Mpox Unmasked: What you need to know and how to keep calm during this outbreak

Mpox is a viral infection that first emerged in captive monkeys during the 1960s, hence the name. However, it’s not just a monkey problem. Dr Regina Berba, head of the Philippine General Hospital’s Infection Control Unit, explains, “Mpox manifests primarily as a flu-like illness with a rash. The virus was first detected in humans in 1970, and while it was mostly confined to Africa, it has since spread globally. The WHO renamed it ‘mpox’ in 2022 to avoid the stigma associated with the name ‘monkeypox.’”

While the 2022 mpox outbreak reached more than 100 countries, it lasted only a few months, with PHEIC status lifted by May 2023. The recent resurgence is due to a new strain, Clade Ib, which has been more transmissible and caused a rise in cases. “In August 2024, a new PHEIC was declared due to this more transmissible strain,” Berba adds. “It spreads through skin-to-skin contact, including direct contact with the rash, hugging, kissing, or sexual contact. It can also be transmitted via contaminated objects.”

Dr Edsel Salvaña, an infectious diseases expert, elaborates: “Mpox is similar to smallpox and primarily spreads through close, intimate contact. These include direct skin-to-skin contact with the lesions, kissing, sexual contact, and contact with surfaces contaminated with pus from the lesions that still have viable virus.”

If the thought of pustular lesions and flu-like symptoms worries you, you’re not alone. However, there’s good news—the disease is generally mild. Berba reassures us, “Most patients recover with supportive care, which includes medicine for fever and pain, maintaining hydration and nutrition, and skin care. The rash typically clears up in two to four weeks if prevented from getting secondary bacterial infection.”

In the Philippines, none of the confirmed mpox cases has been fatal, and the nine cases from the 2022 outbreak have all fully recovered. “The mpox illness is actually mostly mild, and most patients should recover,” Berba emphasises.

Compared to COVID-19, mpox is “much less transmissible,” says Salvaña. The virus has two clades: Clade I, which has a mortality rate of up to 10 per cent, and Clade II, which ranges from 0.1 per cent to 4 per cent. Most deaths have occurred in children under five and immunocompromised individuals. “Most healthy persons will survive mpox,” Salvaña assures.

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It’s not just physical health that’s at risk—mental well-being can suffer too. Dr Joan Rifareal, vice president of the Philippine Psychiatric Association, highlights that outbreaks can intensify feelings of isolation and anxiety. “The disruption of daily routines and social interactions during outbreaks can exacerbate mental health issues, leading to increased feelings of loneliness and anxiety,” she says, noting that those who have pre-existing mental health concerns are at risk of heightened emotions.

For those directly affected by mpox, the mental toll can be even greater. "Infected individuals may develop symptoms such as Post-traumatic Stress Disorder (PTSD), anxiety, depression, and other related mental health concerns," Rifareal warns.

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To manage anxiety, Rifareal suggests, “Establish new routines that offer a sense of normalcy. Physical activities, for example, can be substituted with in-home workouts or other non-sedentary activities to promote physical well-being. Socialisation in the form of friend meet-ups can be transitioned into online means to minimise potential risks.” 

Most importantly, remembering that you are not alone in these unprecedented times is important. “Join online support groups, reach out to family members, and openly discuss the outbreak to de-stigmatise the occurrence and all the affected by the virus itself,” Rifarael stresses. “It’s okay not to be okay, and it’s okay to reach out and to share all worries and concerns with others.”

So, how can you protect yourself from mpox? Berba offers practical advice: “During an outbreak, isolation of infected individuals is crucial. Avoid close contact, such as hugs and kisses, and be cautious about touching contaminated items. Frequent handwashing and use of alcohol-based sanitisers are essential.”

Salvaña adds, “Practise good hygiene by washing your hands frequently and avoiding touching your face. If you’re in a crowd, cover any exposed skin and minimise direct skin-to-skin contact. Safe sex practices are also important.”

Additionally, be mindful of potential animal reservoirs since mpox is a zoonotic infection. “Although animal sources are not entirely clear, it’s wise to take extra care during activities like farming or hunting,” Berba advises.

And if you do develop a suspicious rash, don’t panic. Salvaña advises, “If you develop a rash, contact your doctor immediately.” By staying informed and taking these precautions, experts say we can navigate this outbreak with confidence, keeping both your physical and mental health in check.

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