ask ST
More monkeypox cases expected to surface in Singapore in weeks ahead
Sign up now: Get ST's newsletters delivered to your inbox
More monkeypox cases are expected to surface here in the weeks ahead as more than 18,000 cases have been reported in 78 countries, with the majority in Europe.
Singapore saw its first monkeypox case on July 6, and now has six local and five imported cases. The cases are not linked, but contact tracing is ongoing.
Last Saturday, the World Health Organisation (WHO) declared monkeypox a global health emergency.
The risk to the general public remains low, but more questions have surfaced. The Straits Times answers some of them.
Q Will heterosexual networks be safe from monkeypox?
A Professor Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection, said: "While currently most cases globally are among MSM (men who have sex with men), there is no reason why it cannot spread into heterosexual networks, perhaps among commercial sex workers or the families of affected individuals."
More imported cases can be expected here, and they may spread monkeypox to their close contacts in Singapore, said Associate Professor Hsu Li Yang, an infectious diseases expert and vice-dean of global health at the National University of Singapore's Saw Swee Hock School of Public Health.
"Because we are still seeing sporadic cases with no known links, it seems evident that local transmission of the virus is still occurring."
Q Does monkeypox spread only through sex?
A Dr Rosamund Lewis, WHO technical lead on monkeypox, said: "One of the main modes of exposure for this particular illness is through direct contact... skin-to-skin contact, possibly even face-to-face... exposure to droplets or virus that may be in the mouth. Many people have lesions in the mouth."
She added that household transmission may begin to occur now.
WHO director-general Tedros Adhanom Ghebreyesus said at a media conference on Wednesday: "Monkeypox can be spread in households through close contact between people, such as hugging and kissing, and contaminated towels or bedding."
At the same conference, Dr Lewis said some people have been exposed in a household setting.
Q Have children been affected by monkeypox in this outbreak?
A The US confirmed two such cases recently. Dr Lewis said that globally, 81 children under the age of 17 have been infected.
Not every child who contracts monkeypox will develop severe disease, but there is a preponderance of children, pregnant women and immunocompromised people among those who do develop severe disease, she said.
Q How many people become very ill with monkeypox?
A Most people recover without treatment, but the disease can be very unpleasant. Dr Tedros said about 10 per cent of cases are hospitalised to manage the pain.
Prof Tambyah said almost all the cases here have been mild.
"Hospitals are full right now, and I think it would be most appropriate for monkeypox cases who need to be isolated to be looked after in community care facilities," he said.
Q Is a rash or blister the first sign of monkeypox?
A Two doctors quoted in a WHO Europe release last Sunday said the cases they saw did not always have the rash that is considered the typical symptom of monkeypox.
One doctor has seen people with anal, genital and oral ulcers or with no visible ulcers, and swollen lymph nodes, while the other doctor said some patients had a fever, and inflammation of the colon and rectum, and others had lesions on the chin, chest and stomach.
