Oral Answer

Evidence of Community Spread of Local Monkeypox Cases and Vaccines to Protect Vulnerable Groups

Speakers

Summary

This question concerns the status of monkeypox community transmission in Singapore and the adequacy of vaccine stockpiles to protect vulnerable populations. Dr Lim Wee Kiak inquired about evidence of local spread, the number of smallpox vaccine doses administered, and the national response following global health emergency declarations. Senior Minister of State for Health Dr Janil Puthucheary reported that 11 unlinked cases were detected as of 31 July 2022, with no evidence of further community transmission from reported cases. He noted that 11 close contacts received vaccines and confirmed an adequate stockpile for high-risk groups, though mass vaccination remains unnecessary due to the disease's generally mild nature. The Senior Minister of State for Health emphasized that Singapore’s strategies of early detection, isolation, and contact tracing are aligned with international standards to mitigate public health risks.

Transcript

16 Dr Lim Wee Kiak asked the Minister for Health (a) whether there is any new evidence of community spread of local monkeypox cases; (b) how many doses of smallpox vaccines have been administered; and (c) whether there is an adequate stockpile of vaccines to protect the vulnerable groups.

The Senior Minister of State for Health (Dr Janil Puthucheary) (for the Minister for Health): Sir, as of 31 July 2022, Singapore has had a total of 11 monkeypox cases reported in 2022. None of these cases are linked to each other. All the cases have had mild symptoms and are clinically stable; they were promptly isolated until non-infectious; contact tracing was initiated and 45 close contacts were identified.

All close contacts who remained in Singapore are well and 11 of them have completed their quarantine. Thus far, none of the local contacts had developed symptoms compatible with monkeypox nor tested positive for monkeypox. There is, therefore, no evidence of further spread in the community from the reported cases.

Close contacts were offered the smallpox vaccine as post-exposure prophylaxis, which is reported to be 85% effective at preventing monkeypox infection. To date, 11 close contacts have taken up the smallpox vaccine.

However, and as recommended by WHO, mass population-wide vaccination with the smallpox vaccine is currently not recommended as a preventive strategy for monkeypox as the benefits do not outweigh the risk.

Individuals who are at higher risk of infection due to exposure to confirmed cases or their specimens, including healthcare and laboratory personnel, may be offered the smallpox vaccines to protect them from getting infected. There is an adequate supply of smallpox vaccines.

Based on international data, the current monkeypox outbreak generally causes a mild and self-limiting illness. With globally three deaths out of more than 20,900 cases reported outside of Africa, the case fatality rate currently stands around 0.01%, or approximately one in 10,000. As we learn more about the disease, MOH will continuously review and calibrate our response measures to be commensurate with the public health risk. In line with WHO's recommendations, MOH has also provided appropriate advice and precautionary measures to the public, including the at-risk population, to raise awareness and reduce the risk of onward transmission.

MOH will continue to monitor the monkeypox situation closely and further calibrate our preparedness and response measures, including vaccination strategies, as needed.

Mr Deputy Speaker: Dr Lim Wee Kiak.

Dr Lim Wee Kiak (Sembawang): Thank you, Deputy Speaker. I would like to ask the Senior Minister of State that since WHO declared monkeypox as a global health emergency on 23 July and New York City has just declared monkeypox as a public health emergency two days ago, what is the status of the monkeypox threat in Singapore with the rising numbers and when will it become a public health emergency in Singapore? And if it ever does become one, what are the measures that MOH will take?

Dr Janil Puthucheary: Sir, I thank the Member for his question. I think I have answered the issue of the current status of monkeypox in my original answer.

Notwithstanding the declaration by WHO and the status in New York, the public health response measures adopted Singapore prior to these declarations and the status in New York remain relevant and they are in line with WHO's recommendations after the declaration. Early detection and isolation of cases, prompt contact tracing, quarantining of close contacts – all of these are important strategies and all of these were in place prior to the declaration.