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Monkeypox, dengue loom over PH

Immunocompromised persons, children, pregnant women, and the elderly are at high risk of contracting monkeypox, a health expert said Tuesday.

But the overall risk of the general population contracting monkeypox is “considered low,” said infectious disease expert Dr. Rontgene Solante, head of adult infectious diseases at the San Lazaro Hospital.

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This developed as the number of admissions of non-COVID-19 patients is increasing in hospitals, the Private Hospitals Association of the Philippines Inc. (PHAPI) said Tuesday.

PHAPI president Dr. Jose de Grano said they were seeing a rise in dengue cases in Central Luzon, Calabarzon, and Zamboanga, as well as in the Visayas.

The Philippines has recorded a total of 16,324 dengue cases from June 5 to July 2, 2022, the Department of Health said Tuesday.

Overall, 65,190 dengue cases were registered nationally from January 1 to July 2, 2022, which was around 83% higher compared to the cases reported during the same period last year, the DOH noted.

There were only 35,715 dengue cases recorded from January 1 to July 2, 2021.

Since January 1 this year, a total of 7,892 monkeypox cases have been reported in non-endemic countries, Solante said, citing data from the World Health Organization.

The Philippines has yet to detect a case of the monkeypox virus. The DOH earlier said it was ready to contain it.

Some 78 percent of the cases were males ages 18 to 44, according to data as of July 9. Around 98 percent of the overall cases were identified as men who have sex with men, of which 41 percent were living with HIV.

Solante said the recent spread of monkeypox came with atypical presentations versus its original.

Patients in non-endemic regions presented with lesions first instead of fever and body malaise, and some had fewer or even just a single lesion instead of an eruption of rashes, he said.

Cases in non-endemic countries also presented lesions in the genital or perineal areas, he said.

“It’s difficult to really explain why they present atypical presentations. Is it because they’re immunocompromised, members of the HIV population, or is it because the behavior of the virus is different in this group of patients?” he said in a media forum organized by the Philippine College of Physicians.

“That’s why the high index of suspicion is important. The challenge now among non-endemic countries, is how will you be able to tell…Access to testing is also very important.”

A case is confirmed through RT-PCR testing, while in some countries an antigen test can also be used, he said.

The virus spread in endemic countries through animal-to-human contact, as residents are fond of hunting and handling animals infected with the disease, according to Solante.

The recent outbreak also spread via human-to-human contact or through persons who have had multiple sexual partners, Solante said.

Further research is needed to clarify whether monkeypox can be transmitted sexually through genital fluids rather than via contact with skin lesions, droplets, or fomites, Solante said.

The monkeypox virus’ incubation period usually takes 5 to 21 days, and is febrile for 1 to 4 days, when it is highly infectious, Solante said.

The rashes will be visible for 2 to 4 weeks, and the recovery can take “days to weeks,” he added.

There is no specific treatment for monkeypox and it’s “mainly supportive, directed at relieving symptoms such as fever, body malaise, and exhaustion,” according to the expert.

“If you’re exposed, wash your hands, and always wear your face mask. In any case, you have a patient with fever and rashes, always observe contact and respiratory precaution,” he said.

Those who contracted the virus can have sexual intercourse following their recovery but must wear protection, the doctor added.

There is also no specific vaccine for monkeypox but the smallpox vaccine can be used to prevent infection, Solante said.

Supplies of these are limited and mostly used on health workers and frontline workers exposed to the virus, he added.

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