Department of Health intensifies efforts against the Mpox outbreak
On June 12, Minister Joe Phaahla spoke to the media about the global outbreak of Mpox, formerly known as Monkeypox. This outbreak has been ongoing since 2022.
Mpox is a notifiable disease, meaning healthcare workers must report all suspected and confirmed cases. These conditions are crucial to report due to their significant public health risks, potentially leading to widespread outbreaks and high death rates.
South Africa last recorded Mpox cases in 2022, with five confirmed cases in the Western Cape, KwaZulu-Natal, Limpopo, and Gauteng. No new cases reported in 2023.
According to a World Health Organization (WHO) report published on 31 May 2024, there have been 97 208 laboratory-confirmed Mpox cases and 186 deaths across 117 countries from January 2022 to April 2024. In April 2024, 528 new cases were reported, a 21.2% decrease from March.
The regions most affected by Mpox, based on confirmed cases, are the Americas, Africa, Europe, South-East Asia, and the Western Pacific. In Africa, the Democratic Republic of Congo accounted for 99.6% of the confirmed cases in the recent report.
South Africa is among the countries currently experiencing an Mpox outbreak, a disease caused by the monkeypox virus (MPXV).
The current outbreak involves human-to-human transmission, mainly via direct skin-to-skin and sexual contact. People living with HIV are especially vulnerable.
As of now, South Africa has recorded five confirmed Mpox cases and one death. Two of these cases are in Gauteng and three in KwaZulu-Natal. The death occurred in Tembisa Hospital on 10 June 2024, involving one of the two Gauteng patients.
All cases involve males aged 30-39 years without travel history to other outbreak-affected countries, indicating local transmission, the Minister said in his address.
All five cases have been severe, requiring hospitalisation based on WHO criteria. These individuals also had other health conditions and belong to key populations, specifically Men who have Sex with Men (MSM).
The Health Department is working with HIV programmes and community organisations to spread awareness about Mpox and its local transmission.
According to the Department of Health update currently, one patient has been discharged, another is in home isolation, and two are still in hospital.
Genetic analysis of three cases showed Mpox clade IIb, consistent with the ongoing global outbreak that started in 2022.
The Health Department is working harder to control the Mpox outbreak. All National Health Laboratory Service (NHLS) labs are now sending samples to the National Institute for Communicable Diseases (NICD) for testing.
Private labs are also ready to test for Mpox, with NICD as the main reference.
Since early 2024, the NICD has received 12 Mpox tests, with three positive results. Two more cases were found by private labs.
The NICD is continuing its efforts to track and monitor Mpox cases. In KwaZulu-Natal, they found 38 contacts, including family, hospital staff, partners, and friends. One case involved a person with multiple partners including females.
In Gauteng, a case from May 8 led to seven contacts being monitored for 21 days, with no symptoms found. Another case from June 7 has led to more people being tracked. Efforts to find more contacts continue.
“At the current moment, there is no registered treatment for Mpox in South Africa. However, the World Health Organization recommends the use of Tecovirimat (known as TPOXX) for the treatment of severe cases, such as in individuals with a CD4 count of less than 350.
However, the Department has obtained Tecovirimat via Section 21 SAPHRA approval on compassionate use basis for the five known patients with severe disease,” the statement read.
The Department of Health (DoH) announced that three of the five Mpox cases received Tecovirimat treatment, thanks to approval from the South African Health Products Regulatory Authority (SAPHRA) and donations from the World Health Organization (WHO).
The WHO plans to donate a stockpile of Tecovirimat for quick use if the outbreak spreads.
South Africa is exploring vaccines for high-risk groups, like sex workers, men who have sex with men, and healthcare workers. The country aims to get vaccines from WHO member countries with extra supplies and from GAVI.
The National Advisory Group for Immunisation (NAGI) is also looking at pre- and post-exposure vaccines for these groups. The vaccines will be stored and distributed from provincial depots.
Although, the World Health Organization has not recommended any travel restrictions, travellers to and from endemic countries need to alert health officials on the situation to enable them to guide case detection and management.
“We can prevent avoidable deaths by cooperating with health officials when they conduct contact tracing and case finding. One death is too many, especially from a preventable and manageable disease like mpox,” said Minister Joe Phaahla in the statement.