DOH says RITM can now test for monkeypox

A real time polymerase chain reaction (PCR) assay was set up by the Department of Health (DOH) to detect possible monkeypox virus cases in the country.

In an advisory, the agency said its Research Institute for Tropical Medicine (RITM) “successfully optimized” the PCR assay for monkeypox cases “as part of the national preparedness and response to the threats of [the] disease.”

A second PCR assay for differentiating the monkeypox virus clade is also being worked on by the RITM technical team, it added.

Based on DOH’s Department Memorandum 2022-0220 or the “Interim Guidelines for the Implementation of Monkeypox Surveillance, Screening, Management, and Infection Control,” samples will only be collected from all individuals fitting case definitions for suspect or probable case of monkeypox.

Their samples will then be coordinated with the Epidemiology Bureau for referral to the appropriate laboratory facility for confirmatory testing.

In DOH’s case classification, an individual is considered a “suspected case” if he or she shows an unexplained acute rash and one or more of the following symptoms:

• Headache;
• Acute onset of fever (>38.5°C);
• Myalgia;
• Back pain;
• Asthenia; and
• Lymphadenopathy.

Meanwhile, a person is considered a “probable case” if he or she meets the definition for a suspected case and one or more of the following:

• Has an epidemiological link (face-to-face exposure, including health care workers without respiratory protection; direct physical contact with skin or skin lesions, including sexual contact; or contact with contaminated materials such as clothing, bedding or utensils) to a probable or confirmed case of monkeypox in the 21 days before symptom onset;
• Reported travel history to a monkeypox endemic country in the 21 days before symptom onset;
• Has had multiple sexual partners in the 21 days before symptom onset; and
• Is hospitalized due to the illness.

DOH emphasized that suspected or probable monkeypox cases have to undergo home isolation for at least 21 days or until all symptoms, including any rash, crusting, or scabs are gone.

Travelers from countries with reported or ongoing cases of monkeypox, who are manifesting the monkeypox signs and symptoms, also have to coordinate with the Philippine Embassy or the Department of Foregin Affairs (DFA), the DOH Bureau of Quarantine (BOQ), Department of Labor and Employment (DOLE), Overseas Workers and Welfare Administration (OWWA), and Philippine Overseas Employment Administration (POEA) for proper coordination and management.

A Monkeypox Operation Center will also be established by the DOH, while an Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID) will be activated once there is an observed increasing risk of monkeypox cases in the country.

Moreover, DOH said it is organizing a training or orientation on the clinical approach to skin lesions, including the collection, handling, and transport of samples from skin lesions, to guide all of its Disease Reporting Units and Epidemiology and Surveillance Units.

Philippine Genome Center (PGC) Executive Director Dr. Cynthia Saloma earlier said they are prepared to sequence any suspected monkeypox samples in the country.

There is no vaccine against monkeypox yet that has been approved or authorized by the Philippines’ Food and Drug Administration, according to Health Secretary Francisco Duque III. However, they are now discussing with the World Health Organization (WHO) where the country can procure monkeypox antivirals in case of an outbreak in the country.

DOH also previously announced that the country has adopted a "four-door" strategy in intensifying border control to prevent the entry of monkeypox virus into the country.

The first case of monkeypox in Southeast Asia this year was already detected in Singapore on Tuesday, as confirmed by its health ministry.

Monkeypox is a viral infection initially endemic in parts of west and central Africa. It spreads chiefly through close contact, and until the recent outbreak has only rarely been seen in other parts of the world. The majority of the recent cases have been reported in Europe.

Just recently, the WHO removed the distinction between endemic and non-endemic countries in its data on monkeypox to better unify the response to the virus. —KG, GMA News