Ports begin screening for mpox

WHO alert

On 14 August 2024 the World Health Organization (WHO) declared the mpox (monkeypox) outbreak in parts of Africa a public health emergency of international concern (PHEIC) for the second time in two years. This is the highest level of alert the WHO can issue and underlines the organisation’s concerns about the rapid spread of the disease. Its decision was prompted by a significant increase in mpox cases in the Democratic Republic of Congo (DRC) and several neighbouring countries, including the emergence of a new strain of the virus which may cause a higher percentage of patients to become seriously ill or die compared to the global mpox outbreak in 2022. However, the WHO also emphasises that mpox “is not the new Covid-19” and the risk to the general public in countries outside the DCR and neighbouring countries remains moderate.

Situation report

According to the WHO’s 2022-24 Mpox (Monkeypox) Outbreak: Global Trends report as of 28 August 2024, only a few African countries in addition to the DRC have so far reported mpox cases of the new virus strain. Outside the African region, the number of reported cases remains low and primarily relate to individuals with travel histories to countries in Africa where mpox is circulating. However, as the situation may change quickly, we recommend ship operators to stay alert to the situation and follow the evolution of the ongoing outbreak.

Travel advice

At the time of writing, WHO’s recommendation to its member states is to “refrain from implementing travel-related health measures specific for mpox, such as entry or exit screening, or requirements for testing or vaccination”. However, we are aware that some port authorities have started to implement stricter health and epidemiological measures to prevent the disease from spreading via international vessels. Current examples are Singapore, India, Bangladesh, Argentina, Uruguay and Venezuela, and others may follow.

In order to avoid unnecessary delays when entering a port or conducting crew changes, ship operators and their masters should make frequent checks with local sources of information, e.g. vessel's agent and/or Gard's correspondents, to obtain the most up to date travel and port entry requirements available at any given time.

Crew information

It is also important to keep ship personnel informed about mpox through risk communication, e.g., by displaying posters, videos, and message boards. Promotion of personal protective measures and risk-reducing behaviour is important, particularly before shoreside visits or crew changes. Key messages should include information about:

Symptoms: Common symptoms of mpox include a rash lasting for two to four weeks, which may be started with or followed by fever, headache, muscle aches, back pain, low energy and swollen lymph nodes. The rash looks like blisters and can affect the face, palms of the hands, soles of the feet, groin, genital and/or anal regions, mouth, throat or the eyes. The number of sores can range from one to several thousand.
Transmission: Mpox can spread from person to person through:
- direct contact with the infectious rash, scabs, or body fluids; respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing or sex; and
- touching items (such as clothing or linens) that has been in contact with the infectious rash or body fluids. It is also possible for people to get mpox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.
Prevention: Personal hygiene is paramount. Self-protection steps include avoiding skin-to-skin or face-to-face contact with anyone with symptoms, practicing safer sex, cleaning hands with water and soap or alcohol-based hand rub, and respiratory etiquette. There are vaccines recommended by WHO for use against mpox. However, mass vaccination is not currently recommended and only people who are at risk of exposure to mpox should be considered for vaccination, according to WHO. We therefore recommend checking with a medical doctor mpox vaccination is available for and needed for seafarers.
Reporting: Any rash-like illness should be immediately reported to a medic, including information about all recent travel and potential contact with infected persons. The ill person should remain isolated.

General information and advice

For the latest official information and advice related to the mpox outbreak, we recommend consulting the following organizations’ websites dedicated to the disease:

For medical officers, we recommend consulting the diseases section of the Mariners Medico Guide app, to obtain up to date medical information and treatment support for mpox. This international guide is designed by doctors specialised in maritime medicine as an assessment tool specifically for seafarers while at sea. It is written in easy-to-follow language and steps and includes contact details and links to shore based telemedical assistance. The app can be downloaded for free and once downloaded, the guide is available without internet access.