Introduction

Mpox, previously known as monkeypox, has emerged as a growing global public health concern, including in Malaysia. Mpox is caused by the mpox virus, belonging to the Orthopoxvirus genus. It primarily spreads through zoonotic transmission, with rodents and primates acting as reservoirs. Human-to-human transmission occurs through close contact with infected individuals, bodily fluids, or contaminated materials such as clothing or bedding​​​​.

 

Global Context and Impact on Malaysia

 First identified in Africa, it has spread globally, prompting the World Health Organization (WHO) to declare it a Public Health Emergency of International Concern (PHEIC) twice, first in July 2022 and again in August 2024.

Malaysia’s proximity to other affected regions, such as Singapore, which has reported 15 cases in 2024, underscores the importance of maintaining vigilance.

As of late 2024, Malaysia has reported a total of nine confirmed cases of mpox, with the first detected in July 2023. No fatalities reported. All cases involved individuals with a history of high-risk activities, and no deaths have been reported. Suspected cases have also been investigated, with rigorous screening at international entry points, resulting in all 52 suspected cases testing negative for the virus​​​​.

 

Symptoms of Mpox

Mpox symptoms typically appear 5 to 21 days after exposure and can last for 2 to 4 weeks. Common symptoms include:

Fever and chills

Swollen lymph nodes

Muscle aches and fatigue

Rash that progresses from macules to pustules and scabs

Headache and respiratory symptoms in some cases​​​​.

 

Mode of Transmission

It typically spreads through close contact with infected individuals or contaminated materials. The mpox virus spreads primarily through:

1. Direct Contact: Skin-to-skin contact with lesions or bodily fluids of infected person.
2. Respiratory Droplets: Prolonged exposure to an infected individual.
3. Zoonotic Transmission: Handling infected animals, particularly rodents and primates.
4. Contaminated Surfaces: Touching objects or surfaces exposed to the virus such as bedding or towels

As a zoonotic disease caused by the mpox virus, its transmission and prevalence have implications for workplaces, particularly those involving close contact or travel.

 

Sources of Risk in relation to the Workplace

Certain industries are at higher risk of mpox transmission, including:

1. Healthcare Settings: Direct patient care increases exposure risks.
2. Hospitality and Wellness: Spas, massage parlors, and other businesses involving skin contact may inadvertently spread the virus.
3. Travel and Transport: Workers in international travel hubs are more exposed due to high traveller traffic. This may include workers with frequent travellers, such as attending businesses or conferences.

 

Issues and Key Challenges

1. Public Awareness and Stigma: Limited public knowledge about mpox and its transmission pathways may lead to stigma and hinder timely reporting and treatment. Social stigma can discourage individuals from seeking timely diagnosis or treatment.
2. Surveillance and Detection: Despite enhanced measures, detecting cases among asymptomatic individuals or those with mild symptoms remains challenging, especially in high-traffic entry points.
3. Cross-Border Transmission: With significant international travel, Malaysia faces a continuous risk of imported cases. Malaysia’s position as a major travel hub increases the risk of imported cases, requiring robust border control measures​​.
4. Resource Allocation: Ensuring adequate resources for prevention, adequate access to vaccines, testing, treatment and protective equipment across all industries.

 

Challenges in Workplace Management

1. Stigma and Reporting: Employees may avoid reporting symptoms due to fear of discrimination. Fear of social stigma may deter individuals from reporting symptoms or seeking medical help.
2. Economic Impact

The need for isolation or quarantine can disrupt business and services operations.

3. Detection: Asymptomatic or mild cases can go unnoticed, enabling silent transmission.
4. Operational Disruption: Cases may require quarantine measures, affecting workforce availability. Workplace outbreaks can lead to significant productivity losses and financial strain.
5. High traveller volume and close proximity to affected regions increase the risk of imported cases​​​​

 

Malaysia’s Response

The Malaysian Ministry of Health (MOH) has implemented several measures to address MPox:

1. Enhanced Surveillance: Increased monitoring at airports, seaports, and land entry points, with guidelines for health checks and symptom monitoring among travelers. Screening travelers from high-risk areas and enforcing self-monitoring for symptoms.
2. Public Health Advocacy: Education campaigns targeting high-risk groups and establishments such as spas and massage parlors to improve hygiene and reduce risky practices​​
3. Medical Preparedness: Availability of antiviral treatments for high-risk groups and detailed management protocols accessible to healthcare professionals​​.
4. Collaborations: Ongoing partnerships with international organizations like WHO and local agencies to ensure coordinated responses.

 

Prevention MPox in the Workplace

Effective prevention measures for individuals and workplaces include:

 

For Employees

1. Personal Hygiene: Frequent handwashing with soap and water or using alcohol-based hand sanitizers.
2. Avoiding close contact with symptomatic individuals and infected animals.
3. Protective Measures: Use gloves, masks, and other personal protective equipment (PPE) when handling potentially contaminated materials.
4. Seek early treatment and keep social distance or isolation if developed symptoms

 

For Employers

1. Screening and Education: Regular temperature checks and education about mpox symptoms, such as fever, rash, and swollen lymph nodes.
2. Workplace Hygiene: Frequent cleaning and disinfection of shared spaces and touched surfaces. Ensuring proper waste disposal
3. Providing Vaccination: Vaccines to high-risk groups, including healthcare and frontline workers.

 

Workplace Management Strategies

Workplaces play a pivotal role in managing and preventing the spread of mpox.

Strategies include:

1. Policy Development

Developing and Implementing clear guidelines for symptom reporting, isolation, and return to work procedures for suspected mpox cases.

Provide paid sick leave to infected employees to encourage early reporting and reduce the risk of workplace outbreaks.

 

2. Risk Assessment

Identify high-risk roles, such as healthcare and hospitality workers, and providing targeted training or protective measures.

 

3. Collaboration with Authorities

Work closely with health authorities for case tracking and compliance with public health guidelines.

Partnering with public health authorities for regular updates, case management, and compliance​​​​.

 

4. Remote Work Policies

Allowing employees to work remotely if they suspect exposure or experience symptoms.

 

5. Education and Training

Conducting awareness campaigns on mpox transmission, symptoms, and preventive measures.

 

Conclusion

Mpox presents a unique challenge for Malaysia’s workplaces, combining public health concerns with economic implications. While the number of cases remains low, proactive measures, including vaccination, public awareness, and workplace hygiene, are essential to prevent outbreaks. Effective management requires collaboration between employers, employees, and public health authorities. By prioritizing education, hygiene, and preventive measures, Malaysia can minimize mpox's impact, ensuring safe and healthy workplaces while maintaining productivity.

The article is provided by:

Dr. Arma Noor
Head,
University Health Centre, UPM.

Date of Input: 25/11/2024 | Updated: 25/11/2024 | izzatussofia