MALAYSIANS should remain vigilant about mpox as there are concerns about the disease's potential to spread rapidly, especially in populations with low immunity due to the cessation of smallpox vaccination programmes.
This raises questions about the vulnerability of populations, such as in Malaysia, where there is currently no widespread immunity against orthopoxviruses, says molecular virologist Associate Professor Dr Vinod Balasubramaniam.
With the monkeypox virus (MPXV), transmission occurs through several primary routes, with human-to-human transmission being the most significant, says Vinod, who's also leader of infection and immunity research strength at the Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia.
Transmission typically involves direct contact with the lesions or bodily fluids of an infected person, particularly during intimate interactions, as well as respiratory droplets during prolonged face-to-face contact.
"Contaminated surfaces can also facilitate transmission, while animal-to-human transmission is another critical route, often occurring through direct contact with infected animals."
Vertical transmission from mother to foetus during pregnancy has also been reported.
Vinod adds that the epidemiology of mpox has shifted, especially since the
outbreak in May 2022, with a notable increase in cases among men who have sex with men, indicating a change in transmission dynamics.
The disease presents with symptoms such as fever, lymphadenopathy, and skin lesions, and while it is less lethal than smallpox, it poses significant health risks.
"Enhanced surveillance, public health education, and vaccination are crucial in controlling the spread of mpox, particularly in non-endemic regions like Malaysia, where monitoring for potential cases is essential to prevent outbreaks."
Monkeypox, now referred to as mpox, is caused by the monkeypox virus, a member of the orthopoxvirus genus, which also includes the variola virus responsible for smallpox.
The first human case was documented in 1970 in the Democratic Republic of the Congo (DRC).
Vinod says mpox has two primary clades: the more virulent Central African strain and the less severe West African strain.
While historically rare outside Africa, cases surged globally starting in May 2022, prompting the World Health Organisation (WHO) to declare the outbreak a Public Health Emergency of International Concern (PHEIC) due to its rapid spread and potential for severe health impacts. It was declared a PHEIC for the second time on Aug 14.
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