Monkeypox: SA on high alert

THERE has been a multinational outbreak of monkeypox reported in several European countries: the United States, Canada, and Australia this month. However, there are no suspected or confirmed cases of monkeypox in South Africa as of yesterday.

“We don’t expect large numbers of cases, but it’s important that we remain vigilant and identify cases earlier and disrupt the chain of transmission, should the virus come to South Africa,” said the National Institute for Communicable Diseases (NICD) executive director Professor Adrian Puren.

The NICD hosted another technical briefing today, where Dr Jacqueline Weyer from the Centre for Emerging, Zoonotic and Parasitic Diseases shared insights on the outbreak.

Weyer said the multinational outbreak was linked to international travel with a community-based spread, no fatalities have yet been reported and the source and linkage of the cases are still under investigation.

“This is the first outbreak of monkeypox to involve cases simultaneously from various non-endemic locations around the globe. It is already the largest outbreak of monkeypox recorded outside of endemic locations,” she said.

Endemic countries include Democratic Republic of Congo, Nigeria, Central African Republic, Cameroon, Ghana, Sierra Leone, Liberia, South Sudan and Ivory Coast.

“Before this current outbreak, there were seven instances of exportation of monkeypox in different ways. It happens either through the exportation of animals from endemic countries to non-endemic countries or travellers to an endemic area returning to non-endemic areas,” Meyer said.

The NICD said monkeypox could be transmitted in two ways, zoonotic transmission and person-to-person transmission. Zoonotic transmission can occur through close contact with infected animals, bites, scratches, bush meat preparation and contact with contaminated materials.

“The interesting thing about monkeypox is that monkeys are not regarded as the natural hosts of the virus, and there are many other animals that tested positive for monkeypox before, most probably from the rodent species,” Meyer said.

Person-to-person transmission can occur through close contact (prolonged face-to-face contact, kissing and sexual contact), contact with materials contaminated with the virus, and large droplet transmission is possible.

The virus enters the body through broken skin, respiratory tract of the mucous membrane (eyes, nose or mouth).

Meyer said the infection could be divided into two periods, namely the invasion period and skin eruption. The invasion period can last between zero to five days, where patients can experience fever, intense headaches, swollen lymph glands, back pain, body aches and intense weakness. The skin eruption period can begin with one to three days after the appearance of the fever, and patients can experience a rush concentrated on the face, palms of the hands, soles of the feet, feet, mouth, genitalia, eyes and cornea, rarely.“The rash grows from a baby lesion to an adult lesion. Macules (lesions with a flat base) develop into papules (a blister that has fluid in it), pustules (lesions filled with yellowish fluid) and crusts, which dry up and fall off,” Meyer said. The number of lesions depends on the severity of the case.

The NICD said that most cases do not need any specific treatment and that the infection resolves on its own without long-term side effects, but doctors may prescribe medication to alleviate the symptoms. |