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Singapore to offer Mpox vaccine to high-risk healthcare workers and close contacts

Singapore will offer free mpox vaccines to high-risk healthcare workers and close contacts of confirmed cases, amid concerns over the deadlier clade 1 strain. The Ministry of Health stated mask-wearing is unnecessary for the public, as the virus primarily spreads through close contact.

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Singapore has announced new measures to combat the spread of the deadlier mpox clade 1 strain, as concerns mount over its potential impact.

At a press conference on Wednesday, Health Minister Ong Ye Kung revealed that the mpox vaccine JYNNEOS will be offered to two key groups: healthcare workers at high risk of exposure and close contacts of confirmed cases.

The announcement comes as the World Health Organization (WHO) declared mpox a global public health emergency for the second time in two years due to the resurgence of clade 1 cases in Africa.

Minister Ong emphasized that while there is limited data on the virus, the government has sufficient information to implement precautionary measures. “We do not have full information on the characteristics of this virus, but we have good information on how it behaves,” he said. Ong added that Singapore’s response plan would remain flexible and adapt as the global understanding of the virus evolves.

Response Measures and Border Controls

As part of a whole-of-government approach, the Ministry of Health (MOH) has coordinated a comprehensive public health strategy to prevent the spread of mpox clade 1 in Singapore.

While no direct flights connect Singapore to countries experiencing mpox outbreaks, temperature and visual screening measures have been put in place at Changi and Seletar airports for travellers and crew arriving from affected regions. Screening at sea checkpoints has also been implemented for ships from mpox-affected areas.

Travellers are required to report any mpox-related symptoms (such as fever or rash) and provide travel history via the SG Arrival Card. Those displaying symptoms will be assessed by medical professionals at the borders and referred to hospitals if necessary.

Vaccination Strategy and Quarantine

The JYNNEOS vaccine, previously approved in Singapore for both smallpox and mpox, will be offered to two key groups. Healthcare workers at the National Centre for Infectious Diseases (NCID) and other high-risk facilities will be provided with pre-exposure prophylaxis, in addition to existing infection control protocols. Close contacts of confirmed mpox cases will receive a single vaccine dose within 14 days of exposure during their 21-day quarantine period. The MOH has assured that the current vaccine supply is sufficient to meet the needs of these priority groups.

MOH highlighted that a “significant” portion of the population—those born before 1981—may already have some immunity due to mandatory smallpox vaccinations administered in Singapore until that year.

Detection, Isolation, and Treatment

MOH has instructed all healthcare providers to be vigilant and promptly report any suspected mpox cases, especially those involving clade 1.

Suspected cases will be referred to designated hospitals for further assessment and testing, with paediatric cases directed to KK Women’s and Children’s Hospital and adult-child family groups to National University Hospital. Confirmed clade 1 cases will be isolated in healthcare facilities until they are no longer infectious to prevent further community spread.

Testing for mpox involves polymerase chain reaction (PCR) testing conducted at the National Public Health Laboratory. While there are no rapid point-of-care test kits available, cases are managed through supportive care. For severe cases, antivirals such as Tecovirimat may be used, aligning with treatment protocols in other countries.

Community Measures and Mask-Wearing

Based on current data, the virus spreads mainly through close physical contact, such as within households. Therefore, mask-wearing for the general public is not recommended unless there is significant evidence of respiratory transmission. MOH has stated that if respiratory spread becomes a concern, measures such as mask-wearing on public transport or in crowded indoor spaces may be considered.

In settings such as preschools and schools, existing infectious disease protocols—such as visual screenings for symptoms and hygiene measures—will continue to be implemented to control any potential spread. Additionally, MOH, in collaboration with the Ministry of Manpower and the National Environment Agency, has begun wastewater testing at migrant worker dormitories and the Onboard Centre to detect any presence of mpox.

Ongoing Surveillance and Preparedness

MOH will continue to work closely with international counterparts to monitor the evolving mpox situation. Border measures, detection protocols, and vaccination strategies will be adjusted as needed to safeguard Singapore’s public health.

As of now, Singapore has not detected any clade 1 cases, with all 14 mpox cases this year involving the less severe clade 2 subtype. However, Minister Ong stressed the importance of vigilance, particularly in protecting vulnerable groups such as children and the immunocompromised, should clade 1 reach Singapore.

