Should Saudi Arabia be worried about monkeypox?

Special Thermal-imaging cameras have remained at Saudi airports after the COVID-19 pandemic to act as a first line of defense against monkeypox. Below: Blisters are a symptom of infection. (SPA)
Thermal-imaging cameras have remained at Saudi airports after the COVID-19 pandemic to act as a first line of defense against monkeypox. Below: Blisters are a symptom of infection. (SPA)
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Updated 07 August 2022

Should Saudi Arabia be worried about monkeypox?

Should Saudi Arabia be worried about monkeypox?
  • Kingdom well placed to head off health threat thanks to successful policy responses to MERS and COVID-19 outbreaks
  • It has the advantage of effective surveillance, containment and preventive strategies and low transmission rate

JEDDAH: Health officials in Europe and the Americas are raising the alarm over the spread of monkeypox, with many declaring the outbreak a public-health emergency.

In Saudi Arabia, by contrast, where just three cases have been confirmed, the response has been more muted.

Saudi experts say there are several reasons for the Kingdom’s restrained approach, including the presence of well-established surveillance, detection and preventative measures resulting from its handling of previous infectious-disease outbreaks, and the extremely low transmission rate seen in the region.

“We know that especially in the Gulf region and in Saudi Arabia, there have been many efforts to document increasing cases and implement rigorous methods for detecting them, making sure that the right preventative and curative measures are in place to prevent the spread of monkeypox, as well as treating it right away from a medical standpoint,” Dr. Nawaf Albali, a Saudi physician, told Arab News.

“Countries have to implement the proper monitoring and surveillance standards on the borders and increase screening, increase diagnostic capabilities within and beyond borders.”

Once a relatively rare disease, monkeypox has been present in a handful of central and west African countries since the 1970s, with occasional outbreaks of no more than 100 cases over the past four decades. 

People with the illness tend to develop a rash that may be located on or near the genitals or anus, and on other areas such as the hands, feet, chest, face or mouth.

The rash will go through several stages, including scabs, before healing. It can initially look like pimples or blisters, and may be painful or itchy. 

Other symptoms can include fever, chills, swollen lymph nodes, exhaustion, muscle aches, backache, headaches, a sore throat, nasal congestion or a cough.

These symptoms usually start within three weeks of exposure to the monkeypox virus, and will typically last two to four weeks.  

Authorities have detected dozens of cases across Europe, North America and beyond since May, breaking the 28,000-case mark worldwide.

Symptoms of the self-limiting disease typically last from two to four weeks. (Shutterstock)

The World Health Organization declared monkeypox a global health emergency on July 23. To date, there have been at least 75 suspected monkeypox deaths in Africa, mainly in Nigeria and Congo.

On July 29, Brazil and Spain both reported deaths linked to monkeypox, the first reported outside Africa. Spain reported a second death the next day, and India reported its first on Aug. 1.

Just three cases of monkeypox have been detected in Saudi Arabia, among passengers returning from Europe.

Regionally, the UAE has 16 confirmed cases and Qatar has two — indicative of a much slower spread compared to other parts of the world.

Monkeypox is transmitted when a person comes into contact with the eponymous virus from an animal, human or contaminated material.

It often spreads through skin-to-skin contact, and many, though not all, cases have been through physical relations between men.

“The way it spreads is either through skin-to-skin contact, or through contact with certain body fluids, for example sweat, or exposure to sensitive parts in the body like the genitals or private parts,” said Albali. 

“This type of contact and this kind of intimate contact aren’t that common (in the Gulf). It doesn’t mean that they’re not there, but they’re not as common.”

Health officials in Europe and the Americas are raising the alarm over the spread of monkeypox. (AFP)

Dr. Abdulaziz Al-Angari, assistant professor of epidemiology at King Saud bin Abdulaziz University for Health Sciences in Riyadh, said although the WHO has declared monkeypox a public-health emergency of international concern, it is not yet a pandemic.

“The rate of infection is slow and limited considering the transmission pathways of the virus,” he told Arab News. 

To calculate an odds ratio (a statistic that quantifies the strength of the association between two events), a sufficient number of cases needs to be considered. To date, there have been too few cases in the Kingdom to draw conclusions. 

“More detailed information about the cases such as survey investigation (demographic data, history, practices, traveling information etc.) is needed,” said Al-Angari. 

Saudi Arabia and several other countries have taken necessary steps to gather such real-time data and prevent the spread — lessons that were learned from previous viral outbreaks.

In 2012, the first case of Middle East Respiratory Syndrome caused by the MERS coronavirus was identified in Saudi Arabia.

Studies have shown that humans are infected through direct or indirect contact with infected dromedary camels, but the exact transmission route remains unclear. 

The experience prompted the Kingdom to develop detection and containment strategies and infrastructure, which swung into action in 2020 when COVID-19 emerged.

Registered pharmacist Sapna Patel demonstrates the preparation of a dose of the monkeypox vaccine at a pop-up vaccination clinic. (AFP)

The Ministry of Health launched a command-and-control center, and accelerated the establishment of the Saudi Center for Disease Control and Prevention.

