Mpox outbreak in Africa and other countries 'very worrying', virus expected to arrive in Singapore: Ong Ye Kung

SINGAPORE - The mpox outbreak in Africa and other countries is a "very worrying" situation, and Singapore should expect the virus to arrive at its shores.

Giving an update on Aug 17, Health Minister Ong Ye Kung said the current risk of an outbreak in Asia and Singapore is low as there are no direct flights to the affected areas in Africa.

However, the virus, which has seen a rapid surge in several African countries, is expected to spread to the Middle East and Europe.

"I would say, in general, this is a very worrying situation, especially for the African continent," said Mr Ong.

"But I think we should work on the basis that mpox will arrive in Asia. And probably, Singapore will be one of the first places to find cases because of our flight connections (with Middle East and Europe)," said Mr Ong, who was speaking on the sidelines of a skills and career fair at Bukit Canberra, Sembawang.

"This is something worrying. We should be on alert. We should expect it to arrive in Singapore, and then when it does, respond appropriately and effectively."

Mpox, formerly known as monkeypox, causes flu-like symptoms and pus-filled lesions on the body.

A new, deadlier sub-variant of mpox - the clade I variant - has alarmed global health experts due to its ability to spread easily through routine close contact, including sexual contact.

The World Health Organisation on Aug 14 declared mpox a global public health emergency for the second time in two years.

The current outbreak has seen 27,000 cases and more than 1,100 deaths since January 2023, largely among children.

Following an outbreak of the viral infection in the Democratic Republic of Congo and surrounding countries, Sweden on Aug 15 announced its first case of mpox caused by the clade I variant on Aug 15.

To date, all infections detected in Singapore have been the milder clade II infections, mostly coming during the 2022-2023 global outbreak.

Singapore has had 10 cases of mpox since January 2024, which the Ministry of Health (MOH) confirmed were from the clade II variant.

There were 32 cases here in 2023, and 18 cases in 2022 from the time reporting of the disease started at the end of June that year.

Mr Ong said when mpox spreads here, Singapore has to consider a few parameters to understand what it is dealing with.

First, there is a need to understand the virus' severity rate. Mr Ong said clade II has a fairly low fatality rate of 0.2 per cent - meaning for every 1,000 people who are infected, there are two deaths.

He added that the fatality rate of the clade I variant is about 3.5 to four per cent, while the clade 1b variant has a fatality rate of 0.7 per cent.

Mr Ong said the fatality rate should not be taken lightly. When the Covid-19 pandemic first broke, its fatality rate was four per cent before vaccinations.

He said: "Of course, these are numbers recorded from Africa... Africa has many healthcare challenges. (When mpox comes) to Singapore, with our healthcare system and our ability to treat the cases, we hope we can bring it (fatality rate) down significantly.

Second, Mr Ong said there is a need to observe who the virus affects.

He highlighted that mpox appears to affect children, adding that in Africa, where children are not vaccinated against smallpox, a "disproportionate number of children below 15" have been infected with the virus.

Lastly, there is a need to understand the virus' transmissibility and mode of transmission.

The clade II variant was mostly transmitted amongst people engaged in high-risk sexual activities, while the clade I variant spreads amongst close contacts.

Mr Ong said: "On the other hand, there's no evidence to show that it is spreading like Covid, where it can spread far and wide through airborne particles.

"You can think of it maybe a bit like chickenpox. It can spread person to person, especially those living in the same household (and) close contacts."

He said that MOH is monitoring the situation closely as mpox spreads to other countries, but added that Singaporeans should also be aware of the situation and keep themselves healthy.

"If you're healthy, you are less likely to be affected by all these diseases. It was the case for Covid as well. Likewise, it'll be the same for mpox," he added.

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MOH had said on Aug 15 that Singapore's healthcare system has the capability to effectively diagnose and manage mpox infections.

The ministry has informed all medical practitioners and healthcare institutions to be vigilant in detecting and reporting all mpox cases, including those suspected to be clade I infections.

To reduce spread, close contacts of confirmed cases will be quarantined and monitored for up to 21 days from the date of last exposure.

ALSO READ: Low risk of severe mpox variant spreading to Singapore: MOH

This article was first published in The Straits Times. Permission required for reproduction.