MOH: Immediate public health risk of Africa's mpox outbreak to Singapore is low

Despite the World Health Organization (WHO) declaring mpox a global public health emergency on Wednesday (14 August), the Ministry of Health (MOH) has assessed the immediate public health risk of the outbreak in Africa to Singapore as low.

In a statement issued on 15 August, MOH noted,  “While there is cross-border spread of a potentially more severe mpox clade I in parts of Central and East Africa, the outbreak has thus far remained within the African continent, with no reported cases of clade I exported out of the African continent.”

Since January 2024, Singapore has reported 10 cases of mpox, all confirmed to be the milder clade II form of the virus.

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

In 2023, Singapore recorded 32 cases, and there were 18 cases in 2022, starting from the time the disease was first reported in late June of that year.

"To date, all mpox infections detected in Singapore have been the milder Clade II infections, mostly during the 2022-2023 global outbreak," said MOH.

MOH assured that Singapore’s healthcare system has the capability to effectively diagnose and manage mpox infections.

Global health experts have been alarmed by the new, more dangerous Ib sub-variant of the clade I strain, which spreads easily through routine close contact, including sexual contact.

This concern led the WHO to declare mpox a global public health emergency on 14 August for the second time in two years.

The WHO's multi-country outbreak report indicates a significant rise in mpox cases and outbreaks across countries in the WHO African region in recent weeks.

While most cases are concentrated in the Democratic Republic of the Congo (DRC), bordering countries are also affected. Burundi, Kenya, Rwanda, and Uganda have reported their first mpox cases due to clade Ib.

In the DRC, children, who make up over 70% of cases and 85% of deaths, are particularly vulnerable due to high rates of malnutrition.

Sweden Reports First Imported Mpox Clade 1 Variant Case Outside Africa

On 15 August, the WHO warned of the likelihood of further imported cases of this new strain in Europe, following Sweden's report of the first such infection outside Africa.

Sweden’s Public Health Agency reported a case of the Clade 1b subclade of mpox, the same new strain that has surged in the DRC since September 2023.

“A person who sought care at Region Stockholm has been diagnosed with mpox caused by the clade I variant. It is the first case caused by clade I to be diagnosed outside the African continent,” the agency said in a statement.

The patient contracted the virus during a visit to an area in Africa experiencing a major outbreak of Clade 1, as noted by state epidemiologist Magnus Gisslen.

The agency added: “The fact that a patient with mpox is treated in the country does not affect the risk to the general population, a risk that the European Centre for Disease Prevention and Control (ECDC) currently considers very low.”

The WHO’s European regional office in Copenhagen stated that it is working with Sweden to manage the newly detected mpox Clade 1 case.

The office noted, “The confirmation of mpox Clade 1 in Sweden is a clear reflection of the interconnectedness of our world.”

“There are likely to be further imported cases of Clade 1 in the European region over the coming days and weeks, and it is imperative that we don’t stigmatise travellers or countries/regions.”

“Travel restrictions and border closures don’t work and should be avoided,” it added.