OUTLINE

Mpox (MonkeyPox):
Sexual Education for 8-10 y.o. Son:
Current Practical TipsSituation
Indonesian

Robert Sinto
Division of Tropical and Infectious Diseases
Department of Internal Medicine
Cipto Mangunkusumo National Hospital – FM Universitas Indonesia
22 November 2023
Disclaimer OUTLINE
 There are no conflict of interest or restriction related to this
presentation and/ or related materials.
Sexual Education for 8-10 y.o. Son:
Practical
 The information is current Tips
as of the date of the presentation,
which means at some point it may (and likely will be)
outdated.
Outline OUTLINE
•Indonesia cases (and region) update
Sexual
•Clinical Education
characteristics forfactors
and risk 8-10 y.o. Son:
•Treatment and outcome Practical Tips
•Ongoing and future plan
WHO. External Situation Report 29, published 20 October 2023
https://doi.org/10.1016/j.tips.2023.08.003
Outline OUTLINE
•Indonesia cases (and region) update
Sexual
•Clinical Education
characteristics forfactors
and risk 8-10 y.o. Son:
•Treatment and outcomePractical Tips
•Ongoing and future plan
WHO. External Situation Report 29, published 20 October 2023
 Clinical characteristics and risk factors: first 29 cases

40-49 tahun Age Sex Status Possible transmission Sexual orientation

1 18-24
3% tahun Proses biseksual
Isolasi heteroseksual
7 Isolasi 1
Mandiri 3
24% 5 4%
30-39 7 10%
tahun 17%
24%
11
38% Kontak
laki-laki Isolasi RS
Seksual
25-29 29 17 29
tahun 100% 59% LSL
100%
10 25
35% 86%

risk communication and community engagement (RCCE

Symptoms Comorbidities**
Sympt/Asympt 27 24
24
Asimtomatis 18 17
2 12 11 11
7% 10
8 8 7 7
6 6 6 6 6
4 4
2 2 2 2
Simtomatis
27
93% HIV sifilis hipertensi

15
* Kasus dapat memiliki lebih dari 1 gejala
** Kasus dapat mengalami lebih dari 1 kondisi penyerta
DOI: 10.1056/NEJMoa2207323
https://doi.org/10.1016/j.tips.2023.08.003
Brooks JT, 2022.
Indonesian 1st case: 19 August 2022
Imported case
Indonesian case 2023: local transmission case
 Gejala dan tanda Monkeypox Cacar air (Chickenpox/Varicella) Campak (Measles)
Demam Demam > 38 °C , ruam Demam hingga 39 °C ruam Demam tinggi 40.5 °C, ruam
setelah 1-3 hari setelah 0-2 hari setelah 2-4 days

Penampakan ruam Makula, papula, vesikel, Makula, papula, vesikel. Ada di Ruam non vesikel pada berbagai fase
pustul. Jenis ruam sama pada berbagai fase
setiap fase di semua area
tubuh

Perkembangan ruam Lambat, 3-4 minggu Cepat, tampak crops selama Cepat, 5-7 hari
beberapa hari

Distribusi ruam Dimulai di kepala, lebih padat Mulai di kepala; lebih padat di Mulai di kepala dan menyebar; dapat
di wajah dan anggota badan; tubuh; tidak ada di telapak mencapai tangan dan kaki
muncul di telapak tangan dan tangan dan telapak kaki
telapak kaki

Penampakan khas Limfadenopati Ruam gatal Koplik spots

Kematian 3-6% Jarang Bervariasi

Diterjemahkan dari WHO. Introduction to monkeypox. 2020

Outline OUTLINE
•Indonesia cases (and region) update
Sexual
•Clinical Education
characteristics forfactors
and risk 8-10 y.o. Son:
•Treatment and outcomePractical Tips
•Ongoing and future plan
https://www.cdc.gov/poxvirus/monkeypox/clinicians/Tecovirimat.html
Monkeypox: Luaran pada non-endemis

DOI: 10.1056/NEJMoa2207323
Lancet 2023; 401: 939–49
Lancet 2023; 401: 939–49
Lancet 2023; 401: 939–49
Outline OUTLINE
•Indonesia cases (and region) update
Sexual
•Clinical Education
characteristics forfactors
and risk 8-10 y.o. Son:
•Treatment and outcomePractical Tips
•Ongoing and future plan
Response
RCCE
• RCCE through webinars, IEC materials, updates FAQ., press conference

Detection
• Improve case findings at national level, incl engaging the CSO such as Spiritia and Indonesia AIDS
coallition
• Testing for suspected, probable and close contact (sexual contact); Contact tracing
• Lab strengthening : Improve testing and WGS
• IHR Notification

Vaccination
• Vaccine coverage : 1st dose 447 people, using JYNNEOS
• Current target : high risk close contact, MSM community in DKI Jakarta, Lab staff
38
 OUTLINE
Diagnostic capacity
• 15 labs available for molecular detection of Mpox, across 11
provinces (+24)
•
Sexual Education for 8-10 y.o. Son:
Practical Tips
3 labs in Jakarta:
• Laboratorium Pusat Penyakit Infeksi Prof. Sri Oemijati
• Balai Besar Teknik Kesehatan Lingkungan dan Pengendalian
Penyakit (BBTKLPP) Jakarta
• Rumah Sakit Penyakit Infeksi Soelianti Saroso
Case Report Form
Suspect, Probable and Confirmed Cases

40
 Surveillance indicators

❑ 1stIndicator: Proportion of suspect and probable cases who were

tested Target: 100%.
❑ 2nd Indicator: Proportion of confirmed cases with complete
epidemiological surveillance (including: demographic,
epidemiology, clinical, daily monitoring, contact tracing) Target:
100%.
❑ 3rd Indikator: Proportion of contact who were monitored up to 21
days Target: 100%.
Response
RCCE
• RCCE through webinars, IEC materials, updates FAQ., press conference

Detection
• Improve case findings at national level, incl engaging the CSO such as Spiritia and Indonesia AIDS
coallition
• Testing for suspected, probable and close contact (sexual contact); Contact tracing
• Lab strengthening : Improve testing and WGS
• IHR Notification

Vaccination
• Vaccine coverage : 1st dose 495 people, using JYNNEOS
• Current target : high risk close contact, MSM community in DKI Jakarta, Lab staff
42
https://www.cdc.gov/poxvirus/monkeypox/interim-considerations/overview.html
https://www.cdc.gov/poxvirus/mpox/interim-considerations/jynneos-vaccine.html