Asia ramps up border controls, tests and vaccines as new clade of mpox spreads

The preemptive move stands in stark contrast to preparations in the UK and across much of Europe

Countries across Asia are ramping up surveillance and countermeasures against mpox as Thailand reported its first suspected case of a new, more dangerous variant of the virus.
The preemptive action, deeply embedded in local pandemic plans, stands in contrast to the UK where border checks have yet to be actioned.
The rapid spread of the new mpox strain – known as clade 1b – in Africa prompted the World Health Organisation to declare a public health emergency last week.
Following the move, countries have begun tightening health screening at their borders, closely monitoring arrivals from African states that have been hit hardest.
Some countries have also begun stockpiling vaccines.
South Korea said on Wednesday that epidemiologists and public health doctors will be deployed at the gates of flights arriving from Ethiopia, a major transport hub for Africa, to monitor incoming passengers.
A spokesperson for the Korea Disease Control and Prevention Agency (KDCA) said it  identified eight countries at particular risk – Rwanda, Burundi, Uganda, Ethiopia, Central African Republic, Kenya, Congo, and the Democratic Republic of Congo.
Anyone with mpox symptoms will be required to report to quarantine officers on arrival.
Waste from aircraft toilets will also be monitored for the virus, said the KDCA, which is also distributing a brightly coloured leaflet with information on mpox symptoms and prevention as part of a public information campaign to raise awareness. 
The leaflet gives an emergency 24 hour number for anyone who believes they need help.
Health authorities in Thailand on Wednesday said they had detected Asia’s first suspected case of the new clade 1b of the virus in a European man who had recently travelled to Africa.
The patient been quarantined in hospital while the Thai authorities run tests to confirm if the virus is indeed from the new clade of mpox.
The country’s health ministry said it was closely monitoring the situation worldwide and was boosting surveillance at airports.
Passengers who arrive in the country showing a rash or other symptoms consistent with mpox will be isolated and given PCR tests, it said.
Professor Hsu Li Yang, vice dean of global health at the Saw Swee Hock School of Public Health in Singapore said that while the case was concerning and exposed the “very real risk of clade 1b importations into Southeast Asia”, it also revealed the strength of the Thai surveillance system.The country was also the first place outside China to detect Covid-19 in January 2020.
Taiwan, meanwhile, has already begun stockpiling vaccines and conducting targeted immunisation campaigns for people at high risk, including medical workers.
As of August 18, 135,800 people had already been vaccinated, and vials had been purchased to give to 70,000 to 80,000 more by the end of this year, Taiwan’s Centres for Disease Control said.
A nationwide network of seven laboratories was testing for the virus, and a public information campaign was a key plank of the strategy to combat the new strain, a spokesperson said.
Michael Baker, an epidemiologist and public health professor at the University of Otago in Wellington, said that for countries outside of Africa with high performing health systems and access to testing and vaccines, the latest mpox outbreak was “still a very manageable problem.”
The need for more attention and resources within Africa remained “worrying,” he said, but in the Asia-Pacific, countries could take “well-established” approaches to protect themselves based firstly on risk assessments and working out what interventions were needed.
These could either be “case-based” and focused on identifying and isolating patients and tracing their contacts, or “population-based approaches designed to prevent people getting infected” that included vaccination strategies and clear travel advice, he explained.
To date, major Asian nations like China, have centred their strategies on screening arrivals.
China announced on Friday that it would begin monitoring people and goods entering the country for mpox over the next six months.
People travelling from countries where virus outbreaks have occurred, who have been in contact with mpox cases or display symptoms should “take the initiative to declare to customs when entering the country”, China’s customs administration said in a statement.
Vehicles, containers and items from areas with mpox cases should also be sanitised, the statement added.
Prof Baker cautioned that health authorities should also study the evolution of more infectious variants of the virus. Question remained about clade 1b’s transmissibility that could make it harder to contain, he said.
“We have to keep watching this space and getting more data from Africa about it.”
Britain is also ramping up preparations for potential new mpox cases but has yet to tighten border health controls.
On Monday, Cabinet ministers and Chief Medical Officer Chris Whitty met officials from the Department of Health and the Foreign Office to assess the UK’s readiness for a possible outbreak, according to Downing Street.
New protocols include speeding up the process of sending samples from suspected mpox patients to high-security labs at Porton Down. This is to identify the specific virus strain, a spokesperson from the UK Health Security Agency told The Telegraph.
If the more dangerous clade 1b strain is detected, patients will likely be transferred to specialised treatment centres designed for high-consequence infectious diseases like Ebola and Lassa Fever.
However, no updated advice for travellers at airports and ports has yet been issued, nor has surveillance at entry points ramped up, The Telegraph understands.
Prof Geoffrey Smith, an mpox expert at the University of Oxford, suggested that simple measures like health questionnaires or temperature checks could be easily introduced.
The government has also not changed its guidelines on who qualifies for the mpox vaccine, which is currently available only to gay men and trans women in London and Manchester.
Travellers outside these groups, even if heading to high-risk countries like the Democratic Republic of Congo, are not eligible for the vaccine.
European health authorities said on Monday the EU has ruled out imposing border controls as the risk of a global mpox outbreak is still considered “low”.
In a meeting held on Monday, the EU’s Health Security Committee said it would not introduce enhanced surveillance and monitoring measures, and stressed the virus should “not be considered a public health emergency in Europe as things stand”.
So far, one case of clade 1b has been detected in Sweden, although greater spread throughout Europe is “highly likely,” according to the European Centre for Disease Control (ECDC).
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