2022–2023 mpox outbreak in the Philippines

2022–2023 mpox outbreak in the Philippines
DiseaseHuman mpox
Virus strainMonkeypox virus (MPV), clade II,[1] 2017–2019 outbreak subclade[2]
LocationPhilippines
First reportedJuly 28, 2022[lower-alpha 1]
DateJuly 28 – September 15, 2022 (1 month, 2 weeks and 4 days)
Public health emergency of international concern: 23 July 2022 – 11 May 2023 (9 months, 2 weeks and 4 days)
Confirmed cases4
Recovered4
Deaths
0

The 2022–2023 mpox outbreak in the Philippines was a part of the larger global outbreak of human mpox 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

Mpox (formerly known as monkeypox)[4] is an infectious viral disease that can occur in humans and some other animals.[5] Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes.[5] The illness is usually mild and most of those infected will recover within a few weeks without treatment.[6] The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks.[7] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.[8]

The disease is caused by the monkeypox virus,[lower-alpha 2] a zoonotic virus in the genus Orthopoxvirus. The variola virus, the causative agent of the disease smallpox, is also in this genus.[5] Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact.[5] People remain infectious from the onset of symptoms until all the lesions have scabbed and healed.[8] It may spread from infected animals by handling infected meat or via bites or scratches.[8] Diagnosis can be confirmed by PCR testing a lesion for the virus' DNA.[5]

History

Mpox cases in the Philippines  ()
     Deaths        Confirmed cases
JulJulAugAug
Last 15 daysLast 15 days
Date
Cases (rise)
Deaths (rise)
2022-07-28
1(n.a.)
⋮
2022-08-18
2(n.a.)
2022-08-19
4(+2)

Arrival

The first case of human mpox 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 mpox cases. The individual's mpox 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.[9] 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.[10]

Earlier on July 23, 2022, Director-General Tedros Adhanom Ghebreyesus of the World Health Organization declared the mpox global outbreak a public health emergency of international concern.[11]

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.[12]

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.[13] The PCR test conducted for both individuals returned positive results on August 18 and 19 respectively.[14]

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 mpox like lesions on their faces and other parts of their bodies.[15]

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 mpox is less contagious than COVID-19 and that protocols in place for the COVID-19 pandemic is also mitigating the spread of mpox.[16]

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.[17] 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.[18][19][20] 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.[21]

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.[20][22]

The second case was deemed recovered on August 31[23] while the third case was considered the same on September 8. The fourth case was discharged from the hospital on September 15[24] and is deemed to have recovered.[25]

Aftermath

The Philippines would not record any further case of the human mpox. In May 2023, the public health emergency of the WHO was declared over. Meanwhile, the country's health department never declared a health emergency.[26]

On September 5, 2022, the first ever case of mpox in Hong Kong was detected from a passenger who arrived from a flight from Manila.[27] The individual concerned is a 30-year old Hong Konger.[28]

Response

RITM Special Pathogens Laboratory staff prepares reagents during optimization of assay for mpox detection. June 2022

On May 24, 2022, the DOH expressed readiness to detect and contain mpox if it reaches the Philippines. It has classified mpox 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 mpox.[29][30]

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.[31]

As of July 2022, the RITM and the Philippine Genome Center in Quezon City are the only institutions in the Philippines capable of detecting mpox through RT-PCR tests.[32] The DOH has aimed to expand capacity and capability to other institutional hospitals as well. 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).[33] 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.[34][35]

The DOH has also entered negotiations with the United States government in a bid to secure mpox vaccines for a limited demographic.[36] Along with the WHO, the DOH has been proactively monitoring cases and revamping medical facilities in the country.[37]

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 mpox cases.[38]

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.
  2. ↑ The World Health Organization (the authority on disease names) announced the new name "mpox" in November 2022. But virus naming is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV), which is currently reviewing all orthopoxvirus species. As of March 2023, the official name of the virus remains "monkeypox virus".[4]

