Monkeypox outbreak: South Korea, Singapore confirm first cases


Singapore has reported the first confirmed case of monkey pox in Southeast Asia during this year’s outbreak – while another confirmed case was found in South Korea.

The case in Singapore concerns a Briton who was in the city-state between June 15 and 17. He tested positive for monkeypox on Monday after developing rashes and a headache and fever last week.

“During that time, he had mostly stayed in his hotel room, except to visit a massage facility and eat at three restaurants on June 16,” Singapore’s Health Ministry said on Tuesday.

Thirteen of the man’s close contacts have been identified and contact tracing is ongoing, the ministry said, adding that the man is being treated at the National Center for Infectious Diseases.

The case in South Korea involves a South Korean citizen who reported to the Korea Disease Control and Prevention Agency after returning from Germany on Wednesday. The KCDA said the South Korean – who is now being treated at a facility in Seoul – reported a headache before the flight and developed a fever, sore throat, fatigue and skin lesions on arrival in the country.

Meanwhile, South Korea said it was also investigating a second suspected case involving a foreign national who entered the country on Monday and was taken to a hospital in the city of Busan after developing symptoms and a blistering skin lesion.

Monkeypox, considered a less severe cousin of smallpox, has an incubation period of seven to 14 days, according to the Centers for Disease Control and Prevention (CDC).

Initial symptoms are typically flu-like, such as fever, chills, fatigue, headache, and muscle weakness, followed by swelling in the lymph nodes, which help the body fight infection and disease.

The disease later progresses to a rash and lesions that may blister and scab all over the body—usually two to four weeks.

The virus has been circulating for decades in some places, including parts of West and Central Africa.

But the current outbreak has reported more than 2,500 cases in dozens of countries where the disease was not considered endemic — including Australia, which reported its first case on May 20, and the United States, where the CDC reported more on Friday had more than 110 confirmed cases.

The World Health Organization (WHO) recently said it would remove the distinction between endemic and non-endemic nations to reflect a “uniform response”.

“The unexpected occurrence of monkeypox in several regions in the initial absence of epidemiological links to areas where monkeypox has been reported in the past suggests that there may have been undetected transmission for some time,” the WHO said in a recent published update.

A microscopic image of mature, oval-shaped monkeypox virions (left) and spherical immature virions (right) obtained from a human skin sample.

Singapore last detected a case of monkeypox in a 38-year-old man from Nigeria in 2019 who had traveled to the city-state to attend a wedding.

“Monkeypox is not a new disease, so we actually know quite a bit about the disease and the virus [which] has been around for a while,” said Khoo Yoong Khean, a physician and research fellow at the Duke-NUS Center for Outbreak Preparedness in Singapore.

“But there is a shift in the way the disease circulates and spreads in this current outbreak… [and] this appears to be an evolving situation.”

Khoo said lessons learned from the Covid-19 pandemic could be applied to any potential monkeypox outbreak in the region.

“It is advisable that countries pay attention to this. We have many tools that we used for Covid-19 that will come in handy now: contract tracking methods, quarantine protocols and even a mass immunization strategy if needed.

“While I don’t think we need to be overly concerned about the global situation and we may be in a better place now, as we know, disease outbreaks are never predictable. We could see monkeypox surprises in the near future, so we need to keep strengthening our health and surveillance systems, working with other countries, and making better decisions than [we did] during the Covid pandemic.”