". CDC. May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
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  17. ^ Fine, P. E.; Jezek, Z.; Grab, B.; Dixon, H. (September 1988). "The transmission potential of monkeypox virus in human populations". International Journal of Epidemiology. 17 (3): 643–650. doi:10.1093/ije/17.3.643. ISSN 0300-5771. PMID 2850277.
  18. ^ "Prevention". www.cdc.gov. November 29, 2019. Archived from the original on March 14, 2022. Retrieved May 14, 2022.
  19. ^ "Interim Clinical Guidance for the Treatment of Monkeypox | Monkeypox | Poxvirus | CDC". www.cdc.gov. May 26, 2022. Archived from the original on June 7, 2022. Retrieved June 8, 2022.
  20. ^ a b "Monkeypox". GOV.UK. May 24, 2022. Archived from the original on May 18, 2022. Retrieved May 28, 2022.
  21. ^ "Multi-country monkeypox outbreak in non-endemic countries: Update". www.who.int. Retrieved July 2, 2022.
  22. ^ Mercado, Neil Arwin (July 29, 2022). "First case of monkeypox detected in PH". Philippine Daily Inquirer. Retrieved July 29, 2022.
  23. ^ "Philippines reports first monkeypox case, traces 10 close contacts". Reuters. July 29, 2022. Retrieved July 29, 2022.
  24. ^ Bosano, Raphael (August 5, 2022). "DOH: Philippines' 1st monkeypox case ends isolation Saturday". ABS-CBN News.
  25. ^ Mendoza, John Eric (August 19, 2022). "PH detects 2 more monkeypox cases, total infections now 3". Philippine Daily Inquirer. Retrieved August 19, 2022.
  26. ^ Noriega, Richa. "Philippines detects 2 more monkeypox cases; total now 3". GMA News. Retrieved August 19, 2022.
  27. ^ de Vera, Analou (August 19, 2022). "DOH confirms 2 more cases of monkeypox in PH". Manila Bulletin. Retrieved August 19, 2022.
  28. ^ Maru, Davinci (July 31, 2022). "Hospital group warns of home isolation for monkeypox cases". ABS-CBN News. Retrieved August 22, 2022.
  29. ^ "Philippines confirms 4th monkeypox case". GMA News. August 22, 2022. Retrieved August 22, 2022.
  30. ^ Gomez, Carla (August 22, 2022). "4th monkeypox case detected in PH, no if confirmation patient from Iloilo". Digicast Negros. Retrieved August 22, 2022.
  31. ^ "PH posibleng may local transmission na ng monkeypox, ayon sa eksperto" [Local transmission of monkeypox in PH possibly already happening, according to an expert]. ABS-CBN News (in Filipino). August 22, 2022. Retrieved August 22, 2022.
  32. ^ a b Lena, Perla (August 23, 2022). "DOH closely monitors 14 contacts of monkeypox patient in Iloilo". Philippine News Agency. Retrieved August 23, 2022.
  33. ^ Yap, Tara (August 23, 2022). "Mayor, DOH in virtual disagreement on alleged monkeypox case in Iloilo City". Manila Bulletin. Retrieved August 23, 2022.
  34. ^ "DOH probes unauthorized release of monkeypox patient's photos". ABS-CBN News. August 23, 2022. Retrieved August 23, 2022.
  35. ^ Montemayor, Maria Teresa (September 2, 2022). "PH's 2nd monkeypox case recovered, discharged from isolation: DOH". Philippine News Agency. Retrieved September 16, 2022.
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  38. ^ Sarao, Zacarian (September 8, 2022). "Passenger of Manila-HK PAL flight tests positive for monkeypox". Philippine Daily Inquirer. Retrieved September 7, 2022.
  39. ^ "Hong Kong activates monkeypox response plan as arrival becomes city's first case". South China Morning Post. September 6, 2022. Retrieved September 7, 2022.
  40. ^ Ropero, Gillan (May 24, 2022). "What is monkeypox? DOH says ready to detect, contain disease". ABS-CBN News. Retrieved July 29, 2022.
  41. ^ "DOH, Partners: Philippine Monkeypox Response is Ready". Department of Health. Retrieved August 4, 2022.
  42. ^ Ropero, Gillan (June 22, 2022). "RITM says can now detect monkeypox". ABS-CBN News. Retrieved July 29, 2022.
  43. ^ "Mass making of monkeypox vax seen". Manila Standard. July 25, 2022. Retrieved July 29, 2022.
  44. ^ "Why the Philippines is not closing borders vs monkeypox for now". Rappler. August 3, 2022. Retrieved August 3, 2022.
  45. ^ "DOH: No need to delay school opening due to monkeypox". Manila Standard. August 3, 2022. Retrieved August 3, 2022.
  46. ^ Sarao, Zacarian (August 2, 2022). "Monkeypox detection in PH won't stop opening of classes, says DOH". Philippine Daily Inquirer. Retrieved August 3, 2022.
  47. ^ Mercado, Neil Arwin (July 29, 2022). "PH working with US gov't to secure monkeypox vaccines". Philippine Daily Inquirer. Retrieved July 29, 2022.
  48. ^ "WHO to 'continue to work closely' with DOH as monkeypox reaches PH".
  49. ^ Standard, Manila (July 31, 2022). "Hospital group warns of home isolation for monkeypox cases". Manila Standard. Retrieved August 22, 2022.

External links

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