The National Institute for Communicable Diseases (NICD) has
confirmed that there are currently no cases of the virus in South Africa,
despite 15 countries reporting more than 140 monkeypox cases,
In a statement, the NICD reported that on 13 May 2022, the
World Health Organisation (WHO) was notified of two laboratory-confirmed cases
and one probable case of monkeypox, from the same household, in the United
Kingdom.
“On 15th May, four additional laboratory-confirmed cases
were reported amongst sexual health services attendees presenting with a
vesicular rash illness in men practising sex with men. Since then, 15 countries
have collectively reported more than 140 cases,” NICD Executive Director,
Professor Adrian Puren said.
Puren said most cases are mild and present with lesions on
the genitalia or peri-genital areas. Additional symptoms include rash, fever,
painful lymph nodes, and oral ulcers.
He said the first case in the current outbreak was a
traveller who returned to the United Kingdom from Nigeria, a monkeypox endemic
area, on 4 May 2022.
“Clinicians confirmed that the patient had monkeypox three
days later. Investigations have been unable to link that case to any of the
other cases detected to date, suggesting that there have been multiple
introductions of the virus into the United Kingdom and other countries, with
cases potentially having gone undetected [until] now.
“A preliminary genome sequence from a confirmed Portuguese
case indicates that the virus is the West African strain (reduced mortality of
1% compared to the 10% of the Congo Basin strain) and is most closely related
to viruses associated with the exportation of monkeypox from Nigeria to the
United Kingdom, Israel, and Singapore during 2018-2019,” Puren said.
Puren noted that milder cases of monkeypox may go
undetected and represent a risk of person-to-person transmission.
“There is likely to be little immunity to the infection in
those travelling or otherwise exposed, as endemic disease is usually
geographically limited to parts of West and Central Africa.”
Although monkeypox, which is related to smallpox which has
been eradicated, sporadically causes small outbreaks, transmission is believed
to be inefficient as close contact is required and thus the current outbreak is
unlikely to progress to being a global emergency.
“Monkeypox is usually a self-limiting illness, and most
cases will recover within a few weeks without treatment. However, severe
disease maybe observed in young children, pregnant women, and individuals who
are immunocompromised.
“Historically, vaccination against smallpox was shown to be
protective against monkeypox. Contact tracing is ongoing in the countries
reporting cases, and contacts are being assessed based on their level of
exposure and followed up through active or passive surveillance for 21-days
from the date of last exposure to a case,” Puren explained, noting that
smallpox vaccination is being offered to higher risk contacts, but global vaccine
availability is a challenge.
Puren warned that for South Africa the risk of importation
of monkeypox is a reality, as “lessons learnt from COVID-19 have illustrated
that outbreaks in another part of the world can fast become a global concern”.
“Residents and
travellers to endemic countries should avoid contact with sick animals that
could harbour monkeypox virus, such as rodents, marsupials, and primates and
should refrain from eating or handling wild game. A good history is essential
to rule out other differential diagnoses, including malaria,” Puren advised.
Done By: Mitchum George
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