News Focus – First monkeypox confirmed in Indonesia

Jakarta (Indonesia Window) – The Indonesian Ministry of Health has stated that one citizen of the country has been confirmed to have monkeypox.

The patient is a 27-year-old man, with a history of travel to the Netherlands, Switzerland, Belgium, and France before contracting the infection.

“Currently the patient is in good condition, not seriously ill, and he has smallpox or rashes on his face, palms and feet. Patients do not need to be hospitalized, but self-isolation is sufficient,” the ministry’s spokesman Mohammad Syahril said in a press statement on Saturday (Aug. 20).

Based on an investigation, the patient traveled abroad from July 22 until arriving back in Jakarta on Aug. 8, 2022.

The patient began experiencing early symptoms of monkeypox on Aug. 11, 2022 and after consulting several health facilities, the patient was admitted to a hospital owned by the Ministry of Health on Aug. 18 and the patient’s PCR (polymerase chain reaction) test results were confirmed positive on the evening of Aug. 19.

Syahril called on the public not to panic because the transmission and fatality of monkeypox are very low compared to COVID-19.

As an illustration, there are currently 39,718 confirmed cases of monkeypox worldwide and 12 people died, or less than 0.001 percent of the total cases.

In addition, monkeypox transmission is not as easy as COVID-19 through airborne droplets.

“The transmission of monkeypox is through close contact,” Syahril said.

The confirmation of the first monkeypox case in Indonesia has been followed up by the Jakarta Health Service together with the Directorate of Disease Prevention and Control of the Ministry of Health to carry out surveillance to the community or close contacts of patients

As a form of vigilance, the Ministry of Health has carried out intensive monitoring at all entrances to Indonesia, both from the air, sea, and land that are in direct contact with countries that have reported cases of monkeypox, Syahril added.

There are about 89 countries that have reported cases of monkeypox.

“The (Indonesian) government has also given an alert status to all airlines and ports to jointly share a vigilance if there are passengers who have symptoms of monkeypox,” he said.

According to Syahril, the next step is that his party has provided socialization and education to the entire community, health workers, and health care facilities to be aware of monkeypox.

“Reminding all people to always practice clean and healthy lifestyle and improve health protocols. This health protocol is not only for COVID-19 but also for all infectious diseases,” he explained.

Furthermore, the Indonesian government has provided guidelines to all health offices, hospitals, and health centers to pay more attention to monkeypox cases.

Regarding the PCR tests for monkeypox, Syahril said that currently it can only be done in two places, namely the Health Ministry’s national reference laboratory and the Bogor Institute of Agriculture’s laboratory.

Currently additional ten laboratories to carry out the PCR tests are under process. There are also several hospitals that are already able to carry out PCR tests.

The Indonesian Ministry of Health has prepared 1,200 reagents for monkeypox tests, Syahril said, adding that a test is carried out when there is a suspicion of monkeypox.

“This monkeypox PCR test is different from the COVID-19 PCR test. PCR monkeypox is done by swab on rashes on the patient’s body,” he said.

Monkeypox patients also need no isolation rooms like COVID-19 patients.

Secondary bacterial infections should be treated as indicated. An antiviral known as tecovirimat developed for smallpox was licensed by the European Medicines Agency (EMA) for monkeypox in 2022 based on data in animal and human studies.

Tecovirimat is not yet widely available. If used for patient care, tecovirimate should ideally be monitored in the context of clinical research with prospective data collection.

Syahril pointed out that regarding vaccination, the World Health Organization or WHO has not provided a recommendation for mass vaccination against monkeypox.

There are two or three countries that have already vaccinated and Indonesia is also in the process of procuring vaccines under a recommendation from the National Agency of Drug and Food Control.

Monkeypox patients would recover if there are no additional infections or there are no severe comorbidities that can worsen the patients’ conditions.

“If patients have no comorbidities and no other aggravating diseases, God willing, the patients can actually recover,” Syahril said.

Symptoms of monkeypox are similar to those of chickenpox, but milder. Symptoms begin with fever, headache, muscle aches, and fatigue.

The main difference between the symptoms of chickenpox and monkeypox is that monkeypox causes swelling of the lymph nodes (lymphadenopathy) whereas chickenpox does not.

Monkeypox is usually a self-limiting disease with symptoms lasting from two to four weeks.

The first case of monkeypox was confirmed in Jakarta, the country’s capital city.

Jakarta Governor Anies Baswedan on Sunday (21/8) stated that this first patient contracted the disease after traveling from abroad.

“We are monitoring it,” Anies said, adding that his party would monitor the development of the monkeypox patient.

The Executive Board of the Indonesian Medical Association (IDI) through its Monkeypox Task Force has asked the public to remain calm and not panic as directed by the Ministry of Health.

IDI said it continues to coordinate with the Indonesian Ministry of Health and local health services, as well as IDI’s regional branches regarding the vigilance of monkeypox disease in Indonesia.

“We ask the medical team and health workers to remain vigilant and immediately report to the local health offices if a patient is found with symptoms similar to monkeypox, so that it can be immediately handled and followed up,” IDI’s General Chairperson, Dr. M. Adib Khumaidi said in a press release on Saturday (Aug. 20).

The World Health Organization (WHO) on July 23, 2022 declared monkeypox as a global health emergency.

Reporting by Indonesia Window