Vulnerable sectors at 'high risk' of contracting monkeypox: expert

Gillan Ropero, ABS-CBN News

Posted at Jul 19 2022 02:41 PM

MANILA - Immunocompromised persons, children, pregnant women, and the elderly are at high risk of contracting monkeypox, an infectious disease expert said Tuesday.

The overall risk of the general population contracting monkeypox is "considered low," according to Dr. Rontgene Solante, head of adult infectious diseases at the San Lazaro Hospital.

Since January 1 this year, a total of 7,892 monkeypox cases have been reported in non-endemic countries, Solante said, citing data from the World Health Organization.

The Philippines has yet to detect a case of the monkeypox virus. The Department of Health earlier said it was ready to contain it.

Some 78 percent of the cases were males ages 18 to 44, according to data as of July 9. Around 98 percent of the overall cases were identified as men who have sex with men, of which 41 percent were living with HIV.

The recent spread of monkeypox came with atypical presentations versus its original, Solante said. Patients in non-endemic regions presented with lesions first instead of fever and body malaise, and some had fewer or even just a single lesion instead of an eruption of rashes, Solante added.

Cases in non-endemic countries also presented lesions genital or perineal area, he said.

"It’s difficult to really explain why they present atypical presentations. Is it because they're immunocompromised, member of the HIV population, or is it because the behavior of the virus is different in this group of patients?" he said in a media forum organized by the Philippine College of Physicians.

"That's why the high index of suspicion is important. The challenge now among non-endemic countries, how will you be able to tell...Access to testing is also very important."

A case is confirmed through RT-PCR testing, while in some countries an antigen test can also be used, the expert said.

The virus spread in endemic countries through animal-to-human contact, as residents are fond of hunting and handling animals infected with the disease, according to Solante.

The recent outbreak also spread via human-to-human contact or through persons who have had multiple sexual partners, Solante said. 

Further research is needed to clarify whether monkeypox can be transmitted sexually through genital fluids rather than via contact with skin lesions, droplets, or fomites, he added.

The monkeypox virus' incubation period usually takes 5 to 21 days, and is febrile for 1 to 4 days, when it is highly infectious, Solante said. The rashes will be visible for 2 to 4 weeks, and the recovery can take "days to weeks," he added.

There is no specific treatment for monkeypox and it's "mainly supportive, directed at relieving symptoms such as fever, body malaise, and exhaustion," according to the expert.

"If you're exposed, wash your hands, always wear your face mask. In any case you have a patient with fever and rashes, always observe contact and respiratory precaution," he told doctors.

Those who contracted the virus can have sexual intercourse following their recovery but must wear protection, he added.

There is also no specific vaccine for monkeypox but smallpox vaccine can be used to prevent infection, Solante said. Supplies of these are limited and mostly used on health workers and frontline workers exposed to the virus, he added.


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