Applicability and benefits of telemedicine in the monitoring of monkeypox close contacts

Abstract

Monkeypox is a zoonotic disease caused by the monkeypox virus and classically presents as a vesicular rash accompanied by fever and lymphadenopathy. Singapore reported the first imported case of monkeypox infection on 21 June 2022, the first local unlinked case on 6 July 2022, and the first local linked case on 5 August 2022. Telemedicine was used in the management of monkeypox close contacts to (1) screen for the development of signs and symptoms consistent with monkeypox infection, (2) assess for successful post-exposure prophylaxis via direct visualisation of vaccination site morphological progression, (3) detect serious reactions arising from post-exposure prophylaxis administration, and (4) evaluate for deterioration in mental health status during the 21-day quarantine period. A case series of 13 close contacts who received post-exposure prophylaxis in the form of the ACAM2000 live Vaccinia virus preparation is presented, illustrating the safe and efficacious application of telemedicine in the clinical follow-up of quarantined close contacts throughout the 21-day incubation period, and post-exposure prophylaxis monitoring. Inherent limitations included difficulties in the assessment of sensitive areas such as the peri-genital and peri-anal regions and video quality–related issues.