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. 1 2 "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). November 28, 2022. Retrieved November 29, 2022.
  5. 1 2 3 4 5 "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). April 18, 2023. Archived from the original on April 21, 2022. Retrieved May 21, 2023.
  6. ↑ "Monkeypox". GOV.UK. May 24, 2022. Archived from the original on May 18, 2022. Retrieved May 28, 2022.
  7. ↑ "Mpox Symptoms". U.S. Centers for Disease Control and Prevention (CDC). February 2, 2023. Archived from the original on May 21, 2023. Retrieved May 21, 2023.
  8. 1 2 3 "Mpox (monkeypox)". World Health Organisation. May 12, 2023. Archived from the original on May 23, 2023. Retrieved May 24, 2023.
  9. ↑ Mercado, Neil Arwin (July 29, 2022). "First case of monkeypox detected in PH". Philippine Daily Inquirer. Retrieved July 29, 2022.
  10. ↑ "Philippines reports first monkeypox case, traces 10 close contacts". Reuters. July 29, 2022. Retrieved July 29, 2022.
  11. ↑ "WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern". World Health Organization (WHO). July 23, 2022. Retrieved August 4, 2022.
  12. ↑ Bosano, Raphael (August 5, 2022). "DOH: Philippines' 1st monkeypox case ends isolation Saturday". ABS-CBN News.
  13. ↑ Mendoza, John Eric (August 19, 2022). "PH detects 2 more monkeypox cases, total infections now 3". Philippine Daily Inquirer. Retrieved August 19, 2022.
  14. ↑ Noriega, Richa. "Philippines detects 2 more monkeypox cases; total now 3". GMA News. Retrieved August 19, 2022.
  15. ↑ de Vera, Analou (August 19, 2022). "DOH confirms 2 more cases of monkeypox in PH". Manila Bulletin. Retrieved August 19, 2022.
  16. ↑ Maru, Davinci (July 31, 2022). "Hospital group warns of home isolation for monkeypox cases". ABS-CBN News. Retrieved August 22, 2022.
  17. ↑ "Philippines confirms 4th monkeypox case". GMA News. August 22, 2022. Retrieved August 22, 2022.
  18. ↑ Gomez, Carla (August 22, 2022). "4th monkeypox case detected in PH, no if confirmation patient from Iloilo". Digicast Negros. Retrieved August 22, 2022.
  19. ↑ "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.
  20. 1 2 Lena, Perla (August 23, 2022). "DOH closely monitors 14 contacts of monkeypox patient in Iloilo". Philippine News Agency. Retrieved August 23, 2022.
  21. ↑ Yap, Tara (August 23, 2022). "Mayor, DOH in virtual disagreement on alleged monkeypox case in Iloilo City". Manila Bulletin. Retrieved August 23, 2022.
  22. ↑ "DOH probes unauthorized release of monkeypox patient's photos". ABS-CBN News. August 23, 2022. Retrieved August 23, 2022.
  23. ↑ Montemayor, Maria Teresa (September 2, 2022). "PH's 2nd monkeypox case recovered, discharged from isolation: DOH". Philippine News Agency. Retrieved September 16, 2022.
  24. ↑ Montemayor, Maria Teresa (September 16, 2022). "3rd monkeypox case fully recovered: DOH". Philippine News Agency. Retrieved September 16, 2022.
  25. ↑ "Philippines' 4th monkeypox case has recovered—DOH". Manila Bulletin. October 11, 2022. Retrieved October 13, 2022.
  26. ↑ Relativo, James. "'Road to recovery': DOH welcomes lifting of global health emergency vs monkeypox". The Philippines Star. Retrieved August 10, 2023.
  27. ↑ Sarao, Zacarian (September 8, 2022). "Passenger of Manila-HK PAL flight tests positive for monkeypox". Philippine Daily Inquirer. Retrieved September 7, 2022.
  28. ↑ "Hong Kong activates monkeypox response plan as arrival becomes city's first case". South China Morning Post. September 6, 2022. Retrieved September 7, 2022.
  29. ↑ Ropero, Gillan (May 24, 2022). "What is monkeypox? DOH says ready to detect, contain disease". ABS-CBN News. Retrieved July 29, 2022.
  30. ↑ "DOH, Partners: Philippine Monkeypox Response is Ready". Department of Health. Retrieved August 4, 2022.
  31. ↑ Ropero, Gillan (June 22, 2022). "RITM says can now detect monkeypox". ABS-CBN News. Retrieved July 29, 2022.
  32. ↑ "Mass making of monkeypox vax seen". Manila Standard. July 25, 2022. Retrieved July 29, 2022.
  33. ↑ "Why the Philippines is not closing borders vs monkeypox for now". Rappler. August 3, 2022. Retrieved August 3, 2022.
  34. ↑ "DOH: No need to delay school opening due to monkeypox". Manila Standard. August 3, 2022. Retrieved August 3, 2022.
  35. ↑ Sarao, Zacarian (August 2, 2022). "Monkeypox detection in PH won't stop opening of classes, says DOH". Philippine Daily Inquirer. Retrieved August 3, 2022.
  36. ↑ Mercado, Neil Arwin (July 29, 2022). "PH working with US gov't to secure monkeypox vaccines". Philippine Daily Inquirer. Retrieved July 29, 2022.
  37. ↑ "WHO to 'continue to work closely' with DOH as monkeypox reaches PH".
  38. ↑ Standard, Manila (July 31, 2022). "Hospital group warns of home isolation for monkeypox cases". Manila Standard. Retrieved August 22, 2022.
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