Clinical Scorecard: Mpox Risk Among Massage Therapists in the Philippines

At a Glance

Key Highlights

• Mpox cases in the Philippines have increased from zero in July 2022 to 18 confirmed cases by August 2024, with predictions of further rise.
• Massage therapy involving 'extra service' sexual activities poses a high risk for mpox transmission due to close physical contact.
• Sex work is illegal in the Philippines and often disguised as massage therapy, complicating public health interventions.

Guideline-Based Recommendations

Diagnosis

• Identify suspected mpox cases based on exposure history and clinical signs following close contact with confirmed or probable cases.

Management

• Implement vaccination for high-risk populations such as massage therapists and sex workers.
• Conduct country-wide information campaigns led by the Department of Health to improve case management and surveillance.

Monitoring & Follow-up

• Perform efficient contact tracing with daily monitoring or self-monitoring of contacts for 21 days from last exposure.

Risks

• Close physical and sexual contact in massage therapy settings increases mpox transmission risk.
• Stigma and criminalization of sex work hinder access to healthcare and public health interventions.

Patient & Prescribing Data

High-risk individuals including massage therapists and sex workers involved in close physical contact with clients

Mpox vaccination is recommended for high-risk groups to prevent infection; broad vaccination is not currently advised.

Clinical Best Practices

• Lead targeted information campaigns through government health departments to educate and monitor at-risk populations.
• Prioritize vaccination policies for vulnerable groups with close contact exposure.
• Establish efficient contact tracing and monitoring protocols for suspected and confirmed mpox cases.
• Consider border control measures with countries having heightened mpox alerts to prevent importation.

References

• Mpox outbreak and risk among sex workers in Africa
• World Health Organization mpox transmission information
• Philippines Department of Health mpox case updates
• News reports on massage parlor raids in the Philippines
• Revised Penal Code of the Philippines Article 202
• Department of Health guidelines on mpox surveillance and management
• CDC recommendations on mpox vaccination