Health director-general Dr Radzi Abu Hassan, in a statement today, said the third case was confirmed on Oct 21 after the man showed symptoms of fever and blisters on Oct 6.

The fourth case is a close contact of the third case and was confirmed positive on Oct 23, with the patient beginning to exhibit the same symptoms on Oct 6, he said.

“Both cases are undergoing isolation at home and are in stable condition. Both of them deny having travelled abroad within the 21-day period before the symptoms first appeared.

“All contacts for the third and fourth cases have been identified and have not experienced symptoms of monkeypox infection. Their health status is still being monitored,” he said.

Radzi said the two new cases were not related to the first and second cases reported in July.

Monkeypox is a type of infection caused by a virus and infection occurs through close contact with individuals who have symptoms and signs of infection.

The symptoms are fever, along with maculopapular rash on the face, palms, soles, genitalia and cornea.

“The incubation period before an individual starts showing symptoms is between five and 21 days from the date of exposure.

“Individuals tested positive with monkeypox infection can infect others a day before the symptoms appear until all the blisters have completely dried up and fallen off. Usually, monkeypox cases will heal on their own without any specific treatment,” he said.

Radzi said medical practitioners should be vigilant about patients with rashes or blister symptoms who turn up for treatment.

He added that a history of close contact with symptomatic individuals must be obtained.

“For suspected monkeypox cases, blister swabs, oral swabs and blood or serum samples need to be sent for laboratory testing.

“Suspected cases should be reported to the nearby district health office through the e-notification system for further investigation and control measures to be implemented.”