<M>MFox: Oral Blister Confirmed Patient May Infect by Cough... Seek Treatment if Fever Present</M>

M-Fox Photo by Yonhap News

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Three domestic Mpox (monkeypox) patients have been reported within five days from the 7th to the 11th, bringing the total to eight since the first confirmed case in June last year. The 6th to 8th 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 and Jeonnam, some are concerned that significant local transmission may be occurring.

We summarized expert consultations from Jeong Ki-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, regarding the possibility of a large-scale Mpox outbreak and whether it could become endemic without ending.

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

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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 probability increases when coming into contact with secretions from blisters appearing on the skin, mouth, or genitals of confirmed patients. As domestic and international travel has become freer with the return to normal 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 clothing, towels, and other items used by confirmed patients is also quite 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 results in further transmission.

Q. It is said to heal naturally in 3 to 4 weeks; how is it treated?

In Korea, 5,000 doses of Mpox vaccine and 504 doses of antiviral drugs are available. Hospitalization treatment is provided upon confirmation, 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 known to be 0.13%, with severity under 1%. If symptoms such as fever, rash, and lymphadenopathy occur, one should promptly visit a public health center for testing and treatment.

Q. Should we prepare for Mpox becoming endemic?

Among experts, there are mixed views: some predict Mpox will not be eradicated, while others believe it is 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 wastewater-based infectious disease surveillance, and efforts should be made to build infrastructure for domestic vaccine and treatment development.”

On the other hand, Chair Jeong Ki-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 we need to observe further whether additional confirmed cases will appear or if it will end as is for the time being.

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