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Mpox in the Philippines

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Mpox in the Philippines
DiseaseHuman mpox
Virus strainMonkeypox virus (MPV), clade II,[1] 2017–2019 outbreak subclade[2]
LocationPhilippines
First reportedJuly 28, 2022[a]
Date
2022–23 outbreak

July 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)

2024– epidemic
August 19, 2024 –(2 months, 4 weeks and 1 day)
Confirmed cases27
Active cases13
Recovered14
Deaths
0

The Philippines was among the countries which reported cases during the 2022–2023 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

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These paragraphs are an excerpt from Mpox and 2022–2023 mpox outbreak.
See also: 2023–2024 mpox epidemic

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

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

Vaccination is recommended for those at high risk of infection.[8] No vaccine has been developed specifically against mpox, but smallpox vaccines have been found to be effective.[9] There is no specific treatment for the disease, so the aim of treatment is to manage the symptoms and prevent complications.[8][10] Antiviral drugs such as tecovirimat can be used to treat mpox,[8] although their effectiveness has not been proved.[11]

History

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Mpox cases in the Philippines  (
)
     Deaths        Confirmed cases
Date
Cases (rise)
Deaths (rise)
2022-07-28
(n.a.)
⋮
2022-08-19
3(n.a.)
⋮
2022-08-22
4(n.a.)
⋮
2022-08-31
4(n.a.)
⋮
2022-09-08
4(n.a.)
⋮
2022-09-15
4(n.a.)
⋮
2023
9(n.a.)
⋮
2024-08-19
10(n.a.)
⋮
2024-08-26
12(n.a.)
2024-08-27
12(=)
2024-08-28
14(+2)
2024-08-29
14(=)
2024-08-30
14(=)
2024-08-31
14(=)
2024-09-01
17(+3)
⋮
2024-09-09
23(n.a.)
2024-09-10
23(=)
2024-09-11
24(+1)
⋮
2024-09-16
27(n.a.)

2022–2023 outbreak

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Arrival

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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.[12] 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.[13]

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.[14]

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.[15]

Further cases

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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.[16] The PCR test conducted for both individuals returned positive results on August 18 and 19 respectively.[17]

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.[18]

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.[19]

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.[20] 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.[21][22][23] Iloilo City mayor Jerry Treñas in an interview with local radio stations said that the individual worked in a fast food chain in the city and added that he had a relative who recently came in from abroad.[24]

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.[23][25]

The second case was deemed recovered on August 31[26] while the third case was considered the same on September 8. The fourth case was discharged from the hospital on September 15[27] and is deemed to have recovered.[28]

Aftermath

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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.[29] There has been five more cases since then, bringing the total number of cases to nine. The last three cases were in December 2023. No cases would be reported for the earlier months of 2024.[30]

2023–2024 outbreak

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Amidst the 2024 mpox epidemic which largely affected Africa, the Philippines' Department of Health (DOH) on August 19, 2024 announced that a positive case of mpox was reported to it the day prior. It was that of a 33-year old male in Metro Manila with no prior history of travelling overseas.[31] The patient is later determined to have contracted the milder clade II variant, the same as the one from 2022–23.[32] This case is the tenth overall since July 2022.[31][33] Two more cases were confirmed in the metropolis on August 26.[34]

On August 28, the DOH confirmed two more cases. One each in Metro Manila and Calabarzon. The next day, the health department's Central Visayas office disclosed there are five suspected mpox cases in the region.[35][36]

September 1, 2024 saw more cases. Two in Metro Manila and one in Calabarzon.[37]

By September 9, the number of active cases rose to 14, or 23 overall since July 2022. Mpox has been detected in three regions by around this time,[38] with the DOH Cagayan Valley confirming the first case in the region in September 7.[39][40] Two days later a new case was confirmed.[41]

By September 16, there is now a total of 27 mpox cases since July 2022. Eighteen since August 2024; five of which have recovered. All eighteen cases have no determined epidemiological link.[42]

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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.[43] The individual concerned is a 30-year old Hong Konger.[44]

Response

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

2022–2023 outbreak

[edit]

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.[45][46]

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.[47]

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.[48] 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).[49] 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.[50][51]

The DOH has also entered negotiations with the United States government in a bid to secure mpox vaccines for a limited demographic.[52] Along with the WHO, the DOH has been proactively monitoring cases and revamping medical facilities in the country.[53]

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.[54]

