Overview of the Global Mpox Outbreak
Mpox Outbreak in South Africa: The Mpox disease, formerly known as Monkeypox, has been a global concern since 2022. Mpox is a notifiable medical condition, requiring healthcare workers to report all suspected and confirmed cases. Such conditions are critical for public health due to their potential to cause widespread outbreaks and high fatality rates.
Mpox Outbreak in South Africa
Recent Mpox Cases and Statistics
The last recorded Mpox cases in South Africa were in 2022, with five confirmed cases in the Western Cape, KwaZulu-Natal, Limpopo, and Gauteng. No cases appeared in 2023. The World Health Organization reported that from January 1, 2022, through April 30, 2024, there were 97,208 laboratory-confirmed cases of Mpox worldwide, including 186 deaths, across 117 countries. In April 2024, 528 new cases emerged, marking a 21.2% decline from March 2024.
Most Affected Regions
The WHO regions most affected by Mpox are:
- Region of the Americas
- African Region
- European Region
- South-East Asia Region
- Western Pacific Region
The Democratic Republic of the Congo (DRC) reported 99.6% of the confirmed Mpox cases in the African Region for the reporting month.
Transmission and Impact of Mpox
The monkeypox virus (MPXV) causes Mpox, spreading from person to person through close contact and from unknown animal reservoirs in East, Central, and West Africa. Sustained human-to-human transmission via direct skin-to-skin and sexual contact characterizes this multi-country outbreak, disproportionately affecting people living with HIV.
Local Transmission in South Africa
South Africa has recorded five laboratory-confirmed cases and one death. Two cases were confirmed in Gauteng and three in KwaZulu-Natal. The death occurred among the two cases reported in Gauteng, with the patient passing away on June 10, 2024, at Tembisa Hospital. All patients are males aged 30-39 years, with no travel history to countries currently experiencing an outbreak, indicating local transmission.
Mpox Case Details
| Case | Confirmation Date | Area/Province | Age | Hospitalized |
|---|---|---|---|---|
| Case 1 | 8 May 2024 | Sedibeng, GP | 35 | Yes |
| Case 2 | 21 May 2024 | eThekwini, KZN | 39 | Yes |
| Case 3 | 31 May 2024 | eThekwini, KZN | 30 | Yes |
| Case 4 | 3 June 2024 | eThekwini, KZN | 33 | Yes |
| Case 5 | 7 June 2024 | Tembisa, GP | 37 | Yes |
Mpox Outbreak in South Africa: Clinical Severity and Management
All five cases were classified as severe per WHO definition, requiring hospitalization. The cases have comorbidities and belong to key populations, specifically Men who have Sex with Men (MSM). The Department is collaborating with organizations on HIV programs and other stakeholders to implement targeted communication to raise awareness about the outbreak and local transmission.
Mpox Epidemiology and Surveillance
The National Institute for Communicable Diseases (NICD) continues epidemiological and surveillance activities to identify cases for investigation and estimate the disease’s magnitude through systematic data collection and analysis. The outbreak response teams identified 38 contacts in KwaZulu-Natal, including household contacts, hospital contacts, partners/sexual partners, and friends.
Contact Tracing for Mpox
For the case notified on May 8, 2024, in Gauteng, the team monitored seven contacts for 21 days with no signs of Mpox. For the case notified on June 7, 2024, the team developed a list of identified contacts and will monitor them for symptoms for 21 days.
Mpox Treatment Options
Currently, there is no registered treatment for Mpox in South Africa. However, the World Health Organization recommends Tecovirimat (TPOXX) for treating severe cases, such as those with a CD4 count of less than 350. The Department has obtained Tecovirimat via Section 21 SAPHRA approval on a compassionate use basis for the five known patients with severe disease.
Access to Tecovirimat for Mpox Treatment
Three of the five cases had access to Tecovirimat treatment as advocated by the NICD. The Department obtained the drug via Section 21 and the SAPHRA approval process, and WHO donated it.. SAPHRA has approved a request for a small stockpile of Tecovirimat, supported by WHO, for rapid deployment in case of a wider outbreak.
Vaccination Efforts for Mpox
Options are being considered for which population groups should be targeted for vaccination. South Africa is trying to source vaccines from WHO member countries with excess stockpiles and from GAVI. These vaccines will be stored and distributed from provincial depots. The National Advisory Group for Immunisation (NAGI) Technical Working Group for Mpox vaccines is considering vaccines for both pre- and post-exposure administration for high-risk groups, including sex workers, MSM, healthcare workers, and laboratory workers.
Risk Communications for Mpox
The Department, in collaboration with partner organizations, has intensified targeted and public awareness efforts using various communication channels to provide crucial information about Mpox. The Department convened a clinical management webinar, which 500 healthcare workers and public health professionals from across the nation attended.
Community Engagement for Mpox Awareness
Risk communication and community engagement (RCCE) are crucial interventions. Efforts include addressing high-risk populations without discrimination to avoid stigma. The Department is also working with organizations on HIV programs and key populations such as MSM to reach their members.
Travel and Health Guidance for Mpox
Although WHO has not recommended any travel restrictions, travelers to and from endemic countries should alert health officials to enable guidance for case detection and management. Early diagnosis and effective treatment can prevent further spread of Mpox.
Preventing Mpox Transmission
Supporting those diagnosed with Mpox to take their treatment and prevent infecting others can disrupt local transmission. Cooperation with health officials during contact tracing and case finding can prevent avoidable deaths from this manageable disease.
For more information, visit the source article: South African Government.