Singapore’s first case of monkeypox infection has been confirmed by Singapore authorities, imported by a 38-year-old Nigerian who arrived on 28 April 2019 and tested positive for the virus on 8 May 2019. The man is suspected to have contracted the rare virus from eating bush meat at a wedding in Nigeria before flying to Singapore. Based on Ministry of Health of Singapore investigation and contact tracing thus far, 23 persons have been identified as close contacts of the patients, of whom five are Singapore residents.

Potential of Transmission

Monkeypox can be spread though close contact with the blood, bodily fluids or lesions of infected animals such as rodents and monkeys. The virus can also be contracted by eating meat of such animals that was improperly cooked. Human-to-human transmission Is possible through close contact with an infected person or with objects recently contaminated by their bodily fluids. Symptoms include lesions, fever, muscle ache, swollen lymph nodes and chills. According to the US Centers for Diseases Control and Prevention, outside Africa, monkeypox infections have only been reported in the United States, Britain and Israel.

Response from the Government of Indonesia

Batam, about an hour’s ferry ride from Singapore, is taking steps to prevent a potential monkeypox outbreak after Singapore reported its first case of the rare virus. Indonesian authorities have readied two hospitals, namely the Batam Free Trade Zone Hospital and Embung Fatimah Public Hospital, as the main treatment centres for suspected monkeypox patients. Thermal detectors have also been set up at five international ports connecting Singapore and Batam.

In response to the potential contagion, the government has conducted the following efforts:

  1. The ministry of Health has issued circular letter of the transmission alertness to provincial and district health offices, port health offices, hospitals, and primary health centres across countries.
  2. Providing risk communication to mass media to educate and inform public how to prevent themselves from the infection.
  3. Providing public health emergency operation center ready for 24 hours to respond to any report from the public regarding monkeypox cases.

Suggested Preventive actions

  1. Avoid contact with animals that could harbor the virus (including animals that are sick or that have been found dead in areas where monkeypox occurs)
  2. Avoid contact with any materials, such as bedding, that has been in contact with a sick animal.
  3. Isolate infected patients from others who could be at risk for infection.
  4. Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer.
  5. Use personal protective equipment (PPE) when caring for patients.

Travellers with symptoms on board a conveyance

There is a possibility that a person who has been exposed to Monkeypox virus and developed symptoms may board a commercial flight or other mode of transport, without informing the transport company of his/her status. Such travellers should inform the crew about their symptoms and recent travel history, so that necessary arrangements can be made for medical assistance upon arrival, and further transmission can be prevented. Information of close contacts of this person on board aircraft (e.g. passengers one seat away from ill traveller on the same flight including across an aisle, and crew who report direct body contact with the ill traveller) should be obtained through collaboration with various stakeholders at points of entry (e.g. airline reservation system) in order to undergo contact tracing.