2022–2023 mpox outbreak in Asia
History
History
-------

### Imported cases before the outbreak

According to the [World Health Organization](/wiki/World_Health_Organization "World Health Organization"), imported cases of mpox from [Nigeria](/wiki/Nigeria "Nigeria") was detected in [Israel](/wiki/Israel "Israel") and [Singapore](/wiki/Singapore "Singapore") in September 2018 and May 2019, respectively.

In 2018, an imported case was detected in Israel. A 38\-year\-old man came from [Rivers State](/wiki/Rivers_State "Rivers State"), [Nigeria](/wiki/Nigeria "Nigeria") in late September. He showed the symptoms of the disease on that month. Later on October the patient sought medical attention at [Shaare\-Zedek Medical Center](/wiki/Shaare_Zedek_Medical_Center "Shaare Zedek Medical Center") in [Jerusalem](/wiki/Jerusalem "Jerusalem"). He was confirmed to be infected with the West African Clade of [monkeypox virus](/wiki/Monkeypox_virus "Monkeypox virus") that month. All of the patient's contacts were traced and followed up but no virus transmission were detected.

### Arrival

[thumb\|Ichilov General Hospital (in the middle) in [Tel Aviv Sourasky Medical Center](/wiki/Tel_Aviv_Sourasky_Medical_Center "Tel Aviv Sourasky Medical Center"), where the first case was isolated](/wiki/File:Tel_Aviv_20.05.11_008.jpg "Tel Aviv 20.05.11 008.jpg")
As the outbreak was spreading in Europe in the middle of May 2022, the [Israeli Health Ministry](/wiki/Ministry_of_Health_%28Israel%29 "Ministry of Health (Israel)") reported a suspected mpox case in the country on 20 May. The case was confirmed by testing on 21 May, becoming the first case in Israel during the outbreak, which also became the first in Asia.

The 30\-year\-old man returned from [Western Europe](/wiki/Western_Europe "Western Europe") and contracted the disease from there. The ministry reported that he was in isolation in the [Ichilov General Hospital](/wiki/Ichilov_General_Hospital "Ichilov General Hospital") in [Tel Aviv](/wiki/Tel_Aviv "Tel Aviv").

### Cases transited through Asia

In May and June 2022, two Australians tested positive for mpox in Australia, but before that they stayed in transit in airports for some hours in [Southeast Asia](/wiki/Southeast_Asia "Southeast Asia").

On 30 May, Thai health authorities confirmed that an Australian who stayed in transit in [Suvarnabhumi Airport](/wiki/Suvarnabhumi_Airport "Suvarnabhumi Airport") for two hours that week had tested positive for mpox in Australia.

On 6 June, the [Singaporean Ministry of Health](/wiki/Ministry_of_Health_%28Singapore%29 "Ministry of Health (Singapore)") announced that a mpox case in [New South Wales](/wiki/New_South_Wales "New South Wales") in Australia stayed in transit in Singapore on 2 June. 13 people who had casual contact were isolated.

### Wastewater surveillance

A study from the Faculty of Medicine, Chulalongkorn University, Thailand led by Dr Dhammika Leshan Wannigama reported Multiple traces of monkeypox virus were detected in non\-sewered wastewater with sparse sampling collected from both the Bangkok, Thailand with increasing concentrations from June to August 2022\. This is the first dataset related to monkeypox viral DNA in wastewater in Bangkok. Monkeypox viral DNA was first detected in wastewater in the second week of June 2022\. From the first week of July, the number of viral DNA copies increased. Sanger sequencing confirmed the identification of the monkeypox virus and its relation to the 2022–2023 mpox outbreak. The same group later released findings from wastewater surveillance in six Southeast Asian countries (Thailand, Lao PDR, Myanmar, Cambodia, Vietnam, and Indonesia), which showed the presence of Monkeypox virus (MPXV) DNA, suggesting local transmission. This information serves as a vital notification for healthcare professionals and aids in the distribution of resources such as testing, vaccines, and treatments in regions with limited resources.

### Timeline of cases by country

#### Timeline of first confirmed cases by country or territory

| \+First confirmed mpox cases by country or territory |
| --- |
| Date

 Countries / *Territories*

|  |  |
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#### Timeline of suspected cases by country or territory

*Countries listed below had only suspected cases at the time of reporting. Some countries reported confirmed cases after reporting suspected cases (i.e. [Turkey](/wiki/Turkey "Turkey")). Countries listed several times reported suspected cases again after they discarded suspected cases before.*

| \+Timeline of suspected mpox cases by country or territory |
| --- |
| Date | Countries / *Territories* |
|  |  *(confirmed on 21 May)* |
|  |  *(discounted on 4 June)* |
|  |  *(discounted on 31 May)* |
|  |  *(discounted between 30 May and 5 June)* |
|  |  *(discounted on 2 June)* |
|  |  *(discounted on 7 June)* |
|  |  *(discounted on 5 June)* |
|  |  *(confirmed on 15 June)* |
|  |  *(discounted on 9 June)* |
|  |  *(discounted on 12 June)* |
|  |  *(discounted on 17 June)* |
|  |  *(confirmed on 22 June)* |
|  |  *(discounted on 9 July)* |
|  |  *(confirmed on 14 July)* |


When was the first imported case of mpox detected in Israel?