PRECAUTIONARY MEASURES IN PLACE TO PREVENT IMPORTATION AND SPREAD OF MPOX CLADE I

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

2. The immediate public health risk of the mpox outbreak in Africa to Singapore is assessed to be low. 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. To date, all mpox infections detected in Singapore have been the milder Clade II infections, mostly during the 2022-2023 global outbreak.

3. Singapore’s healthcare system has the capability to effectively diagnose and manage mpox infections. We have informed all medical practitioners and healthcare institutions to be vigilant in detecting and reporting all mpox cases, including those suspected of Clade I infections. To aid in early detection of cases at our borders, we require all travellers to report mpox-related symptoms (e.g. fever or rash) and travel history through the SG Arrival Card. 

4. Should suspect Clade I cases be detected, they will be isolated in hospitals. To reduce spread, close contacts of confirmed cases will be quarantined and monitored for up to 21 days from the date of last exposure.

Health Advisory

5. A general health advisory on the precautionary measures against mpox is available on the MOH website.

6. We advise travellers, especially to countries affected by mpox, to take the necessary precautions. These include:

     a) Maintaining a high standard of personal hygiene; 

     b) Avoiding direct contact with skin lesions of infected persons or animals; 

     c) Avoiding high-risk activities such as having multiple sex partners or casual sex; and 

     d) Avoiding contact with wild animals and consumption of bush meat. 

7. Returning travellers, especially from countries affected by mpox, 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.

8. MOH will continue to monitor the situation closely and ensure that our preparedness and response measures are calibrated based on the prevailing public health risk.

About mpox

9. Since 2023, there has been an increase in the number of mpox Clade I cases reported by the DRC. From July 2024, at least five other countries in the region, including those where historically mpox Clade I was not endemic, have also reported mpox cases and outbreaks¹. To date, there have been no reported cases of Clade I exported out of the African continent. 

10. Mpox virus can be spread through close contact with respiratory tract secretions, skin lesions and bodily fluids of an infected person or animal, or recently contaminated objects or environments. Symptoms of the disease include rash, fever, muscle aches, swollen lymph nodes and profound weakness.

11. Mpox Clade I, which has a recorded case fatality rate of about 3% to 4% in the DRC, has been known to cause more severe disease than the mpox Clade II virus which caused the multi-country outbreak of mpox, including in Singapore, between 2022 and 2023. Based on currently available data, individuals who are at higher risk of severe illness include young children, pregnant women or immunocompromised individuals.

¹ Countries that have reported mpox Clade I cases are Burundi, Cameroon, Central African Republic, Democratic Republic of the Congo, Gabon, Kenya, Republic of Congo, Rwanda and Uganda.