RITM equips for monkeypox national response
RITM facade

RITM equips for monkeypox national response

As one of the national agencies mandated to curtail infectious disease outbreaks in the Philippines, the Research Institute for Tropical Medicine (RITM) is now bracing for a possible surge in monkeypox cases in the country, alongside its COVID-19 pandemic response.

Pursuant to the Department of Health (DOH) Department Memorandum 2022-0220, RITM serves as the primary testing and isolation facility for suspect, probable, and confirmed cases of monkeypox. The Surveillance and Response Unit (SRU) of the Institute will be receiving samples and referring cases to RITM and other agencies.

“The first cases of monkeypox will be admitted at RITM. Because of this, we have prepared some guidelines on the flow of admission of suspect cases and their assigned rooms, sample collection and testing of monkeypox cases, and reporting and surveillance,” relayed RITM Director Dr. Celia Carlos to RITM employees during the Institute’s General Assembly on May 30, 2022.

Laboratory confirmation of samples will be crucial to rule out other infections presenting with rash. Specimens to be sent to RITM may be in the form of vesicular or pustular fluid swab, crust, or roof of skin lesion.

“It is expected that we will be receiving samples from all over the country for suspected monkeypox virus cases. So it is important that our laboratories and personnel are prepared for this response,” said RITM Laboratory Research Division Chief Dr. Amado Tandoc III.

Similar to the testing procedures for COVID-19, polymerase chain reaction (PCR) is the recommended laboratory technique for the diagnosis of monkeypox to indicate the presence of the virus in skin lesions. The RITM Special Pathogens Laboratory (SPL) will be performing the monkeypox virus PCR. SPL is currently in collaboration with the Institute’s Molecular Biology Laboratory (MBL) to establish the test.

Aside from PCR, MBL may also perform metagenomic sequencing as well as whole genome sequencing on the samples if warranted to aid pathogen detection.

In terms of specimen collection, RITM is set to release a technical advisory to guide referring hospitals and facilities on the proper collection, packaging, and transport of samples.

As of writing, there are no reported cases of monkeypox in the country.

A viral infection known since 1958, monkeypox is now reemerging across the globe, affecting 23 non-endemic nations – nations in which monkeypox is not prevalent. The World Health Organization (WHO) reports that the impact and the extent of the infection are yet to be determined.

Monkeypox is a zoonotic disease which means that primary infections are caused by contact with infected animals such as rodents and primates. Human to human transmission is said to be limited but occurs when an individual has a prolonged exposure to an infected individual. Its symptoms include fever, headaches, chills, sore throat, malaise, fatigue, and rashes. The monkeypox rash is often accompanied by lymphadenopathy or the swelling of lymph nodes across the body, which distinguishes the infection from smallpox and varicella or commonly known as bulutong.

As there are currently no vaccines approved and authorized by the Food and Drug Administration (FDA) to be used in the country, suspected cases of monkeypox are advised to follow minimum public health standards and isolate. 

Everyone is encouraged to report any patient with unexpected rashes with fever and lymphadenopathy to health authorities of the DOH Epidemiology Bureau or regional, provincial, or local epidemiology and surveillance units.

by Anel Azel Dimaano