2022–2023 mpox outbreak in the philippines 2022–2023 mpox outbreak in the philippines the 2022–2023 mpox outbreak in the philippines is a part of the larger global outbreak of human mpox caused by the west african clade of the monkeypox virus. the outbreak was first reported in the philippines when a suspected case was confirmed on july 28, 2022 according to the department of health. 2022–2023 mpox outbreak in the philippinesdiseasehuman mpoxvirus strainmonkeypox virus (mpv), clade ii, 2017–2019 outbreak subcladelocationphilippinesfirst reportedjuly 28, 2022datejuly 28, 2022 – ongoing (9 months and 15 days)confirmed cases4recovered4deaths0 background these paragraphs are an excerpt from mpox and 2022–2023 mpox outbreak. mpox (pronounced /ˈɛmpɒks/ em-poks, formerly known as monkeypox) is an infectious viral disease that can occur in humans and some other animals. symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. the time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. there may be mild symptoms, and it may occur without any symptoms being apparent. cases may be severe, especially in children, pregnant women or people with suppressed immune systems. the disease is caused by the monkeypox virus, a zoonotic virus in the genus orthopoxvirus. the variola virus, the causative agent of smallpox, is also in this genus. of the two types (called "clades") in humans, clade ii (formerly west african clade) causes a less severe disease than the central african (congo basin) type. it may spread from infected animals by handling infected meat or via bites or scratches. human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route. people can spread the virus from the onset of symptoms until all the lesions have scabbed and fallen off; with some evidence of spread for more than a week after lesions have crusted. diagnosis can be confirmed by testing a lesion for the virus's dna. there is no known cure. a study in 1988 found that the smallpox vaccine was around 85% protective in preventing infection in close contacts and in lessening the severity of the disease. a newer smallpox and mpox vaccine based on modified vaccinia ankara has been approved, but with limited availability. other measures include regular hand washing and avoiding sick people and animals. antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin and the smallpox vaccine may be used during outbreaks. the illness is usually mild and most of those infected will recover within a few weeks without treatment. estimates of the risk of death vary from 1% to 10%, although few deaths as a consequence of mpox have been recorded since 2017. history mpox cases in the philippines () deaths confirmed casesjuljulaugauglast 15 dayslast 15 days datecases (rise)deaths (rise) 2022-07-281(n.a.) ⋮ 2022-08-182(n.a.) 2022-08-194(+2) arrival the first case of human mpox in the philippines was confirmed on july 28, 2022. the case involved a 31-year-old filipino national who arrived from abroad to the philippines on july 19, 2022. he also had prior travel to countries with documented mpox cases. the individual's mpox infection was confirmed through a reverse transcription–polymerase chain reaction (rt-pcr) test at the research institute for tropical medicine in muntinlupa which yielded a positive result on july 28, 2022. the patient had already recovered at the time of the health department's announcement but is undergoing isolation at home. ten other people, including three people from the individual's household were identified as close contacts. on august 6, 2022, the patient was discharged after undergoing the 21-day quarantine isolation to which no other person was infected according to the department of health (doh). other close contacts tested negative too though they are still required to complete their 21 days of quarantine. further cases on august 19, 2022, the doh announced the detection of two more cases; those of a 34-year-old and a 29-year-old both of which has a history of travel abroad. the 34-year-old patient is undergoing home isolation and the 29-year-old patient is in isolation at a health facility. contract tracing was conducted for both with the latter having 17 identified contacts. the pcr test conducted for both individuals returned positive results on august 18 and 19 respectively. all three cases at that time are unrelated to each other as they entered the philippines from different countries and the doh considered these cases as "imported" cases. they have exhibited typical symptoms associated with mpox like lesions on their faces and other parts of their bodies. doh technical advisory group (tag) member dr. edsel salvana says he expects more cases to be detected but allayed concerns of a local transmission or the disease becoming endemic in the country. he points out that mpox is less contagious than covid-19 and that protocols in place for the covid-19 pandemic is also mitigating the spread of mpox. on august 22, the doh announced that the country has detected its fourth case that of a 25-year-old filipino who have no travel history outside the country. the individual's pcr test returned a positive result on august 19. the health department also stated that the fourth case is not related to the previous three. the following day the health department's western visayas regional office, released further details regarding the patient confined in a hospital; a male who works in iloilo city and resides in iloilo province. iloilo city mayor jerry treñas in an interview with local radio stations said that the indicidual worked in a fast food chain in the city and added that he had a relative who recently came in from abroad. the doh also asked the western visayas regional office to investigate the photos of the patient shared on social media as early as august 22 deeming such act as an unauthorized disclosure of private and confidential information. the second case was deemed recovered on august 31 while the third case was considered the same on september 8. the fourth case was discharged from the hospital on september 15 and is deemed to have recovered. related cases abroad on september 5, 2022, the first ever case of mpox in hong kong was detected from a passenger who arrived from a flight from manila. the individual concerned is a 30-year old hong konger. response on may 24, 2022, the doh expressed readiness to detect and contain mpox if it reaches the philippines. it has classified mpox as a notifiable disease requiring health facilities in the country to report all patients under investigation and cases to its epidemiology bureau (eb) and regional epidemiology surveillance unit. it also announced that all suspected cases are to undergo reverse transcription–polymerase chain reaction (rt-pcr) tests for mpox. by june 20, 2022, the research institute for tropical medicine in muntinlupa announced that it has optimized its real-time polymerase chain reaction (pcr) assay for the detection of monkeypox virus. as of july 2022, the ritm and the philippine genome center in quezon city are the only institutions in the philippines capable of detecting mpox through rt-pcr tests. the doh has aimed to expand capacity and capability to other institutional hospitals as well. ninoy aquino international airport and several national airports ramped up their surveillance to detect the virus. in an explicit statement on august 2, 2022, doh officer in charge maria rosario vergeire said that borders and foreign entry are not to be shut down whilst not yet receiving recommendations from the world health organization (who). furthermore, it was affirmed that the opening of classes and universities will still resume on august 22 accordingly along with the cooperation of deped and local lgus. the doh has also entered negotiations with the united states government in a bid to secure mpox vaccines for a limited demographic. along with the who, the doh has been proactively monitoring cases and revamping medical facilities in the country. upon the detection of the first case, the private hospitals association of the philippines inc. released a statement advising against home isolation for further suspected mpox cases. notes date when the monkepox infection of the index case was confirmed through a positive test. the individual involved arrive in the country on july 19, 2022. the first case was announced publicly by the department of health on july 29, 2022. the patient was already tagged as recovered by the time of the announcement though still undergoing mandatory quarantine. the world health organization (the authority on disease names) announced the new name "mpox" in november 2022. but virus naming is the responsibility of the international committee on the taxonomy of viruses (ictv), who are currently reviewing all orthopoxvirus species. as of march 2023, the official name of the virus remains "monkeypox virus".