MOH confirms the first case of monkeypox in Singapore
MOH has confirmed one imported case of monkeypox in Singapore. Monkeypox is a rare viral disease that is primarily transmitted to humans from animals...
The Ministry of Health (MOH) has confirmed one imported case of monkeypox in Singapore. Monkeypox is a rare viral disease that usually occurs in West and Central Africa, and is primarily transmitted to humans from animals.
According to the MOH statement on 9 May 2019, the patient is a 38-year-old Nigerian national who arrived in Singapore alone on 28 April 2019. He was tested positive for monkeypox on 8 May 2019.
He is currently warded in an isolation ward at the National Centre for Infectious Diseases (NCID), and his condition is stable.
The MOH has also revealed that the patient stayed at a hotel at 21 Lorong 8 Geylang from 28 April. He had attended a workshop at 3 Church Street on 29 and 30 April 2019.
On 30 April, he developed fever, muscle ache, chills and skin rash. He reported that he had remained in his hotel room most of the time between 1 and 7 May. He was conveyed to Tan Tock Seng Hospital by an ambulance on 7 May and referred to NCID on the same day.
According to details given by the patient, prior to his arrival in Singapore, he had attended a wedding in Nigeria, where he may have consumed bush meat, which could be a source of transmission of monkeypox virus.
Based on investigations, 23 persons have been identified by MOH as close contacts of the patient.
These include 18 participants and trainers who attended the same workshop, one staff at the workshop venue and four hotel staff who had close contact with the patient.
Healthcare workers who were in contact with the patient had used personal protective equipment.
“These close contacts of the patient have been assessed by NCID and offered vaccination, which can prevent the disease or reduce the severity of symptoms.
“As a precautionary measure, they will be quarantined and monitored for 21 days from their date of exposure to the patient.
“Those who develop symptoms will be treated at NCID. All other contacts who have a low risk of being infected are nevertheless put under active surveillance, and will be contacted twice daily to monitor their health status.
“One workshop participant had left Singapore on 5 May 2019, before the patient was seen and diagnosed at the hospital. This workshop participant has reported to MOH that he was, and remains, well with no symptoms. Nonetheless as a precaution, MOH has informed the public health authority in his home country,” said MOH.
Monkeypox is a rare disease caused by a virus that is primarily transmitted to humans from animals. Transmission of monkeypox mainly occurs when a person comes into close contact with infected animals (typically rodents) through the hunting and consumption of bush meat.
Human-to-human transmission, while possible, is limited. A person is infectious only during the period when he has symptoms, particularly skin rash.
Transmission typically occurs from close contact with the respiratory tract secretions or skin lesions of an infected person, or objects recently contaminated by an infected person’s fluids or lesion materials.
The incubation period (interval between infection to onset of symptoms) of monkeypox is usually from 6 to 16 days but can range from 5 to 21 days.
The infection can be divided into two periods:
The invasion period (Between 0-5 days)
This period is characterised by fever, headache, swelling of the lymph node, back pain, muscle ache and lack of energy.
The skin eruption period (Within 1-3 days after onset of fever)
In this period, rash appears, often beginning on the face and then spreading elsewhere on the body. The face (in 95% of cases), and palms of the hands and soles of the feet (in 75% of cases) are most affected.
Evolution of the rash from lesions with a flat base to small fluid-filled blisters, pustules, followed by crusts occurs in approximately 10 days.
Three weeks might be necessary before the complete disappearance of the crusts.
Some patients develop severe lymphadenopathy (swollen lymph nodes) before the appearance of the rash, which is a distinctive feature of monkeypox compared to other similar diseases.
“The disease is usually self-limiting, with most patients recovering within two to three weeks.
In some cases, however, the virus can cause serious complications such as pneumonia, sepsis, encephalitis (brain inflammation) and eye infection with ensuing loss of vision.
There have been reported mortality rates of 1% to 10% during outbreaks, with most deaths occurring in younger age groups,” said the MOH statement.
There are no specific treatments or vaccines available for monkeypox infection, but outbreaks can be controlled:
- Close physical contact with monkeypox infected people or contaminated materials should be avoided.
- Gloves and protective equipment should be worn when taking care of ill people.
- Regular hand washing should be carried out after caring for or visiting sick people.
- Isolation of patients either at home or in health facilities is recommended.
Here is MOH’s advice on travelling to areas affected by monkeypox in Central and Western Africa:
- Maintain a high standard of personal hygiene, including frequent hand washing after going to the toilet, or when hands are soiled.
- Avoid direct contact with skin lesions of infected living or dead persons or animals, as well as objects that may have become contaminated with infectious fluids, such as soiled clothing or linens (e.g. bedding or towels) used by an infected person.
- Avoid contact with wild animals, and consumption of bush meat.
- Returning travellers from areas affected by monkeypox should seek immediate medical attention if they develop any disease symptoms (e.g. sudden onset of high fever, swollen lymph nodes and rash) within three weeks of their return. They should inform their doctor of their recent travel history.