SA health scientists monitoring monkeypox outbreak, have test kits

There are no monkeypox cases in SA, the National Institute for Communicable Diseases (NICD) says, but the institute is equipped to test travellers if needed.

Fifteen countries have collectively reported more than 140 cases of monkeypox. Of the cases with available information, men accounted for more than 70%, mostly aged between 20 and 55, and most detected through sexual health services.

“Most cases are mild and present with lesions on the genitalia or peri-genital areas. Additional symptoms include rash, fever, painful lymph nodes and oral ulcers.

“Possible transmission between sexual partners may occur due to contact during sex with infectious skin and mucosal (including oral) lesions, as sexual transmission of monkeypox has not yet been proven.”

Genital lesions have previously been uncommon and reflect a unique aspect of this outbreak, said the NICD.

The first case in the outbreak was a traveller who returned to the UK from Nigeria, a monkeypox endemic area. Investigations have been unable to link that case to any of the other cases detected to date, suggesting that there have been multiple introductions of the virus into the UK and other countries, with cases potentially having gone undetected till now.

Close contact is required to transmit monkeypox, and the NICD believes the current outbreak is unlikely to progress to being a global emergency.

“The implications for SA are that the risk of importation of monkeypox is a reality, as lessons learnt from Covid-19 have illustrated that outbreaks in another part of the world can fast become a global concern,” said NICD executive director Prof Adrian Puren.

The NICD said it would continually assess the risk for local introduction and transmission in collaboration with the national department of health and the World Health Organisation (WHO) in line with international health regulations.

Dr Jacqueline Weyer, from the Special Viral Pathogens Division at the Centre for Emerging Zoonotic and Parasitic Diseases, said the NICD was equipped to test for monkeypox as the centre has a diagnostic polymerase chain reaction (PCR) in place and electron-microscopy capacity.

The NICD sequencing core facility will work to provide sequencing analysis rapidly, should a case be identified, to determine relatedness to the outbreak strain.

Puren said for travellers entering SA, any illness during travel or upon return from an endemic area should be reported to a healthcare professional, including information about recent travel, immunisation history and contact with any known cases.

Residents and travellers to endemic countries should avoid contact with sick animals that could harbour the monkeypox virus, such as rodents, marsupials and primates, and should refrain from eating or handling wild game.

Historically, vaccination against smallpox, which has been eradicated, was shown to be protective against monkeypox.

Smallpox vaccination is being offered to higher risk contacts, but global vaccine availability is a challenge.

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