“Our best course of action is to suppress the spread, provide proper treatment, and have an effective vaccination strategy in place,” Ong said. Despite the concern surrounding mpox, Ong reassured the public that it is unlikely to cause the level of disruption seen during COVID-19.

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Health

Baby born with 26 fingers and toes in India, considered reincarnation of Hindu deity

A baby in Bharatpur, India, was born with 26 fingers and toes, believed to be a reincarnation of a Hindu deity.

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A baby was born with an astonishing 26 fingers and toes in a hospital in Bharatpur, a city in the northern Indian state of Rajasthan.

While medical experts describe the condition as a genetic anomaly known as polydactyly, the baby’s family is rejoicing, believing that their child is the reincarnation of a revered Hindu deity.

The baby, whose name has not been disclosed, entered the world with 14 fingers on its hands and 12 toes on its feet, leaving medical professionals both astounded and intrigued.

As reported by the Daily Mail on Tuesday (19 Sep), doctors described it as a genetic anomaly known as polydactyly, where someone is born with one or more extra fingers or toes. It can occur on one or both hands or feet.

However, the family is reported to be happy and openly refers to it as a reincarnation of Dholagarh Devi, a famous local deity whose temple is located near the girl’s birthplace. The deity’s statue depicts a young girl with multiple hands.

The baby’s mother, Sarju Devi, aged 25, expressed immense joy at the birth of her child. Sarju Devi’s brother, whose name was not disclosed, spoke to local media, proudly stating, “My sister has given birth to a baby with 26 fingers, and we consider it to be the incarnation of Dholagarh Devi. We are overjoyed.”

The baby’s father, Gopal Bhattacharya, a Central Reserve Police Force officer, is also reported to be ecstatic about the birth.

Dr BS Soni, a medical practitioner at the hospital where the baby was born, offered a medical perspective on the condition, saying, “Having 26 fingers is not harmful, but it is a genetic abnormality. The little girl is perfectly healthy.”

The big question now is whether the family from Bharatpur, in the northern Indian state of Rajasthan, plans to undergo surgery to reduce the number of fingers and toes on their newborn baby.

This decision is yet to be disclosed as the family continues to bask in the belief that their child is a divine reincarnation.

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Health

Singaporean aesthetic clinic experts share insights on filler-related blindness risks

In July, Singapore experienced its inaugural case of blindness linked to dermal filler use, as a woman lost her vision following an injection. Subsequently, the Ministry of Health (MOH) and Health Sciences Authority (HSA) initiated an investigation.

Meanwhile, experts from a Singaporean aesthetic clinic have shared their insights on this concerning issue via social media.

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SINGAPORE: In July of this year, Singapore witnessed its first reported case of blindness resulting from dermal filler usage, when a woman lost her vision after receiving a dermal filler injection.

On the 20th of July, a woman underwent a procedure involving AestheFill, a South Korean dermal filler renowned for its temporary wrinkle and skin fold reduction properties, at a Redhill clinic.

As reported by The Straits Times, a source familiar with the incident confirmed that the patient was a Singaporean woman in her thirties.

Prompted by a complaint received on July 29th from Parvus, the distributor of AestheFill, the Ministry of Health (MOH) and Health Sciences Authority (HSA) promptly initiated an investigation into the case.

The regulatory body is currently probing whether there were any defects related to product batches that may have compromised product safety and quality.

Distributor’s investigation unveils dermal filler’s role in woman’s vision loss

According to the findings of the product distributor’s investigation, the accidental injection of the dermal filler into the bloodstream resulted in the woman’s vision loss.

Providing further insight into the incident, a Parvus spokesperson revealed, “The outcome of our investigations indicates that the complication was caused by a blood vessel occlusion (or blockage) during the procedure, which, in turn, was caused by an inadvertent administration of the product into the bloodstream.”

The Parvus spokesperson refrained from divulging additional details about the incident, citing patient confidentiality.

Meanwhile, the Singapore Medical Council is closely monitoring the situation and is prepared to take appropriate action as needed, pending the conclusion of investigations by MOH and HSA.

The Parvus spokesperson strongly advised individuals contemplating aesthetic treatments of this nature to exclusively seek consultations from qualified medical practitioners who have received proper training in dermal filler administration.

