EXPLAINER | Four things you need to know about Mpox as cases rise

South Africa is grappling with a new health challenge as cases of Mpox, previously known as monkeypox, continue to rise in parts of the country.

The health department confirmed on Thursday cases of Mpox increased from seven last week to 13. Two of the 13 people have died so far. All infected people so far have been men, mostly from KwaZulu-Natal.

Here are five things you need to know about Mpox:

What are the symptoms?

Mpox is a zoonotic viral disease that mainly infects humans and animals. According to the National Institute for Communicable Diseases (NICD) a person can develop Mpox symptoms seven to 14 days (on average) after being infected. Symptoms include fever, headache, muscle aches, back ache, chills and exhaustion.

One can develop blister-like lesions on the face, the soles of the feet and hands in the initial stages of infection. The lesions can also pop up on other parts of the body.

Does Mpox affect men only?

The rise in infections have sparked a wave of public reactions and concerns, reflecting fear of another widespread health crisis and hope for effective management and containment of the disease.

Though all 13 confirmed cases of Mpox in South Africa are men, women can also get infected. NICD medical scientist Dr Jacqueline Weyer, in a recent interview, said while most of the cases seen around the world have been in men, women could also be infected.

“All [previous confirmed seven cases] cases are male, with comorbidities (HIV-positive), and five of the seven identified as ‘men who have sex with men’. Globally, more than 80% of cases reported in the multi-country outbreak of Mpox have been in men in the 30 to 39 age group. If we are saying the virus transmits through skin to skin contact, this is efficiently achieved through sexual encounters. Though some would have sex with women, in which case those women would also be at risk of transmission,” she said.

How is the virus transmitted?

According to the NICD, person to person transmission involves close contact with an infected person or materials that have been contaminated by an infected person. The virus can also be transmitted from an infected animal to a human.

“It is also believed large social gatherings may have served as superspreading events aiding in the international spread of the virus. In the context of the multi-country outbreak a notable mode of transmission has been through sexual contact in the community of men having sex with men. A risk factor identified from early epidemiological investigations is having multiple sexual partners,” the NICD said.

Weyer described the transmission process.

“It’s a skin infection, so the most pronounced features of the illness are skin lesions or a rash. The lesions can be few or, in a compromised patient, many. The lesions or blisters are filled with fluid that contains a lot of the virus, which is also present on the surface of the lesion, so skin to skin contact can lead to transmission.

“When the lesions are evolving they develop scabs which are also filled with the virus. If the scabs fall off or if you have direct contact with the scabs on a person’s body, that can lead to transmission. The most infectious period is when the lesions are present and until the lesions have completely healed,” she said.

Does South Africa have treatment?

Health department spokesperson Foster Mohale said the department received medicine for treatment of Mpox this week.

“The department has received a batch of Mpox-specific treatment. Tecovirimat (also known as TPOXX or ST-246) for treatment of patients who experience severe health complications as a result of Mpox. The process to secure more treatment including vaccine is under way in case the need arises.

“All mild cases will continue to be managed with supportive treatment used to manage complications such as fever, pneumonia and skin infections. The department urges people regardless of gender, age, sexual orientation, with suspected Mpox symptoms or who had physical contact with known cases to present themselves at a healthcare facility for clinical evaluation because anyone can contract this preventable and treatable disease.

“Hand hygiene is one of the most effective ways to protect people from getting sick and prevent transmission, hence people are reminded to wash hands with soap and water or use an alcohol-based hand sanitiser, especially before eating or touching your face and after you use the bathroom.”