Jigmi Wangdi
After the World Health Organisation (WHO) declared mpox as a public health emergency of international concern (PHEIC) on August 14, the Ministry of Health (MoH) has been vigilant. It has been taking precautionary measures to handle any cases that might reach Bhutan.
In the WHO South-East Asia Region, Pakistan reported three cases on August 16 and one case on August 19. The cases reported were the Clade 2 variant of the virus. Similarly, Thailand detected one mpox case with a travel history to Africa on August 21.
The variants of mpox are classified into Clade 1 and Clade 2, based on genetic differences. The variant from the recent outbreak is categorised as Clade 1b, according to officials from MoH.
The mpox preparedness report by the MoH highlighted that the Clade 1b variant is reported to be deadlier and more easily transmitted from person to person.
The report shared that identifying mpox is difficult as other infections and conditions tend to look similar.
“It is important to distinguish mpox from chickenpox, measles, bacterial skin infections, scabies, herpes, syphilis, other sexually transmissible infections, and medication-associated allergies. Someone with mpox may also have another sexually transmissible infection such as herpes. Alternatively, a child with suspected mpox may also have chickenpox,” the report stated.
The common symptoms of mpox are skin rash or mucosal lesions which can last 2–4 weeks accompanied by fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.
The virus is transmitted to humans through physical contact with someone who is infectious with contaminated materials, or with infected animals. Sexual contact is the most commonly reported mode of transmission.
To address the global declaration of the global health emergency, Health Emergency Operation Centre (HEOC) was activated on August 15. The HEOC is currently in the alert phase.
The HEOC will work in coordinating response efforts, ensuring rapid decision-making, and efficient resource allocation if the situation worsens.
The ministry has been maintaining surveillance at the point of entry. Since August 16, the ministry has started with the inflight announcement for the incoming airlines with the support of the Department of Air Transport and both airlines.
Passengers coming from the affected countries were asked to self-report to the Airport Heath Office for health assessment.
As of August 21, there were 1,382 incoming passengers in 32 flights. However, none of the passengers reported having either signs/symptoms or travel history to the affected countries.
The ministry has also communicated with the Department of Immigration to help with the surveillance efforts for travellers entering the country via road.
If travellers come from affected countries through ground crossings, particularly Samtse, Phuentsholing, Gelephu, and Samdrupjongkhar, immigration officials are instructed to immediately notify health personnel.
The Department of Public Health under MoH and the Royal Centre for Disease Control will enhance surveillance systems to promptly identify and report new cases, with a special focus on points of entry.
MoH will focus on strengthening health infrastructure, focusing on equipping isolation facilities, ensuring the availability of vaccines and immunisation services, enhancing laboratory and diagnostic capacities, providing personal protective equipment (PPE), and conducting comprehensive training for healthcare workers in infection prevention and control, case investigation, and case management.