Health Advisory for Travellers

Health advisory for travellers to countries affected by mpox Clade I

Since 2023, there has been an increase in the number of mpox Clade I cases reported by the Democratic Republic of the Congo (DRC). From July 2024, other countries in the African region, including those where historically mpox Clade I was not endemic, have also reported mpox cases and outbreaks. While there is cross-border spread of mpox Clade I in parts of Central and East Africa, the Clade I outbreak has thus far largely remained within the African continent. Outside of Africa, mpox Clade I has only been detected in Sweden, Thailand, India and Germany which have each reported one case in travellers since August 2024, but which have not led to further local spread.

On 14 August 2024, the World Health Organization (WHO) has declared that the ongoing mpox outbreak in the Democratic Republic of the Congo (DRC) and the growing number of countries in Africa constitutes a Public Health Emergency of International Concern (PHEIC). This follows the Africa Centres for Disease Control and Prevention’s declaration of a Public Health Emergency of Continental Security on 13 Aug 2024.

Mpox Clade I has been known to cause more severe disease than the mpox Clade II virus which caused the multi-country outbreak of mpox between 2022 and 2023.

Travellers to affected countries are advised to adopt precautionary measures against mpox. Returning travellers should seek immediate medical attention if they develop symptoms (e.g. fever or rash) within 21 days of their return. They should inform their doctor of their recent travel and exposure history.

For more information, please refer to the MOH webpage on mpox.

Health advisory for all travellers

The Ministry of Health would also like to advise all travellers visiting any country to be vigilant and to adopt the following precautions, where relevant.

Before trip:

• Visit your doctor four to six weeks before your trip for a travel health risk assessment, including advice on vaccinations¹ required or prophylaxis recommended prior to travel.

• Please take note of our yellow fever vaccination requirement to enter Singapore if you will be travelling to a country at risk for yellow fever. Refer to the MOH webpage on yellow fever for more information.

• Keep up-to-date with the recommended vaccinations and boosters in the National Adult Immunisation Schedule (NAIS) or National Childhood Immunisation Schedule (NCIS).

• Check and be aware of the health situation and entry requirements for your destination country. Some countries may require proof of vaccination for diseases such as yellow fever, meningococcal etc., before you are allowed entry.

¹ For Mpox Clade I, there is currently no vaccination recommendation for travellers to affected countries.

During trip:

• Observe and practise good personal hygiene at all times.

• Wash your hands regularly with soap, especially before handling food or eating, after going to the toilet, or when hands are dirty from coughing or sneezing. If water is not available, use an alcohol-based hand sanitiser that contains at least 60% alcohol.

• Avoid close contact and sharing common items with persons who are unwell or have symptoms of infectious diseases.

• Cover your mouth with a tissue when coughing or sneezing, and dispose the soiled tissue into the bin immediately. Avoid touching your face, including eyes, nose and mouth with unwashed hands after coughing or sneezing.

• Eat food that have been fully cooked and wash fruits and vegetables before eating them. Avoid eating raw or undercooked meat and seafood, milk/milk products, and food prepared in unhygienic conditions.

• Drink boiled water or water from sealed bottles.

• Protect yourself from insect bites by using effective insect repellent (e.g. those containing DEET, Picaridin or IR3535 as the active ingredient), wearing long-sleeved clothes and long pants outdoors, and sleeping in an air-conditioned or insect-screened room, or under an insecticide-treated bed net.

• Avoid feeding or touching animals, especially stray or wild animals.

• Avoid high-risk sexual activities such as having multiple sex partners or engaging in casual sex.

After trip:

• Wear a mask and seek medical attention promptly if you become unwell or develop respiratory symptoms such as cough or runny nose, and inform the doctor of your travel or exposure history.