Dr. Regina P. Berba, chair of the PGH Infection Control Unit, shared how PGH is preparing for monkeypox cases and provided some insights into how it can be controlled within hospitals during  the Stop COVID Deaths Webinar #111 “MONKEYPOX, NANDITO NA: Are We Ready?” held on August 5, 2022. 

Organized by the University of the Philippines TV UP and UP Manila National Institutes of Health’s National Telehealth Center, the webinar was held in response to the detection of the first case of monkeypox in the country. It took an in-depth look at the monkeypox infection and how to prevent, diagnose, treat, and manage patients with monkeypox and protect our health workers from getting infected.

“The number of monkeypox cases confirmed in the Philippines is only one. We call it an outbreak because monkeypox is not present/endemic in PH,” said Dr. Regina Berba. She stressed there is a memorandum from the Department of Health that guides us on how the response should be. She asserted that the response should identify the cases efficiently, reduce new cases, reduce confusion, reduce stigma, and protect the health care workers.

Dr. Berba explained that the Philippines follows the international case definitions. A suspected case is a person of any age with unexplained acute rash with any one of the following: headache, fever, myalgia, lymphadenopathy, and no other disease to explain the rash. The probable case is when there is an epidemiologic link, which means there was face-to-face exposure or healthcare worker exposure to monkeypox, travel to monkeypox-endemic countries in the past 21 days, or has a history of multiple sexual partners in the last 21 days. To confirm, specimens will be sent to the Research Institute of Tropical Medicine (RITM) for PCR test. Those who are suspected and then eventually found to be negative are called discarded cases. 

“I think it’s very important to figure out who among your patients are at risk to get monkeypox and where they will most likely go in your facility,” discussed Dr Berba. She added that in PGH, there is a large community of persons living with HIV and Men having Sex with Men (MSM) community that need to be informed. She identified infectious disease experts, dermatologists, and urologists as some of the healthcare workers who  may have to manage suspect or probable cases of monkeypox.

Dr. Berba also mentioned other important points to consider such as identifying the things needed for the diagnosis including the PPE, setting up an ambulance system or a courier system that will bring the samples to RITM for diagnosis, identifying the isolation area within the facility, and identifying who is going to do the swab and collect the specimen. She added it’s good if facilities have a checklist or a monkeypox case investigation form ready that will help the healthcare personnel in screening patients.

She stated that since not all monkeypox patients need to be admitted, it is important to determine how the patient can be safely discharged and followed up during home quarantine. In this case, she indicated the use of telehealth in the management of patients with monkeypox.

For MSM, she recommended to get the contact details of any new sexual partner. If the partner has monkeypox,  he should avoid sex,  kissing, holding hands, and sharing of towels. Wash hands and clean all the stuff that the patient uses, and avoid touching the rash.

“It’s important that the World Health Organization declare monkeypox a public health emergency of international concern because this gives us a window of opportunity to learn as much as we can and protect each other, even those who are at risk of the illness and reduce the number of cases in our country,” Dr. Berba said.

She stressed that it is important to provide relevant information to prevent the spread of monkeypox, and to educate the public since the lesion may make people afraid and stigmatize other groups.

Charmaine Lingdas