Mpox claims first life in South Africa

Minister of Health Joe Phaahla has confirmed South Africa’s first death from mpox disease, formerly known as monkeypox.

“The five confirmed cases were classified as severe as per the World Health Organisation’s (WHO) definition requiring hospitalisation.

“The death occurred in the two cases reported in Gauteng. The patient died on Monday in Tembisa Hospital,” Phaahla said.

Three cases were reported in KwaZulu-Natal.

Local transmission in SA

“All cases/patients are males aged between 30-39 years without travel history to the countries currently experiencing an outbreak, which suggests there is local transmission of this infectious disease in the country,” he said.

“Two cases are still in hospital. Sequencing analysis of three of the cases revealed mpox clade 2, in keeping with the multicountry mpox outbreak that began in 2022.

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“The last time South Africa recorded positive cases of mpox was in 2022, when five cases were confirmed in the Western Cape, KwaZulu-Natal, Limpopo and Gauteng,” Phaahla said.

According to WHO, from 1 January, 2022, through 30 April this year, a total of 97 208 cases were reported, including 186 deaths in 117 countries.

Most affected regions

The most affected regions were the Americas, Africa, the European region, Southeast Asia and the Western Pacific region. In Africa, the DRC reported the most cases (99.6%).

Phaahla said the disease was caused by the monkeypox virus (MPXV), an orthopoxvirus that transmits through close contact and from unknown animal reservoirs in East, Central, and West Africa.

“This multicountry mpox outbreak is characterised by sustained human-to-human transmission via direct skin-toskin and sexual contact. People living with HIV are disproportionately affected,” he said.

There is no registered treatment for mpox in South Africa currently.

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“WHO recommends the use of Tecovirimat (known as TPOXX) for treatment of severe cases, such as in individuals with a CD4 count of less than 350,” he said.

“The department has obtained Tecovirimat, approved by the South African Health Products Regulatory Authority, on a compassionate use basis for the five patients with severe disease,” Phaahla said.

Mpox clade 2 less severe

Medical expert Dr Angelique Coetzee said mpox clade 2, which has been recorded in West Africa and South Africa, was less severe.

“Clade 1 is the outbreak we see in the DRC and the Congo currently, which is more severe.” Clade 1 has death rates of up to 10%, while 99.9% of patients contracting clade 2 survived, Coetzee said.

A person infected with mpox will experience flu-like symptoms like fever and a skin rash. The patient will be contagious until the rash has healed.