(UPDATE) TWO new mpox cases have been detected in the country, bringing the total cases to 12, the Department of Health (DoH) reported on Monday.

The Health Department said the 11th case is a 37-year-old male from Metro Manila who exhibited symptoms starting August 20 — rashes on his face, arms, legs, thorax, palms and soles.

He had no known exposure to any person with similar symptoms "but admitted to close, intimate and skin-to-skin contact within 21 days before the start of his symptoms."

The patient was admitted to a government hospital two days later and remains there. A skin sample was taken from him and subsequently tested at the Research Institute for Tropical Medicine (RITM).

Meanwhile, the 12th case is a 32-year-old male, also from the National Capital Region, with symptoms that started manifesting on August 14.

The DoH said he noticed skin lesions or clear, fluid-filled vesicles in his groin area, followed by a fever a few days later.

He also admitted to close, intimate and skin-to-skin contact with one sexual partner.

He was then advised to seek consultation at a DoH hospital, where a skin sample was taken on August 23. He was advised home isolation while awaiting results and has been staying at home since then.

Local government units where cases 11 and 12 are from have been informed and have the power and authority by law to disclose more detailed information, including response actions, at their discretion.

"We continue to see local transmission of mpox clade II here in the Philippines, in Metro Manila in particular. Mpox moves from skin to skin, both during sexual encounters and also other intimate forms of skin contact. It is not airborne," Health Secretary Teodoro Herbosa said.

"Avoid close, intimate, skin-to-skin contact so as not to get mpox. Wash hands with soap and water. Cover your skin. Our health system will continue to detect and protect," he added.

Common symptoms of mpox are a skin rash or mucosal lesions, which can last two to four weeks. The rashes are accompanied by fever, headache, muscle aches, back pain, low energy and swollen lymph nodes.

Anyone can get mpox. Mpox can be transmitted to humans through close, intimate contact with someone who is infectious, with contaminated materials like used clothes or utensils, or with infected animals.

Soap and water can kill the virus. When washing contaminated materials, use gloves.

Laboratory confirmation of mpox is done by testing skin lesion material by PCR. Dermatologists and other physicians who suspect mpox cases are reminded to record the name and contact information of their patients and guide them to the nearest major hospital.

Mpox is treated with supportive care. Patients with no other illnesses may stay home after testing until all scabs fall off and a new layer of skin forms, typically after two to four weeks.

Meanwhile, the Quezon City government shut down a fitness club after it barred a contact-tracing team from conducting an investigation into the establishment.

Padlocked was Fahrenheit Cafe and Fitness Center or F Club, located along E. Rodriguez Sr. Avenue, Mayor Joy Belmonte said on Monday.

She said the local government immediately served a cease-and-desist order and a notice of violation to the establishment for not allowing the city's contact-tracing team to conduct an investigation and inquiries.

On Saturday, August 24, the City Epidemiology and Surveillance Division (CESD) went to F Club to initiate contact-tracing measures, following the Health Department's instructions for possible mpox transmission.

However, F Club's management refused to cooperate, the local government said.

"We consider this refusal to cooperate with the authorities a clear threat to the health and interest of QCitizens," Belmonte said.

"The city government was prompt to act on this health matter, but there would be a problem if we have this establishment that is not cooperating," she added.

Republic Act 11332, or the Mandatory Reporting of Notifiable Diseases and Health Events of Public Concern Act, states that the non-cooperation of the person or entities identified as having the notifiable disease or affected by the public health event is prohibited.

WITH ARLIE O. CALALO