2023–2024 outbreak

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The Research Institute for Tropical Medicine serves as the testing center for mpox once again for the epidemic which started in August 2024.[55]

Notes

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  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

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References

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  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. Archived from the original on August 3, 2022. Retrieved August 3, 2022.
  4. ^ "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). November 28, 2022. Archived from the original on December 1, 2022. Retrieved November 29, 2022.
  5. ^ a b c "Mpox". World Health Organization (WHO). August 17, 2024. Archived from the original on August 19, 2024. Retrieved August 22, 2024.
  6. ^ "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). April 18, 2023. Archived from the original on April 21, 2022. Retrieved May 21, 2023.
  7. ^ "Mpox Symptoms". U.S. Centers for Disease Control and Prevention (CDC). March 15, 2024. Archived from the original on April 2, 2024. Retrieved August 22, 2024.
  8. ^ a b c d e f "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). April 18, 2023. Archived from the original on April 21, 2022. Retrieved May 21, 2023.
  9. ^ Christodoulidou MM, Mabbott NA (January 1, 2023). "Efficacy of smallpox vaccines against Mpox infections in humans". Immunotherapy Advances. 3 (1): ltad020. doi:10.1093/immadv/ltad020. PMC 10598838. PMID 37886620.
  10. ^ "Mpox (formerly Monkeypox)". NIH: National Institute of Allergy and Infectious Diseases. December 6, 2022. Archived from the original on May 23, 2023. Retrieved May 24, 2023.
  11. ^ "Patient's Guide to Mpox Treatment with Tecovirimat (TPOXX)". U.S. Centers for Disease Control and Prevention (CDC). November 28, 2022. Archived from the original on May 24, 2023. Retrieved May 24, 2023.
  12. ^ Mercado, Neil Arwin (July 29, 2022). "First case of monkeypox detected in PH". Philippine Daily Inquirer. Retrieved July 29, 2022.
  13. ^ "Philippines reports first monkeypox case, traces 10 close contacts". Reuters. July 29, 2022. Retrieved July 29, 2022.
  14. ^ "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.
  15. ^ Bosano, Raphael (August 5, 2022). "DOH: Philippines' 1st monkeypox case ends isolation Saturday". ABS-CBN News.
  16. ^ Mendoza, John Eric (August 19, 2022). "PH detects 2 more monkeypox cases, total infections now 3". Philippine Daily Inquirer. Retrieved August 19, 2022.
  17. ^ Noriega, Richa. "Philippines detects 2 more monkeypox cases; total now 3". GMA News. Retrieved August 19, 2022.
  18. ^ de Vera, Analou (August 19, 2022). "DOH confirms 2 more cases of monkeypox in PH". Manila Bulletin. Retrieved August 19, 2022.
  19. ^ Maru, Davinci (July 31, 2022). "Hospital group warns of home isolation for monkeypox cases". ABS-CBN News. Retrieved August 22, 2022.
  20. ^ "Philippines confirms 4th monkeypox case". GMA News. August 22, 2022. Retrieved August 22, 2022.
  21. ^ Gomez, Carla (August 22, 2022). "4th monkeypox case detected in PH, no if confirmation patient from Iloilo". Digicast Negros. Retrieved August 22, 2022.
  22. ^ "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.
  23. ^ a b Lena, Perla (August 23, 2022). "DOH closely monitors 14 contacts of monkeypox patient in Iloilo". Philippine News Agency. Retrieved August 23, 2022.
  24. ^ Yap, Tara (August 23, 2022). "Mayor, DOH in virtual disagreement on alleged monkeypox case in Iloilo City". Manila Bulletin. Retrieved August 23, 2022.
  25. ^ "DOH probes unauthorized release of monkeypox patient's photos". ABS-CBN News. August 23, 2022. Retrieved August 23, 2022.
  26. ^ Montemayor, Maria Teresa (September 2, 2022). "PH's 2nd monkeypox case recovered, discharged from isolation: DOH". Philippine News Agency. Retrieved September 16, 2022.
  27. ^ Montemayor, Maria Teresa (September 16, 2022). "3rd monkeypox case fully recovered: DOH". Philippine News Agency. Retrieved September 16, 2022.
