The Ministry of Health would like to provide an update on the multi-country Monkeypox outbreak reported recently in the media. On July 23, the Director-General of the World Health Organization declared the outbreak of Monkeypox a Public Health Emergency of International Concern (PHEIC).
A PHEIC is defined as “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”.
This is the first time that many Monkeypox cases and clusters have been reported concurrently across a wide geographic area, including in countries without any history of Monkeypox.
Worldwide
Between 1 January and 22 July 2022, 16 016 laboratory confirmed cases of Monkeypox have been reported to WHO from 75 countries/territories/areas in all six WHO Regions. Five deaths have been reported, all from the African Region.
The majority of the 11,104 cases reported in the past four weeks were from Europe (72%) and the Americas (26%).
Pacific Region
As of 22 July 2022, there have been 41 cases of confirmed or probable Monkeypox in Australia. This includes 22 in New South Wales, 15 in Victoria, 2 in the Australian Capital Territory, 1 in South Australia and 1 in Queensland. The risk of community transmission remains low and contact tracing in ongoing.
New Zealand health authorities have confirmed 2 Monkeypox cases, both of which are in confirmed travellers with no link to each other.
New Caledonia confirmed their first case of Monkeypox on 12 July in an individual who had returned from Metropolitan France. There have been no cases of Monkeypox confirmed in Fiji as all suspected cases have tested negative so far.
The overall risk of Monkeypox across the Western Pacific Region has been assessed as low to moderate, based on disease severity, importation risk, and transmission risk in the region.
Implications for Vanuatu
The Ministry of Health is closely monitoring the global and regional situation. It is highly likely that other, as yet unaffected countries will also identify cases in the coming weeks given the spread of cases to date. Further cases are expected in affected countries across a range of population groups. Therefore, it is important to prepare for cases of Monkeypox in Vanuatu.
While there are still many unknowns in relation to the current Monkeypox outbreak, temporary recommendations issued by WHO of relevance to Vanuatu focus on: ensuring readiness for response actions across sectors; increasing awareness of signs and symptoms and detection capacity; promoting reporting and care seeking behaviour; facilitating timely access to quality clinical care; and protect the human rights, privacy and dignity of affected individuals and their contacts. While transmission and treatment differ from COVID-19 and there is no vaccine available for Monkeypox, human resources and systems capacity built throughout the COVID-19 pandemic will certainly assist in addressing this new infectious disease challenge.
The Ministry of Health are taking action to ensure staff at health facilities across the country are on the alert for patients that may present with symptoms of Monkeypox. Surveillance systems are being strengthened for rapid detection of Monkeypox and other infectious diseases.
Transmission and symptoms
Monkeypox has previously occurred mostly in tropical rainforest areas of Central and West Africa, and has occasionally been exported to other regions. Monkeypox is caused by the monkeypox virus, which is related to the now eradicated smallpox virus.
Anyone can catch Monkeypox especially if they have travelled to countries with cases. Monkeypox virus is transmitted through close contact with lesions, bodily fluids, respiratory droplets of an infected person or animal, or with material contaminated with the virus such as bedding.
The time from infection to onset of symptoms of Monkeypox is usually 6 to 13 days but can range from 5 to 21 days.
The typical feature of Monkeypox is a rash with blisters on face, hand, mouth and genital. A genital and peri-anal rash has been mostly reported linked to the current outbreak. The symptoms also include:
- Fever
- Feeling of discomfort or illness
- Swollen lymph nodes.
- Headache
- Tiredness, fatigue
Monkeypox is less contagious than smallpox and causes less severe illness. It is usually a self-limited disease, most people recovered without specific treatment, with symptoms lasting from 2 to 4 weeks. Medical complications can occur, such as:
- Secondary infections
- Bronchopneumonia
- Sepsis
- Encephalitis
- Eye infection with loss of vision
Based on current available information for this outbreak, cases have mainly but not exclusively been identified amongst men who have sex with men (MSM) seeking care in primary care and sexual health clinics.
Prevention and treatment
Prevention and control of human Monkeypox rely on raising awareness in communities and educating health workers to prevent infection and stop transmission.
Close contact with infected people or contaminated materials should be avoided. Gloves and other personal protective clothing and equipment should be worn while taking care of the sick, whether in a health facility or in the home.
Monkeypox symptoms often resolve on their own without the need for treatment. Treatment of Monkeypox patients is supportive dependent on the symptoms. It is important to take care of the rash by letting it dry if possible or covering it with a moist dressing to protect the area if needed. Avoid touching any sores in the mouth or eyes.
Actions
Vanuatu currently has no cases of Monkeypox. However, those with recent travel history to countries with Monkeypox and those they have been in contact with are urged to be particularly vigilant for symptoms.
If you think you may be infected with Monkeypox, seek urgent medical assistance. Go to your nearest health facility.
The Ministry of Health will provide further updates on Monkeypox if needed, as the situation evolves.