In light of more than a dozen severe Mpox cases in South Africa, experts do not foresee a widespread epidemic but are urging people to get tested for HIV. Mpox, caused by the monkeypox virus, results in flu-like symptoms and a skin infection with a rash, lesions, or blisters. Although typically not fatal, two of the 13 hospitalised patients in South Africa have died.
The first case was identified on May 9 in Gauteng. All patients are males aged 30 to 39, and none had travelled to countries with current outbreaks, indicating local transmission. Dr Jeremy Nel, head of the Wits Infectious Diseases Research Institute, pointed out that milder cases likely go undiagnosed because individuals are not seeking testing or clinicians may miss the unfamiliar disease. He stated that the death rate would be lower if milder cases were included.
The duration and spread of the outbreak are unpredictable
Nel emphasised the significant concern over HIV, noting that controlled HIV allows patients to recover from Mpox similarly to healthy individuals. Jacqueline Weyer, head of the Centre for Emerging Zoonotic and Parasitic Diseases at the National Institute for Communicable Diseases, noted the unpredictability of the outbreak’s duration and spread. She highlighted ongoing measures to control the outbreak, such as prompt diagnosis and public health messaging, alongside plans for Mpox vaccination.
Weyer explained that individuals with immunodeficiencies, such as those with untreated HIV infection, typically report severe Mpox. Professor Yunus Moosa, an infectious diseases specialist at the University of KwaZulu-Natal, stressed that while Mpox is generally treatable, it poses a greater risk for vulnerable populations. He urged people with HIV to seek treatment, as controlled HIV helps mitigate severe Mpox outcomes.
Teams deployed to monitor cases
South Africa has received its first batch of Mpox medication, Tecovirimat, with plans to secure more treatments and vaccines if necessary. Foster Mohale, spokesperson for the Department of Health, mentioned that mild cases would continue to be managed with supportive therapies.
The department has deployed response teams and has monitored patients’ contacts for 21 days, conducting active case searches, case management, and risk communication in affected communities.
The World Health Organisation declared a public health emergency over an Mpox outbreak in 2022, with five cases initially reported in South Africa. Low-level cases persist in some countries despite the major outbreak ending last year. According to the Africa Centres for Disease Control and Prevention, seven African countries have reported infections since January.
According to the National Institute for Communicable Diseases, 95,912 Mpox cases have been reported from 118 countries since January 1, 2022, with 185 deaths as of March 31, predominantly in the Americas. Mohale urged anyone with suspected Mpox symptoms or who has had physical contact with known cases to seek clinical evaluation, emphasising that the disease is preventable and treatable.