Four Mpox Patients Who Did Not Travel Abroad Occurred in Six Days... "Crisis Alert Level Raised to Caution" (Comprehensive)

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Four domestic Mpox (monkeypox) patients have been reported within six days from the 7th to the 12th, increasing the total to nine since the first confirmed case in June last year. The 6th to 9th new confirmed cases were found to have no history of overseas travel within three weeks of symptom onset, and since their residences are spread nationwide including Seoul, Gyeonggi, and Jeonnam, some are concerned that significant local transmission may be occurring.

The Korea Disease Control and Prevention Agency (KDCA) raised the crisis alert level from ‘Interest’ to ‘Caution’ on the 13th due to the increase in domestic Mpox cases. This follows ongoing outbreaks in neighboring countries such as Japan and Taiwan, as well as consecutive confirmed cases domestically. The infectious disease crisis alert system consists of four levels: Interest → Caution → Alert → Severe. Accordingly, the KDCA plans to upgrade the currently operating Mpox task force to the Central Disease Control Headquarters (headed by the KDCA Commissioner) and strengthen response measures, while local governments will establish regional quarantine task forces focusing on areas with confirmed cases and adjacent regions.

Regarding the possibility of a large-scale Mpox outbreak and whether it could become endemic without ending, we have summarized expert advice from Jeong Gi-seok, Chair of the National Infectious Disease Crisis Response Advisory Committee; Kim Woo-joo, Professor of Infectious Diseases at Korea University Guro Hospital; and Shin Sang-yeop, Research Fellow at KMI Korea Medical Institute.

From the left, Jeong Gi-seok, Chair of the National Infectious Disease Crisis Response Advisory Committee; Kim Woo-joo, Professor of Infectious Diseases at Korea University Guro Hospital; Shin Sang-yeop, Research Fellow at KMI Korea Medical Institute

Q. Is there a possibility of a large-scale Mpox outbreak in the future?

Unlike respiratory infectious diseases such as COVID-19, Mpox is transmitted through skin contact. Infection risk increases when coming into contact with secretions from blisters appearing on the skin, mouth, or genitals of confirmed patients. As domestic and international movement has become freer with the recovery of daily life, additional confirmed cases may continue to emerge following the 6th to 8th cases. However, since airborne transmission is extremely rare, the possibility of large-scale spread is low.

Q. Is Mpox mainly transmitted through sexual contact between men?

Since May 2022, there has been a sharp increase in Mpox cases transmitted through sexual contact between men in Europe and the Americas. However, infection through contact with clothing, towels, and other items used by confirmed patients is also possible. In extreme cases, a person nearby could be infected by the cough of a confirmed patient with oral blisters. Incorrect social stigma delays diagnosis and leads to further transmission.

Q. It is said that natural recovery occurs within 3 to 4 weeks. How is it treated?

Domestically, 5,000 doses of Mpox vaccine and 504 doses of antiviral drugs are stocked. Confirmed patients receive inpatient treatment, and in rare cases, people with human immunodeficiency virus (HIV) or immunocompromised individuals may die. The current fatality rate of the ongoing Mpox outbreak is 0.13%, with severity under 1%. If symptoms such as fever, rash, and lymphadenopathy occur, timely visits to public health centers for testing and treatment are necessary.

Q. Should we prepare for Mpox becoming endemic as well?

Among experts, opinions coexist that Mpox may not be eradicated in the future and that it is still too early to judge. Research Fellow Shin Sang-yeop said, “If many people avoid diagnosis due to stigma concerns and community transmission spreads, cases are likely to continue.” He added, “To prepare for endemicity, Mpox should be included in the national sewage-based infectious disease surveillance, and efforts should be made to build infrastructure for domestic vaccine and treatment development.”

On the other hand, Chair Jeong Gi-seok stated, “For an infectious disease to become endemic, a certain scale of patients must occur annually on a large scale, like COVID-19 or influenza. Mpox, as an emerging infectious disease, arose suddenly through specific routes such as skin and sexual contact, and it is unpredictable whether it will occur next year.” He emphasized that it is necessary to observe whether additional confirmed cases will appear or if the outbreak will end as is for the time being.

This content was produced with the assistance of AI translation services.