“Our experience with MERS-CoV was painful and peculiar in our region, and between 2013 and 2015, health authorities understood the magnitude of disease prevention, lockdowns, closing of markets and certain commercial activities related to camels,” said Albali.

“So we understand the effectiveness of early intervention when it comes to disease control. We’ve developed that kind of capability and the sense of urgency around the world health system.”

Reiterating the importance of early detection and documenting cases, Al-Angari said: “The global health systems developed critically after the recent pandemic in data collection, surveillance and tracking systems. 

“With this, contact tracing is a must to prevent the upcoming introduction of the virus to new populations.

“Although it might not be necessary now, using systems such as the Tawakkalna app might be considered at some point.”

The Saudi Data and Artificial Intelligence Authority developed Tawakkalna to support the government’s efforts to confront COVID-19 by managing the process of granting permits for leaving home during the lockdown phase, which helped limit the spread of the virus. 

In June, the app received the UN Public Service Award 2022 for institutional resilience and innovative responses to the pandemic.

The Kingdom understands the effectiveness of early intervention when it comes to disease control, according to Dr. Abdulaziz Al-Angari, assistant professor of epidemiology at KSAU-HS. (Supplied)

With travel demand skyrocketing after the loosening of COVID-19 restrictions, Al-Angari underscored the importance of monitoring points of entry. 

“Since the (monkeypox) virus is transmitted from human to human, all necessary arrangements should be implemented,” he said.

“Activation of thermal cameras is necessary at all times, not only for this disease but for all future ones, and random health screening of people who are in contact with animals on a regular basis is important to prevent zoonotic diseases.”

Just like the early days of COVID-19, infrared cameras placed at airport arrival halls are an integral part of the syndromic surveillance process — a process of collecting, analyzing and interpreting health-related data to provide an early warning of health threats.

“Once a camera detects one of the symptoms of the illness (such as elevated body temperature), the case is isolated at the airport, and as part of Saudi Arabia’s preventive measures, other individuals that could’ve potentially been exposed to the case must also be tested,” said Albali.

“That’s how the cases were detected, and an investigation was launched after, with no other cases detected to date.”

Beyond surveillance, according to Albali, health authorities must provide sufficient information and guidelines for travelers heading to countries considered monkeypox hotspots.

“The main lesson learned from the COVID-19 pandemic is a heightened community awareness about the virus and how to protect themselves,” he said.

“The same rule of thumb now applies to this current outbreak, even though it’s barely made a mark on our shores in Saudi Arabia, and with the transparent communication strategy by health authorities, the level of awareness will continue to increase and further protect the community from future outbreaks.” 

Monkeypox immunization programs have been launched in the US, the UK, Denmark, Spain, Germany, France and Canada among other countries. However, Saudi Arabia is unlikely to launch a vaccine rollout unless it becomes necessary for the purpose of protecting the most vulnerable, such as children, the elderly and the immunocompromised.

Although monkeypox in most cases has no complications, the Saudi Ministry of Health told Arab News that the vaccine is available as a precautionary measure and is given only to people who are at higher risk for infection because they have had contact with confirmed cases.

“Vaccines can be implemented,” said epidemiologist Al-Angari with the caveat that distribution on a mass community level is unlikely to happen in the Kingdom because monkeypox “isn’t a current threat, at least (not) in this region.”


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RIYADH: Saudi Arabia’s Crown Prince Mohammed bin Salman on Thursday unveiled the Savvy Games Group’s strategy, Saudi Press Agency reported.
“Savvy Games Group is one part of our ambitious strategy aiming to make Saudi Arabia the ultimate global hub for the games and esports sector by 2030,” the crown prince said.
“We are harnessing the untapped potential across the esports and games sector to diversify our economy, drive innovation in the sector and further scale the entertainment and esports competition offerings across the Kingdom,” he added.

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Updated 29 September 2022

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DUBAI: Saudi Arabia on Thursday has strongly condemned the Iranian attacks on the Kurdish region of northern Iraq.
Iran’s Revolutionary Guards said they had fired missiles and drones at militant targets in several Kurdish sites, killing over a dozen people.
“The Ministry of Foreign Affairs has expressed the Kingdom of Saudi Arabia’s strong condemnation of the Iranian attacks on Kurdistan Region of the Republic of Iraq, killing and wounding a number of innocent people,” the Kingdom’s Ministry of Foreign Affairs said in a statement.
“The Ministry of Foreign Affairs reiterated its total rejection of all attacks that threaten the security and stability of Iraq, stressing the importance of the international community standing up against all Iranian violations that contradict international laws, charters and norms,” the statement read.

The Kingdom also expressed its deepest sympathy and condolences to the government and people of Iraq.
Thirteen people were killed and 58 wounded in the attacks near Irbil and Sulaimaniya in Iraqi Kurdistan, Iraq’s state news agency said, citing its counter-terrorism service in Kurdistan.
Iran’s elite military and security force said they would continue targeting what it called terrorists in the region.

