A 31-year-old Filipino man stepped off a flight into the Philippines on July 19, 2022. Nine days later, a lab test came back positive for mpox, and the country had its first confirmed case.
The Department of Health announced the result on July 28. The man had traveled through countries with documented mpox cases before coming home. A reverse transcription-polymerase chain reaction test at the Research Institute for Tropical Medicine in Muntinlupa produced the positive result. By the time of the announcement he had already recovered, though he stayed in home isolation. Ten close contacts were identified, three of them members of his household.
The timing was hard to miss. Five days earlier, on July 23, WHO Director-General Tedros Adhanom Ghebreyesus had declared the global mpox outbreak a public health emergency of international concern.
Preparing before the first case
Manila had been getting ready for months. On May 24, the health department said it could detect and contain the virus if it arrived, and it made mpox a notifiable disease. Health facilities had to report every patient under investigation to the Epidemiology Bureau and the Regional Epidemiology Surveillance Unit, and every suspected case was to be tested by RT-PCR. By June 20 the Research Institute for Tropical Medicine said it had optimized its real-time PCR assay for the virus.
Capacity was thin, though. As of July, only that institute and the Philippine Genome Center in Quezon City could run the test, and the department wanted to extend it to other hospitals. Ninoy Aquino International Airport and several national airports stepped up surveillance.
On August 2, Maria Rosario Vergeire, the department’s officer in charge, said borders would stay open since the WHO had made no such recommendation. Classes and university terms would still resume on August 22. The department was also in talks with the United States government to obtain mpox vaccines for a limited group of people. The Private Hospitals Association of the Philippines, meanwhile, advised against home isolation for further suspected cases.
More cases follow
On August 6, the first patient was discharged after a 21-day quarantine. Nobody else had been infected, the department said, and the other contacts tested negative, although they still had to finish their own 21 days.
Then came more. On August 19 the department announced two further cases, a 34-year-old and a 29-year-old, both with travel abroad. All three patients had entered from different countries and were unrelated, so the department classed them as “imported”. Dr. Edsel Salvana of its technical advisory group expected more cases but dismissed fears of local transmission or the disease becoming endemic. He noted that mpox is less contagious than COVID-19 and that the pandemic protocols were helping hold it back.
On August 22 came a fourth case, a 25-year-old Filipino with no history of travel outside the country. He worked at a fast-food outlet in Iloilo City, and Mayor Jerry Treñas said a relative had recently returned from abroad. The department then asked its Western Visayas office to look into photos of the patient circulating on social media from that same day, calling the sharing an unauthorized disclosure of private information.
The second patient recovered on August 31 and the third on September 8. The fourth left hospital on September 15.
