Countries in Asia have ramped up precautions after cases of the new and deadlier strain of mpox, known as Clade 1b, was recently found outside the African continent.

At least four countries have recently reported mpox cases outside the African continent — Thailand, Philippines, Sweden and Pakistan.

Thailand, which confirmed its first case of the strain on Thursday, will tighten surveillance and screening measures at its international airports.

Travelers from countries experiencing mpox outbreaks must register on the health ministry’s online platform before departing for Thailand and will be required to undergo health screening upon arrival. Visitors found exhibiting mpox symptoms will be quarantined.

Those arriving from countries with outbreaks will be checked for rashes and have their temperatures scanned. The government has also prepared a quarantine facility in the event of a widespread outbreak. 

Thailand’s first and only Clade 1b strain so far was found in a 66-year-old European man who arrived from Africa.

Singapore stepped up its mpox precautionary measures on Thursday. Temperature and visual screening will be implemented for inbound travelers and crew arriving from flights to certain airports, said the country’s Ministry of Health. Travelers who have rash, fever or other mpox symptoms will be referred for medical assessment.

That said, there are currently no direct flights between Singapore and any mpox outbreak country.

Similar screening procedures will also be applied at sea checkpoints for those arriving on ships from areas affected by mpox. As of Thursday, the country has detected 13 cases of the “less severe” Clade 2 infections this year, the health ministry said. There has been no cases of the Clade 1b strain just yet.

The Korean Disease Control Agency has redesignated mpox as a quarantinable infectious disease, the country’s health authorities said on Tuesday.

Inbound travelers from eight African nations will need to report to quarantine officials should they exhibit mpox symptoms, this include arrivals Rwanda, Burundi, Uganda, Ethiopia, the Central African Republic, Kenya, Congo, and the Democratic Republic of the Congo.

Epidemiologists and public health doctors will be deployed at the direct Ethiopian flight gates at the Incheon Airport, the main international airport in Seoul. South Korea has not had a case of the Clade 1b variant.

While the Philippines has yet to roll out specific preventive measures at its airports, a Philippine senator recently appealed to schools to enforce stricter health and sanitation measures. He also reiterated his call to set up a  Philippine Center for Disease Control and Prevention, which is aimed at the prevention of all diseases of public health importance.

Philippines this week reported its first mpox case of this year, though the country’s health minister noted that it was the mild Clade 2 variant. The country has had 10 laboratory-confirmed cases since July 2022, according to Reuters.

For Malaysia, travelers from countries that have reported mpox cases are required to monitor their health for 21 days after arriving in Malaysia, said country’s Ministry of Health. 

Those with a “history of risky activities” and carry mpox symptoms are advised to undergo examination at a health facility. Malaysia has yet to report a case on the Clade 1b variant.

Mpox, formerly known as monkeypox, is a viral infection which spreads through close contact and could cause flu-like symptoms and lesions containing pus. While usually mild, it can be fatal.