  28. ^ "Philippines' 4th monkeypox case has recovered—DOH". Manila Bulletin. October 11, 2022. Retrieved October 13, 2022.
  29. ^ Relativo, James. "'Road to recovery': DOH welcomes lifting of global health emergency vs monkeypox". The Philippines Star. Retrieved August 10, 2023.
  30. ^ Cabalza, Dexter (June 11, 2024). "DOH: No new cases, deaths due to mpox". Philippine Daily Inquirer. Archived from the original on June 12, 2024. Retrieved August 23, 2024.
  31. ^ a b "Philippines detects new mpox case after WHO public health emergency declaration". Rappler. August 19, 2024. Retrieved August 19, 2024.
  32. ^ "Philippines says recent mpox case is mild Clade 2 variant". Reuters. August 21, 2024. Retrieved August 21, 2024.
  33. ^ "Philippines detects first mpox case this year, yet to determine strain". Reuters. August 19, 2024. Retrieved August 19, 2024.
  34. ^ Ombay, Giselle (August 26, 2024). "PH detects 2 more mpox cases, both in NCR". GMA News. Retrieved September 16, 2024.
  35. ^ "Philippines says two new mpox cases are milder variant". Reuters. August 26, 2024. Retrieved August 26, 2024.
  36. ^ Palaubsanon, Mitchelle (August 30, 2024). "Subject to confirmatory tests: Five 'mpox cases'". The Philippine Star. Retrieved August 31, 2024.
  37. ^ Magsambol, Bonz (September 1, 2024). "Philippines' active mpox cases now at 8". Rappler. Archived from the original on September 1, 2024. Retrieved September 16, 2024.
  38. ^ Bosano, Raphael (September 9, 2024). "Active mpox cases in PH rise to 14: DOH". ABS-CBN News. Retrieved September 16, 2024.
  39. ^ "First mpox case in Cagayan Valley locally transmitted: DOH". ABS-CBN News. September 11, 2024. Retrieved September 16, 2024.
  40. ^ de la Vega, Chito (September 11, 2024). "DOH Cagayan Valley urges vigilance after first mpox case". Rappler. Retrieved September 16, 2024.
  41. ^ Ferreras, Vince Angelo (September 11, 2024). "Mpox cases in PH rise to 15 — DOH". GMA News. Retrieved September 16, 2024.
  42. ^ Ombay, Giselle (September 16, 2024). "Mpox cases this year rose to 18, vaccines not needed for control —Herbosa". GMA News. Retrieved September 16, 2024.
  43. ^ Sarao, Zacarian (September 8, 2022). "Passenger of Manila-HK PAL flight tests positive for monkeypox". Philippine Daily Inquirer. Retrieved September 7, 2022.
  44. ^ "Hong Kong activates monkeypox response plan as arrival becomes city's first case". South China Morning Post. September 6, 2022. Retrieved September 7, 2022.
  45. ^ Ropero, Gillan (May 24, 2022). "What is monkeypox? DOH says ready to detect, contain disease". ABS-CBN News. Retrieved July 29, 2022.
  46. ^ "DOH, Partners: Philippine Monkeypox Response is Ready". Department of Health. Retrieved August 4, 2022.
  47. ^ Ropero, Gillan (June 22, 2022). "RITM says can now detect monkeypox". ABS-CBN News. Retrieved July 29, 2022.
  48. ^ "Mass making of monkeypox vax seen". Manila Standard. July 25, 2022. Retrieved July 29, 2022.
  49. ^ "Why the Philippines is not closing borders vs monkeypox for now". Rappler. August 3, 2022. Retrieved August 3, 2022.
  50. ^ "DOH: No need to delay school opening due to monkeypox". Manila Standard. August 3, 2022. Retrieved August 3, 2022.
  51. ^ Sarao, Zacarian (August 2, 2022). "Monkeypox detection in PH won't stop opening of classes, says DOH". Philippine Daily Inquirer. Retrieved August 3, 2022.
  52. ^ Mercado, Neil Arwin (July 29, 2022). "PH working with US gov't to secure monkeypox vaccines". Philippine Daily Inquirer. Retrieved July 29, 2022.
  53. ^ "WHO to 'continue to work closely' with DOH as monkeypox reaches PH". Archived from the original on August 6, 2022. Retrieved August 6, 2022.
  54. ^ Standard, Manila (July 31, 2022). "Hospital group warns of home isolation for monkeypox cases". Manila Standard. Retrieved August 22, 2022.
  55. ^ Montemayor, Ma. Teresa (September 16, 2024). "PH logs 18 mpox cases". Philippine News Agency. Retrieved September 16, 2024.
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