“It is crucial to discuss any concerns with your healthcare provider and to fully understand the inherent risks associated with any medical procedure,” he added.

“We are continually investing in training and best practices to ensure that the risks are minimised.”

In response to CNA’s queries on 19 September, Parvus clarified that AestheFill remains safe and approved by Singapore’s Health Sciences Authority (HSA). The company expressed its active cooperation with HSA’s ongoing investigation and reiterated its commitment to product quality and patient safety.

“We are actively cooperating with the HSA in their ongoing investigation, and we maintain that product quality and patient safety are our utmost priorities.”

The spokesperson stated that the batch in question had undergone a comprehensive evaluation in accordance with Korean Food & Drug Administration (KFDA) manufacturing standards and complied with the ISO 13485 quality management system.

AestheFill has been registered in Singapore since October 1, 2021, with dermal fillers classified as Class D medical devices, the highest-risk category, in Singapore.

Expert Insights on filler-related blindness risks

Meanwhile, Dr Siew Tuck Wah and Dr Phoon Yi Shan, both Medical Directors at Radium Medical Aesthetics, a Singaporean aesthetic clinic, recently took to social media to share their insights on filler-related blindness.

While acknowledging the rarity of complications, including blindness, from filler injections, both doctors emphasized the importance of practitioner expertise, encompassing facial anatomy knowledge, safe injection techniques, and the use of clinically proven filler products.

Dr Siew, who is also the clinic’s founder, highlighted the potential for filler-related blindness with any filler type, including hyaluronic acid and biostimulators.

However, he emphasized that such incidents are extremely rare, with a reported occurrence rate ranging from 1 in 100,000 to 1 in 1,000,000 cases.

“It occurred because if you accidentally entered (the filler) into the artery, it can block the arteries supply of the eye.”

Dr Siew pointed out a critical detail: blindness resulting from filler injections typically manifests immediately during the procedure. Therefore, if a patient received a filler injection a day or a week ago without any issues, there’s no need to be concerned about suddenly going blind.

Certain areas of the face pose a higher risk for such complications, including the nose, glabella (the area between the eyebrows), temples, forehead, and nasolabial folds (the lines running from the nose to the corners of the mouth).

“Which is why I always explain extensively to my patients that there is such a risk.”

To minimize this risk, he employs safe injection techniques such as slow injection, using the correct product, and avoiding excessive product injection.

“More importantly, your injector needs to be trained and know the anatomy of the face, and know where the blood supply of the face runs.”

“In my practice, I also use an ultrasound machine to scan my patients before I even put a needle into the face, so that I can map out where the arterial supply is, and avoid those areas.”

In the event of a complication, Dr Siew stressed that quick action is essential, as there is a narrow therapeutic window. Immediate referral to an eye doctor is crucial.

Dr. Siew concluded by advising individuals considering filler injections to thoroughly understand all the associated risks, even though severe complications are rare.

@drsiew

Blindness from filler Injections – do you need to be worried? Here’s everything you need to know. #fillers #fillercomplications #fillerinjection #dermalfillers #Drsiew #drsiewtuckwah #blindness #fillerblindness #ultrasound #singapore #restylane #juvederm #belotero #teoxane #radiesse #sculptra #ellanse #aesthefill

♬ original sound – Dr Siew – Dr Siew

Dr Phoon stresses safety measures for filler injections

Dr Phoon Yi Shan, also a Medical Director at Radium, expressed empathy for the affected patient and extended best wishes for her recovery.

She acknowledged that complications, although rare, can potentially occur in the hands of even the most skilled practitioners.

Complications can range from mild issues like swelling or bruising that resolve within a few days to severe complications such as skin necrosis or blindness, which affect less than 1% of patients.

“This happens when the filler is injected into the blood vessel, obstructing the blood flow.”

“If this is an artery supplying the skin, skin necrosis can occur, but the worst case scenario is when an artery supplying the eye is blocked, leading to blindness.”

To minimize risks, Dr Phoon emphasized the importance of a deep understanding of facial anatomy, careful avoidance of danger zones, and the use of safe techniques and clinically proven filler products with good safety profiles.

“We also have to know exactly what to do if complications arise, as immediate bedside treatment can prevent devastating consequences.”

Dr Phoon also noted that at their clinic, they use ultrasound imaging before injections to visualize blood vessels for added safety.

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