Singapore has announced plans to administer the JYNNEOS vaccine to healthcare workers and close contacts of confirmed mpox cases. The Ministry of Health of Singapore (MOH) has approved the vaccine for protection against both mpox and smallpox, as part of its public health preparedness measures in response to the mpox Clade I epidemic.
The JYNNEOS vaccine will be given as a single dose to close contacts within 14 days of exposure while they are in quarantine to reduce their risk of contracting the disease. However, population-wide vaccination against mpox is not recommended at this time, and there is no vaccination recommendation for travellers to countries affected by mpox.
MOH stated that the current supply of JYNNEOS is projected to be sufficient based on the current vaccination strategy. They will continue monitoring the situation and adjust their vaccination strategy as necessary, depending on the global evolution of the mpox situation and vaccine supplies.
Medical practitioners and healthcare institutions have been notified to be vigilant in detecting and immediately reporting all mpox cases to MOH, with a particular emphasis on suspected Clade I infections. Suspected cases will be transferred to hospitals for further assessment and treatment if needed. Upon confirmation of a Clade I case, MOH will immediately initiate contact tracing.
Close contacts will be quarantined for 21 days in a designated government quarantine facility, following the incubation period observed in Africa. All suspected Clade I cases identified by primary care providers will be referred to designated hospitals for further assessment and testing. Adult cases will be sent to the National Centre for Infectious Diseases (NCID), paediatric cases to KK Women’s and Children’s Hospital, and adult-child family dyads to the National University Hospital.
Cases will be isolated while pending test results. All confirmed Clade I cases will continue to be isolated in healthcare facilities until they are no longer infectious, to prevent further exposure to the community. The treatment of mpox cases primarily involves supportive care to manage symptoms and prevent complications. Antivirals such as Tecovirimat will be prescribed for severe cases, following the practices of other public health agencies.
MOH is considering implementing masking on public transport and in crowded indoor places if there is evidence of significant respiratory transmission in public areas. However, based on current evidence that mpox spreads mainly through close physical contact, such as within households, they do not recommend wearing masks for people who are well.
In addition to these measures, MOH, together with the Manpower Ministry and National Environment Agency, is conducting wastewater testing at migrant worker dormitories and the Onboard Centre as part of its preparedness measures. Temperature and visual screening have also been implemented at the Onboard Centre, where certain newly-arrived Work Permit holders must attend the Onboard programme.
Protocols are in place to handle any detected mpox cases within this group. Mpox, caused by the monkeypox virus, has two subtypes – Clade I and Clade II. The World Health Organisation has declared mpox a Public Health Emergency of International Concern (PHEIC) twice – first in May 2022 and again in August 2024. According to local media, Singapore has detected 14 confirmed cases of mpox this year, all of which are of the less severe Clade II infections.
This proactive stance by Singapore highlights its commitment to safeguarding public health through rigorous measures and effective vaccination strategies. By focusing on high-risk groups and maintaining vigilance, MOH aims to control the spread of mpox while ensuring that healthcare resources are efficiently utilised. As global health dynamics continue to evolve, Singapore’s approach may serve as a model for other nations grappling with similar public health challenges.
The integration of wastewater testing and stringent quarantine protocols underscores the importance of early detection and containment in managing infectious diseases. Such measures not only protect vulnerable populations but also contribute to the broader efforts in mitigating the impact of outbreaks on society.
The decision not to recommend population-wide vaccination at this stage reflects a cautious and evidence-based approach, balancing the need for public health protection with resource allocation efficiency. It also highlights the importance of ongoing research and surveillance in informing public health policies.
Healthcare workers remain at the forefront of this battle against mpox, with their role being crucial in early detection, treatment, and preventing further transmission. The emphasis on vaccinating close contacts within a specified timeframe showcases a targeted strategy aimed at reducing transmission risks among those most likely to be exposed.
