Monkeypox in Malaysia

As Malaysia’s battle with the SARS‐CoV‐2 enters its endemic phase — tension rises once again as a new ‘Monkeypox’ outbreak has been declared a global health emergency by the World Health Organization. According to the Ministry of Health, Malaysia — Monkeypox is a rare zoonotic viral disease caused by the monkeypox virus that belongs to the Orthopoxvirus genus of the Poxvindae family, which also include smallpox, vaccinia, cowpox, camelpox, ectromelia (mousepox) and other viruses. After smallpox eradication in 1980 and consequent to the cessation of smallpox vaccination, monkeypox emerged as the most prevalent orthopoxvirus infection in humans. The name Monkeypox is a bit of a misnomer because the suspected main reservoir is smaller animals, such as rodents. It was first found in laboratory monkeys in the late 1950s. However, scientists aren’t sure if monkeys are the main animal carriers of the virus. [1]

In other parts of the world, Monkeypox has been reported in the tropical rainforest regions of Central and West Africa. It is considered endemic in Democratic Republic of Congo (DRC), with more than 1,000 suspected cases per year since 2005. Nigeria reported a large multistate outbreak in 2017 to 2018.

The monkeypox virus is transmitted to humans through a bite or direct contact with an infected animal’s blood, body fluids or lesions. Human to human transmission is rare and likely to occur by close contact with the maculopapular rash of infected persons or airborne routes. The incubation period is usually 7 to 14 days and it typically lasts for 2 to 4 weeks. It is characterized by fever, myalgia, headache, lymphadenopathy and rash which first starts on the face and spreads to the arms and legs, then to the hands and feet, including the palms and soles — typically within 24 hours. [1]

Monkeypox rash in a four-year-old girl (1971)

In Malaysia, there have been no detected cases as of today. Nine suspected cases were reported, but all were later confirmed to be negative on the 25th of July. One case of monkeypox involving a Malaysian residing in Singapore was reported and confirmed on the 3rd of August as he was traveling from Johor Bahru to Penang and back — which was when he had started to exhibit symptoms. According to Health Minister Khairy Jamaluddin — “The ministry has conducted an investigation and the individual voluntarily informed us of his close contacts. So far, 15 close contacts have been identified, 14 of whom are casual contacts who are at low risk of getting monkeypox infection because they are asymptomatic.” [2] Additionally, about five suspected monkeypox cases were reported in Malaysia earlier this month but none of them were confirmed.

Though it is evident that the risk of its spread in Malaysia is very low due to the limited human-to-human transmission, here are some protective steps recommended by the Centers for Disease Control and Prevention (CDC) in preventing monkeypox [3]:

Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox

  • Do not touch the rash or scabs of a person with monkeypox
  • Do not kiss, hug, cuddle or have sex with someone with monkeypox

Avoid contact with objects and materials that a person with monkeypox has used

  • Do not share eating utensils or cups with a person with monkeypox
  • Do not handle or touch the bedding, towels, or clothing of a person with monkeypox

Wash your hands often

  • Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom

We must all keep in mind that prevention is always better than cure. Even in those instances, if you or your loved ones seem to develop any of the listed symptoms, do seek medical attention immediately and self-quarantine yourself for at least 21 days to observe the severity of your symptoms. Travelers to endemic countries must absolutely refrain contact with sick, dead or alive rodents and marsupials as well as avoid eating or handling bush meat (raw or minimally processed meat that comes from wild animals in certain regions of the world including Africa)





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