Monkeypox: Use experience from Covid-19

PETALING JAYA: Healthcare professionals should learn from the lessons of Covid-19 in managing monkeypox, say experts, urging Malaysians not to overreact to the World Health Organisation’s (WHO) announcement of the outbreak as a global health emergency.

Calling for stricter surveillance of travellers entering the country, they also want public education and awareness of the disease, which has so far killed five people out of over 16,000 infections in 70 nations.

“The lessons from Covid-19 remain relevant for monkeypox,” global health specialist Dr Khor Swee Kheng said, adding that WHO’s announcement of monkeypox as a “public health emergency of international concern (PHEIC)” highlighted the vigilance that countries needed to adopt against the disease.

“However, Malaysia should not overreact,” he said.

On Saturday, WHO director-general Tedros Adhanom Ghebreyesus made the decision to issue the declaration of a global health emergency despite a lack of consensus among experts serving on the United Nations health agency’s emergency committee.

A global emergency is WHO’s highest level of alert, but this does not necessarily mean a disease is particularly transmissible or lethal, but it will allow the agency to take additional measures to try to curb the virus’s spread.

Endemic only in about a dozen countries in Central and Western Africa, cases have ballooned in the past month, with men having sexual relations with men most at risk.

There is no cure for monkeypox, but certain anti-viral treatments are effective. Two vaccines originally developed for smallpox can help prevent infections but these are not widely available as the deadly disease has been declared eradicated since 1980.

Calling on Malaysia to use its lessons from managing Covid-19, Dr Khor said these included strong public education.

“Healthcare professionals who have not seen monkeypox cases before (need) robust laboratory and surveillance to detect such cases,” he said, adding that the government should also be prepared to purchase the relevant vaccines and medicines when needed.

Universiti Putra Malaysia epidemiologist Assoc Prof Dr Malina Osman said the “global health emergency” alert warranted health authorities and those responsible for health policies on communicable diseases to be on full alert for a potential spike in cases that might affect the current healthcare system.

“Full monitoring and continuous surveillance of health risk behaviour patterns and data on current infections – locally or in nearby countries – should be in place.

“Also, (we should) have stricter measures on the entrance of potential cases into the country. Aggressive health promotion to educate and empower the public to prevent the spread of diseases should be advocated from time to time,” she said.

All preparedness and measures to avoid possible outbreaks as well as prevention and control must be in place, Dr Malina said, adding that the Health Ministry’s current strategies were in line with WHO’s recommendations.

“The ministry has years of experience. I believe our health authorities have taken all the relevant measures towards preventing a possible outbreak and any spike of infection.

“It would be great if we could allocate some of our health budget to reserve a certain number of vaccines for monkeypox – just in case the situation worsens in the future,” she said.

Although monkeypox can be spread by touching linen, towels and counters contaminated with the virus from infectious rash or bodily fluids, Dr Malina advised travelling Malaysians not to be over-worried.

“Most hotels or Airbnb provide clean and hygienic bed linen and towels. I don’t think it should be an issue. It would be beyond my imagination if the settings do not prioritise this in their services,” she said.

Exposed to the environment, the virus found on towels, bed linen or counters will usually die off after a few hours.

“Bed linen and towels that are cleaned properly and washed adequately with water and specific detergent do not impose any risk for the transmission of monkeypox.

“Transmission of the infection is usually from the bodily fluids of the skin lesion of the infected individuals, and this usually occurs following close and direct contact, such as during an intimate relationship,” she said.

Public health expert Datuk Dr Zainal Ariffin Omar urged the health authorities to embark on a strict epidemiological surveillance of monkeypox cases and develop appropriate prevention plans.

“Since we have not detected any cases yet, we need epidemiological surveillance on monkeypox, especially for travellers coming from affected and at-risk countries. Public awareness of monkeypox should also be increased,” he said.

Epidemiological surveillance involves the health authorities conducting ongoing systematic collection, analysis and interpretation of health data essential to the planning, implementation, and evaluation of public health practices.

The government, he added, would need to increase the health system’s readiness and “make informed and transparent decisions”.

Dr Zainal Ariffin, who heads the Community Engagement and Empowerment for Covid-19, also called on Malaysians to practise universal precautions at all times and places, such as stopping risky sexual activities and seeking medical advice when necessary.

On June 8, Health Minister Khairy Jamaluddin said the ministry had provided a strategic plan to face the risk of monkeypox entering Malaysia, with some of the steps including procedures for tracking and notifying cases; sampling; investigation and case management; as well as close contact and monitoring at international gateways such as airports.

On May 27, the ministry added a health alert for monkeypox in the MySejahtera app.

So far, Malaysia has not detected any monkeypox cases while its neighbour, Thailand, detected its first on Friday in Phuket, involving a 27-year-old Nigerian man who escaped and was found hospitalised in Phnom Penh, Cambodia, on Saturday.

Singapore’s Ministry of Health confirmed its first monkeypox case on July 6, involving a 45-year-old resident. The republic has registered a total of six cases of monkeypox so far, three of which were local cases, and none of them is linked.

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