The reemergence of Mpox into a global health menace has again worried the world, with the World Health Organization (WHO) classifying it as a Public Health Emergency of International Concern (PHEIC). That classification, in view of the seriousness and international spread of the disease, has happened at the time when Indonesia itself is trying to get a grip on the outbreak. According to the Ministry of Health, there are now a total of 88 cases of Monkeypox reported in Indonesia as of Saturday, August 17, 2024.
Yudhi Pramono, the Director-General of Disease Prevention and Control at the Ministry of Health, gave some positive news from the worrying figures: 87 of the recorded cases were treated and recovered. On the other hand, the outbreak timeline shows October 2023 as being the most burdensome month because it has so far reported the highest number of confirmed Monkeypox cases in Indonesia.
“From the 54 cases we have analyzed, all are of the Clade IIB variant. This specific clade already caused outbreaks since 2022 and is characterized by a reduced fatality rate, basically being transmitted by sexual contact,” Yudhi clarified in a press release issued in Jakarta on Monday, August 19, 2024.
The infection of Mpox in Indonesia does not originate from one area. Cases with the highest density are 59 in DKI Jakarta, then 13 in West Java, 9 in Banten, 3 in East Java, 3 in Yogyakarta, and the last one is 1 in the Riau Islands. The Ministry of Health has proactive measures in place. It has run WGS against 54 cases out of 88 to identify the type of virus variant that causes the infection.
He further enlightened the audience on the fact that the Mpox virus is divided into two major clades. Clade I, of Central African origin—the Congo Basin—has subclade 1a, recognized to have a higher case fatality rate with multiple modes of transmission. In contrast, subclade 1b has a CFR of 11% and is majorly sexually transmitted.
Clade II originated from West Africa and has the subclades IIa and IIb, with a lower case fatality rate of 3.6%. The latter clade has been behind most of the outbreaks since the wave of 2022, which are linked to sexual transmission.
Mpox is an infection that is caused by contact with skin lesions of an infected person, especially those directly linked with sexual activity. Yudhi said that the disease especially afflicts men having sex with other men. Hence, he encouraged the public to take precautions by wearing medical masks in case they are not feeling well and to seek immediate medical attention if there are pus-filled rashes or crusted scabs on the body.
Read also: WHO Declares Monkeypox a Global Health Emergency, Indonesia Prepares Vaccines
In response to the outbreak, the Ministry of Health has strengthened measures to contain the virus. Such measures include intensified surveillance in all health facilities; epidemiological investigation in collaboration with communities living with HIV/AIDS and partners; and designation of 12 national reference laboratories to Mpox testing. WGS testing is also in process to monitor the dynamics of changes to structure of the virus genetic material.
As part of its preventive strategy, the Ministry is also ready to distribute 4,450 doses of the Mpox vaccine, targeting 2,225 people who will be vaccinated twice. “In 2023, we managed to administer vaccinations against Mpox on 495 high-risk individuals,” said Yudhi.
The latest event to cause the WHO to update the status of the situation back to a PHEIC, effective 14 August 2024, has been the resurgence of Mpox onto the world scene. This has been followed by a high surge of cases in the Democratic Republic of the Congo and other African countries.
On top of this worrying development, WHO stated in its update on 15 August 2024 that Sweden became the first country outside Africa to confirm a case of Clade Ib Mpox in an individual with recent travel history to Central Africa. This clade, in particular, while being more virulent and transmissible than Clade II of the Mpox virus, has been responsible for outbreaks most recently.
