Text by: Charmaine A. Lingdas
#SDG3 #SDG4 #SDG17
The 207th episode of the Health Updates webinar series, titled “Mpox Facts: Should the Philippines Be Concerned?” focused on the resurgence of the monkeypox (Mpox) virus. The virus, also abbreviated as MPXV, has recently drawn significant global attention due to its resurgence and widespread spread. The World Health Organization (WHO) has declared the ongoing outbreak a Public Health Emergency of International Concern (PHEIC), emphasizing the urgent need for a coordinated international response and enhanced surveillance efforts. In 2024, the Philippines reported its first MPXV case, highlighting the virus’s global reach and the potential for local transmission. This resurgence underscores the critical importance of heightened awareness, timely diagnosis, and effective prevention strategies among healthcare providers, and hence elicited the importance of it being the topic of the Health Updates series.
The first speaker was Dr. Joseph Adrian Buensalido, an infectious disease specialist from the Philippine General Hospital, Department of Medicine, who provided an in-depth presentation titled “Mpox Facts: Mas Mahina Po Ito!” which delved into the history, transmission, and management of Mpox.
Overview, Transmission, and Clinical Presentation
Dr. Buensalido traced the origins of monkeypox, noting its discovery in the 1950s in Scandinavia. Its first human case was in the 1970s in the Republic of Congo, and is currently spreading from Africa to other parts of the world, including the Philippines.
He clarified the distinction between the two clades of the virus: Clade I (Central African) and Clade II (West African), the latter being less severe but still a concern due to its potential for local transmission. “Most of what we have is the West African clade, which is less contagious and has a lower risk of death,” he stated.
“Basically, rats, mice, squirrels, and other rodents are the ones that can transmit it to us.” He elaborated that Mpox is a zoonotic viral disease primarily transmitted from animals to humans. He noted that factors like deforestation, civil unrest, and poverty increase the risk of transmission by forcing animals and humans into closer contact. Climate change also disrupts natural habitats, leading to more human-animal interactions. “Additionally, the cessation of smallpox vaccination has reduced immunity in the population, as smallpox was in the same family as other related viruses, offering some protection in the past,” he added.
Dr. Buensalido explained that Mpox can also spread through human-to-human contact, especially through respiratory droplets, skin lesions, and contaminated materials. He described the progression of the disease, from the asymptomatic incubation period to the fever phase and finally, the characteristic rash that can last up to four weeks.
He explained that Mpox typically presents with an incubation period of 5 to 21 days, during which the infected individual shows no symptoms. This is followed by a fever phase lasting 1 to 4 days, characterized by fever, headache, chills, sore throat, and swollen lymph nodes. The most distinctive feature of Mpox is the rash, which usually begins on the face and extremities and can last for 2 to 4 weeks.
Dr. Buensalido emphasized that the Mpox rash progresses through several stages, starting as flat lesions (macules) that evolve into raised bumps (papules), then fluid-filled blisters (vesicles), and eventually pus-filled lesions (pustules) before crusting over and healing.
He also emphasized the importance of differentiating Mpox from other viral diseases like chickenpox and measles, particularly by observing the distribution and appearance of the rash. “Mpox rashes are more concentrated on the face and extremities, unlike chickenpox, which primarily affects the trunk,” he noted.
He added that a characteristic feature of the vesicles in Mpox is the central depression, or ‘umbilication.’ Mpox lesions tend to be at the same stage of development across the body, and the rash is often more concentrated on the face and limbs rather than the trunk. These symptoms, along with the swelling of lymph nodes, are key indicators that healthcare providers should watch for when diagnosing Mpox.
In addition to the skin manifestations, Dr. Buensalido highlighted that 1-5% of Mpox cases can also affect the eyes, leading to serious complications such as blepharitis (inflammation of the eyelids), conjunctivitis (redness and swelling of the eye), keratitis (inflammation of the cornea), and even corneal ulcers.
Practical Guidelines and Prevention
Dr. Jemelyn U. Garcia, Medical Specialist II from the Research Institute for Tropical Medicine (RITM), provided critical insights into the practical guidelines for preventing and managing Mpox. She detailed the presentation of recent cases in the Philippines, noting that patients exhibited symptoms such as rashes on the face, limbs, and genital areas, often linked to sexual activity. The rashes often started in specific areas like the groin before spreading to other parts of the body, including the arms, legs, and face.
For those who have been exposed to suspected or confirmed Mpox cases but are asymptomatic, Dr. Garcia recommended a 21-day self-monitoring period, starting from the last day of contact with the infected person. During this period, individuals should be vigilant for any signs or symptoms, such as fever or the development of a rash. If symptoms arise, immediate isolation and medical consultation are crucial.
Dr. Garcia emphasized the importance of remote consultations to reduce the risk of spreading the virus: “Take good pictures of any rashes and be prepared to discuss your symptoms in detail during your teleconsultation.”
She provided additional practical tips for those who might be at risk:
For those needing to send specimens for testing, Dr. Garcia pointed to the RITM guidelines on proper specimen collection, storage, and transport. The guidelines can be accessed on the RITM website, ensuring that healthcare workers follow the correct procedures for handling potential Mpox samples.
Future Implications
In the Q&A session, the panel addressed concerns about the potential spread of the more severe Clade I of the virus. Dr. Buensalido reassured the audience: “Even if Clade I enters the country, it is not as contagious as other viruses like measles or COVID-19. It requires prolonged contact for transmission, so widespread outbreaks are less likely.”
The webinar concluded with a call to action, urging the public to remain vigilant and informed. Dr. Susan Mercado, host of the program, praised the clarity and depth of the presentations, stating, “This virus is not as infectious as COVID-19, but we must continue to spread awareness and take preventive measures.”
As Mpox continues to pose a global health challenge, the insights shared in this webinar are crucial for understanding and managing the risks associated with this re-emerging disease.#
