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06 Jun 2024 | 11:48 AM UTC

South Africa: Confirmed monkeypox (mpox) cases reported in Gauteng and KwaZulu-Natal provinces in early June /update 2

Monkeypox (mpox) cases confirmed in Gauteng and KwaZulu-Natal provinces in South Africa in early June. Maintain basic health precautions.

Informational

South African health officials have reported confirmed monkeypox (mpox) cases in two provinces, with an additional two mpox cases reported May 27-June 5, bringing the total case count to four since May 9. The last identified cases of mpox in South Africa were reported in August 2022. Durban, KwaZulu-Natal (3 cases) is the most affected, followed by Gauteng (1 case). Health officials revealed that the two recent cases reported in KwaZulu-Natal had contact with the other previously confirmed case in the province, suggesting local disease transmission. The South African Department of Health appeals to members of the public who have been in close contact with known or suspected patients to present at the nearest health facility or healthcare provider for clinical evaluation to ensure early diagnosis and effective treatment if they test positive. As disease surveillance and contact tracing continue, officials will likely identify additional cases in the coming weeks. This report represents the most up-to-date information as of June 6.

Practice basic health precautions, including frequent handwashing with soap and water, covering the nose and mouth when coughing, and avoiding obviously ill individuals. Avoid overcrowded areas such as nightclubs and consider using safe sexual practices such as physical barriers (condoms) in countries reporting mpox transmission. Seek medical attention if symptoms develop within two weeks of being in affected areas, especially if you have had one or more new sexual partners. Vaccines are available but limited.

The first confirmed cases of mpox in a Sub-Saharan African country where the disease is not endemic was reported in South Africa on June 23, 2022. These cases were associated with the widespread outbreak of mpox reported by individuals who attended one or more mass gatherings in May 2022 located in Antwerp, Belgium, as well as Madrid and Gran Canaria in Spain, or reported recent close contact with an attendee. Mass gatherings always present an elevated risk of infectious disease transmission. Human-to-human transmission occurs among people in close physical contact, with the increase in recent cases linked to sexual contact suggesting that the virus linked to the disease can be sexually transmitted. The current outbreak highlights the importance of vigilant safe sexual practices and suggests mpox can be transmitted while the infected person displays few or no symptoms; however, the risk is currently assessed as low for individuals not routinely engaging with multiple or anonymous sexual partners.

Most mpox cases in Africa are reported in West and Central Africa, primarily in the DRC, Nigeria, and Cameroon, among individuals who report contact with wild primates or other mammals which may harbor the disease.

Mpox is caused by a virus belonging to the same family as the one that causes smallpox. However, mpox is not the same as smallpox and does not have the same capacity for rapid human-to-human transmission. Mpox is mainly transmitted to humans through direct contact with the bodily fluids of infected rodents or primates. Human-to-human transmission primarily occurs through close personal contact with an infected individual via respiratory droplets, direct contact with bodily fluids, or indirect contact with lesion material (e.g., contaminated clothing or bedding). Symptoms typically appear 6-16 days after exposure but can develop up to 21 days after exposure. Symptoms generally include fever, headache, muscle aches and backaches, swollen lymph nodes, chills, exhaustion, and a distinctive rash characterized by lesions that progress through several stages before falling off.