Saudi Arabia’s FM meets Philippines’ Marcos Jr. in Manila 

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Updated 29 September 2022

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DUBAI: Saudi Arabia’s Minister of Foreign Affairs Prince Faisal bin Farhan met with the Philippines’ President Ferdinand Marcos Jr. in Manila, the Saudi Press Agency (SPA) reported on Thursday. 
The two discussed bilateral ties and friendly relations between the two countries, as well as joint cooperation in various fields, according to SPA. 
Prince Faisal conveyed King Salman and Crown Prince Mohammed bin Salman’s greetings to the Philippines’ president. 
The reception was also attended by Hisham Al-Qahtani, the Kingdom’s Ambassador to the Philippines, and Abdulrahman Al-Daoud, Director-General of the Minister of Foreign Affairs office.

Westlife dazzles AlUla with sparkling performance

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Updated 29 September 2022

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  • Maraya’s stunning mirror hall could not contain fan joy
  • Irish band played mix of old favorites and new songs

ALULA: Maraya’s stunning mirror concert hall here was the scene of wild excitement and lump-in-the-throat nostalgia on Wednesday when Westlife performed for what appeared to be some of their most dedicated fans from Saudi Arabia and other parts of the world.

The Irish boy band had the crowd cheering even before they came on stage in AlUla for their “Wild Dreams Tour.” The audience erupted when the four singers eventually emerged to play their most recent hit “Starlight,” with the fans then singing every line in unison.

It was impossible to keep them in their seats. And when the singers shouted “jump,” they were on their feet.

The vocalists Shane Filan, Mark Feehily, Kian Egan, and Nicky Byrne have been through thick and thin. In 2012 they disbanded temporarily, only to come back bigger and stronger in 2018.

Diana Philander from Cape Town said she has been following them since a teenager. “I was 17 back then and I’m 40 now, so this is one of my favorites. I have been practicing the songs for the whole week and I loved every minute of it.”

Westlife gave fans a chance to snap pictures of them, by posing in all direction. (AN photo by Abdulrahman Binshalhoub)

“Thank you to the Saudi government for making all of this possible, there is just one word I can say and that is, it was just superb.”

The concert was a real treat for fans, with the band playing some of their biggest hits.

Before performing the very first song of their career, “Swear it Again,” Egan stepped forward and said: “Can you believe it? This song came out when we were little boys.”

Later Filan said: “We have played in a lot of places in the world, but honestly Maraya might be the coolest venue we have ever played in.”

“Everything was so beautiful, the ride here was absolutely stunning, and of course, you guys are so beautiful,” Filan said pointing toward the audience. “We have a beautiful family and we have always considered our fans as a part of this family, so thank you for being amazing.”

They also played “When you’re looking like that,” “Money, Money, Money” (originally sung by ABBA), and “Flying Without Wings.”

With fans calling for more, the band returned after briefly walking off the stage and performed “Hello My love” and several other songs.

Jessan Domingo Sanson from the Philippines said she traveled all the way from Dhahran to see the stars. “I have been a fan since I was in sixth grade, and I am now 34 years old.”

The band bid their fans a bittersweet good bye. (AN photo by Abdulrahman Binshalhoub)

Sanson was so excited she could barely form coherent sentences, instead expressing herself with shrieks and gestures. Sitting in the front row, she was over the moon because the band members repeatedly moved forward to wave and make heart signs to her and the other audience members.

“I am just glad that it was their first time here in Saudi Arabia, and I didn’t miss a chance to see them,” she said.

Having been together on the road for 23 years, the singers seemed clearly comfortable on stage, bantering and laughing while performing. They applauded each other when hitting particularly expressive and beautiful notes.

Thomas Wallace Thompson, a Scot who lives in AlUla, said: “It was amazing, a boy band from the 90s was here, all the girls were screaming. I am a man who is nearly 60 years old and still found everything extremely enjoyable. I have so many friends who are fans of Westlife and they are so jealous of me.”

Aisha Ahmed, a Saudi fan who was present at the concert with her husband, said: “The band kept saying that they are taking us through their songs, but it really felt like I went back in time, suddenly I was 13 again and I was listening to them in my bedroom, suddenly I was back with my high school friends dancing with our hairbrushes to their songs.”

Her voice wavered: “I am so emotional right now.”

KSRelief ramps up aid efforts in Pakistan, Yemen, Sudan

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Updated 29 September 2022

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RIYADH: The King Salman Humanitarian Aid and Relief Center (KSRelief) ramped up its aid efforts in Pakistan, Yemen and Sudan.
The KSRelief teams continued to distribute various relief aid to people in flood-hit Pakistan, the Saudi Press Agency (SPA) reported.
About 2,988 food baskets were distributed on Monday in Sindh and Punjab provinces, benefiting 20,916 people, according to SPA.
In Yemen, with the support of KSRelief, the Artificial Limbs Center project continued offering its medical services to Yemenis who lost their limbs.
The center offered 1,613 services to 551 Yemeni patients last month, SPA reported.
The services included manufacturing and rehabilitating artificial limbs for 250 patients, including the delivery of, measuring, and maintenance of limbs, as well as providing physical therapy sessions and specialized consultations to 301 people.
Meanwhile in Sudan, KSRelief distributed 13 tons and 500 kilograms of food baskets in the River Nile State to 1,340 people, according to SPA.