Sarawakians advised to maintain hygiene as Mpox risk remains low, says SGH infectious disease expert

File photo for illustration purposes only. Photo credit: Pixabay

By Karen Bong

KUCHING, Aug 31: The immediate risk of catching monkeypox (Mpox) among Sarawakians is low, but the health authorities have advised the public to ensure that they take the necessary precautions, such as maintaining high levels of hygiene as well as regular exercise and good nutrition to boost their immune system and maintain a healthy body to prevent diseases.

Infectious Disease physician and Sarawak General Hospital’s (SGH) Infectious Disease Unit head Dr Chua Hock Hin emphasised that local transmissions have not been detected in Malaysia to date.

Between Jan 1, 2022 and July 31, 2024, Malaysia detected nine Mpox cases in 2023, with one in Sarawak whereby the patient was isolated and treated in the hospital for three weeks.

“The risk is low, except for those who have travelled to or been exposed to African countries, especially those recording high number of cases, and individuals with multiple sexual partners.

“Meantime, the SGH and other main hospitals have always practiced the standard operating procedures (SOPs) to look out not only for suspected Mpox cases but also other infectious diseases such as turberculosis (TB),” he shared during ShallWeeTalk live session with Kuching South City Council (MBKS) mayor Dato Wee Hong Seng today.

Dr Chua gave an explanation on Mpox on the ‘ShallWeeTalk’ live session on Aug 31, 2024.

The concerns come as the World Health Organisation (WHO) declared on Aug 14 that outbreaks in West and Central Africa constitute a global health emergency, marking the second time it has been elevated to this level since 2022.

According to Dr Chua, the Republic of Congo has reported more than 15,000 cases and 537 deaths so far.

Mpox, previously known as monkeypox, is a viral zoonotic disease caused by the monkeypox virus, which belongs to the Orthopoxvirus genus of the Poxviridae family.

“It is a DNA virus, comprising two distinct groupings – Clades (1 and 2). Most cases in the Republic of Congo fall under Clade 1B, which evidence suggests may be more lethal than Clade 2B.

“However, more studies are needed to understand why children are are particularly affected, as most cases and deaths in the current outbreak have occurred among them, indicating that transmission is occurring by routes other than sexual contact,” he explained.

Symptoms of Mpox

Dr Chua highlighted that the incubation period of the virus typically ranges from six to 13 days following exposure, but it can extend up to 21 days without symptoms.

Early symptoms include fever, muscle aches, enlarged lymph nodes, fatigue, and/or vomiting.

“It can be challenging to differentiate Mpox from a common cold based on these symptoms alone,” he said.

Dr Chua showing a slide on the stages of the development of rashes associated with Mpox.

Physical symptoms such as rashes usually appear after one to four days, which can range from a few to thousands spread across the body, including the face, eyes, oral mucosa, palms, soles, genital areas, and inside the mouth.

Key features of the rash include its centrifugal pattern, uniform stage across the body area, and presence on palms, soles, and lymph nodes.

“The rash is similar to chickenpox, but unlike chickenpox, the lesions appear simultaneously on all rashes,” Dr Chua added.

He elaborated that a person with Mpox is no longer infectious once the pus-filled lesions have crusted and fallen off, revealing a new layer of healthy skin.

“The whole process will take two to four weeks, starting from about a day before symptoms onset,” he said.

Symptoms typically resolve within two weeks, but the disease can be fatal, especially for those with weakened immune systems. Children and pregnant women may also be at higher risk.

How does Mpox spread

The disease can be passed on by close contact with anyone with the infection such as touching, kissing and sexual contact, or with infected bedding and surfaces.

Mpox can also spread through fomites like clothing and gadgets. It can also be transmitted from animals to humans through bites, scratches, contact with body fluids, and consumption of poorly cooked meat, particularly in Africa.

“Those in close contact with Mpox patients or those with multiple sexual partners are at higher risk, as evidenced by cases worldwide,” Dr Chua highlighted.

Complications can include secondary infections, bronchopneumonia, sepsis, encephalitis, corneal infections leading to blindness, and severe dehydration, with high-risk groups including immuno-compromised individuals, young children with poor nutrition, and pregnant women.

Treatment and protection

Suspected Mpox cases are confirmed via RT-PCR and other laboratory tests by taking a sample from the lesions.

However, Dr Chua emphasised that currently, there is no proven definitive treatment and treatment for patients would mainly focused on symptomatic relief and preventing complications.

Dr Chua advised the public to be aware of Mpox signs and symptoms and to seek immediate medical attention if infected.

“Suspected cases should isolate and people should know how the virus is transmitted and the risk of Mpox in the local community,” he added.

While a vaccine is not readily available, Dr Chua noted that individuals who received the smallpox vaccine may have some protection. Additionally, mass vaccination is not currently recommended worldwide. — DayakDaily