Myths vs. Facts: What is the truth about mpox and how is it actually transmitted?

Is mpox a new disease?

Mpox is not a new disease as it has been in existence for several decades now, with its first identification as a distinct illness being in 1958.

"The African continent has had a clustering of cases for several years in small numbers because of the nature of their work that they hunt animals that are carriers of this virus," Solante explained.

Nebrida highlighted that the symptoms start with having a fever, whether low-grade or moderate, as well as muscle pains and body aches. The most tell-tale sign, however, is the appearance of the skin rash.

"The lesions would appear usually one to three days after the symptoms of fever, body pain, and headache. Mga two to three weeks 'yan na mayroon pa silang rashes on the skin," she said.

"Like any other viral infection, there's weakness, low energy, body malaise, exhaustion. A characteristic also of this is swollen lymph nodes and then intense headaches as well," she added.

Can you get mpox in a crowd like COVID-19?

Unlike COVID-19, the virus that has plagued the Philippines since 2020 because of its quick transmission in crowded areas through the air, mpox can only be transmitted through physical contact with an infectious person or animal, or through contaminated materials.

According to Solante, there are several ways in which a person can get the disease.

"When a person who has mpox has their skin lesion touched by another person without washing their hands, and they touch their mouth, touch their eyes—that's lesion-to-skin contact," Solante said.

"Second mode of transmission is when a person who has mpox would talk to you within three feet, will cough or sneeze, then you can also get that through that respiratory droplet," he added.

The third mode is through touching objects, such as furniture, that have been contaminated by skin lesions of a person who has mpox.

"[Mpox] takes longer incubation of contact before you get it. Unlike COVID, even if you are more than three feet, you can still transmit it because it is also airborne," Solante said.

Health Secretary Ted Herbosa told Karen Davila in an interview on ANC Headstart that there isn't a monkeypox outbreak in the Philippines. 

Is mpox a sexually transmitted disease?

Mpox is not considered a sexually transmitted disease in the classic sense, but Solante underscored that it is still a virus that can be acquired through sexual contact because of the "intimate close contact of bodies between two individuals—one with the symptoms and one without."

Does mpox only affect gay and bisexual men?

There is no truth to mpox only affecting homosexual men. According to Solante, there are now reported cases in Congo in Africa where the virus has also been transmitted during contact between heterosexual individuals.

"Fifty percent of cases now in Congo are children less than five years old, and most of those infected are children because of exposure to their parents, exposure to the adults. It is not a homosexual infection, anybody who has close contact whether heterosexual or homosexual can get mpox," he said.

Is mpox always deadly?

Getting infected with mpox doesn't necessarily pose a threat to your life.

"Deadliness is not a characteristic of the mpox, especially the Clade 2 variant. Clade 2 is benign. Usually, a patient recovers in two to three weeks," Solante said.

However, he urged the public to be more cautious of the new Clade 1b virus strain as it is "more virulent and highly transmissible mutated type of mpox." This new variant has resulted in 15,000 cases documented in Congo in just one year, with 500 deaths.

Children, the elderly, and the immunocompromised should especially take precautions as their immunity is not as strong compared to a healthy adult, making them more prone to the severe impacts of mpox. 

"Mamamatay ka lang kung may iba kang cormobids. Elderly, may HIV, AIDS patients, mga diabetic, cancer patients, pero kung hindi naman at maagapan naman ['yung mpox], most of the time, hindi naman siya nakakamatay. Sa Africa, mas maraming namamatay doon kasi marami na rin ang cases," Nebrida said.

Is there a cure for mpox?

The current treatment that is being used by countries affected by the mpox outbreak is Tecovirimat, an experimental drug that has been yielding a good response against the virus.

"In general, there is no absolute treatment for mpox. The current treatment is just experimental and is still under observation," Solante said.

However, since mpox is endemic to the Philippines, there are currently no vaccines available for Filipinos affected by the virus.

"If you have a fever, paracetamol lang, and then if you have open lesions, we give antibiotics para lang hindi magkaroon ng infection. Kung may itchiness, we give antihistamine, kung may pain, we give pain relievers. Kung may secondary bacterial infection, doon lang tayo nagbibigay ng antibiotic," Nebrida said.

Nevertheless, most cases of mpox go away on their own within a few weeks with supportive care.

Are you immune to mpox once you've had it in the past?

Mpox differs from chickenpox in that you are not made immune to the disease for the rest of your life if you previously acquired it.

"Anyone can catch it again. Once you had it, and you are then again exposed, you can get another impact," Solante said.

Other things to know about mpox

As mpox appears to be similar in appearance to other skin infections such as chickenpox and shingles, some might wonder how they can identify which disease they've been infected with.

In distinguishing the three from one another, Nebrida explained that mpox start as blisters that later evolve into pustules that contain pus. Its distribution typically begins on the face before it moves to other parts of the body, whereas chickenpox occurs on the trunk before it spreads out.

"Ang mpox is more of sa face tsaka sa palms and soles 'yung spead niya. Unlike chickenpox, ang spread niya usually makikita mo sa katawan, from the trunk palabas," she said.

"Ang mpox, usually the lesions become erosions unlike chickenpox, parang pinpoint lang siya. Maliit lang. Ito, it can become big na parang necrotic 'yung gitna, parang mayroong dark scabbing on the center.

On the other hand, shingles are usually dermatomal or on one side of the body, whereas mpox can scatter over the body starting from the face, palms, or soles.

Herbosa said that mpox does not come from the same family as shingles and chickenpox.

"Mpox comes from the same family as smallpox," he said. "In fact, the experimental vaccine for mpox comes from [the smallpox vaccine]."

If you manage to get into close contact with a person suffering from the skin disease, Nebrida said that the virus has an incubation period of about five to 21 days, but the manifestations of the symptoms would usually appear about six to 16 days following the exposure.

Once symptoms start to show, it's important to seek consultation from medical experts.

"When we have a suspected case of mpox, our protocol would be to send the patient to the [emergency room], so that they will be isolated right away, just like noong time ng COVID," Nebrida detailed.

All in all, just like with any infectious disease, isolation is the key to avoiding worsening it into an outbreak and protecting the people around you.

"You have to isolate yourself in a room [where] there will be no one coming in and out. Second, you have to wear your face mask so that you cannot transmit it through droplets or talking or sneezing, and third, individuals who will be exposed to mpox should also wear face masks and practice hand-washing. Do not touch whatever is in the room of an mpox patient," Solante urged.