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07 June 2022 | Story Prof Felicity Burt, Prof Dominique Goedhals and Dr Charles Kotzé
Prof Felicity Burt, Dr Charles Kotze and Prof Dominique Goedhals
From the left; Prof Felicity Burt, Dr Charles Kotzé and Prof Dominique Goedhals.

Opinion article by Prof Felicity Burt , Prof Dominique Goedhals , Division of Virology at the University of the Free State (UFS), and Dr Charles Kotzé, National Health Laboratory Service (NHLS), Universitas Academic Hospital.
The recent COVID-19 pandemic has certainly highlighted the importance of vigilance and awareness of emerging diseases with public health implications. The monkeypox virus has recently made headlines, after the detection of more than 200 cases in geographically distinct regions. On 13 May, the World Health Organisation (WHO) was notified of human cases of the monkeypox disease occurring in the United Kingdom, outside of the known endemic region.

Exported cases have been detected previously and usually occur sporadically. In contrast, within the past two weeks, human cases have been confirmed in at least 21 countries, including various European countries, the United Kingdom, Israel, the Canary Islands, Canada and the United States, and Australia. The initial case appears to have been a traveller from Nigeria. Sequence data may help to determine if there have been multiple exportations from West Africa. 

What is monkeypox and what do we know

What is monkeypox and what do we know about the aetiologic agent? Monkeypox is the name given to a disease caused by the monkeypox virus, a zoonotic pathogen endemic in Central and West Africa and responsible for cases of the disease in the endemic region, with occasional exported cases in travellers. The virus was initially identified in 1958 in monkeys housed at a research laboratory in Denmark, and the name monkeypox was derived from the appearance of lesions and the occurrence in monkeys. The first human case was identified 52 years ago in the Democratic Republic of the Congo. Since then, human monkeypox cases have been reported in several other Central and West African countries: Cameroon, the Central African Republic, Ivory Coast, the Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. The first monkeypox outbreak outside of Africa was in the United States of America in 2003 and was linked to contact with infected prairie dogs imported as exotic pets. Since then, there have been various small, contained outbreaks outside of Africa that have mostly been linked to the importation of the virus from African countries. 

The virus is related to the smallpox virus, which was eradicated in the 1970s by vaccination. Although belonging to the same family of viruses as the smallpox virus, the disease caused by monkeypox is less severe, with fewer fatalities.   Unlike smallpox, which carries a case fatality rate of 30%, the case fatality rate in monkeypox is low (estimated at 3-6% in more recent outbreaks).  There are two clades of the monkeypox virus: the West African clade and the Congo Basin (Central African) clade. In this outbreak, all of the cases have been linked to the West African clade of the monkeypox virus.

Transmission occurs from animal to human, and from human to human, through close contact with lesions, body fluids, and contaminated materials. The virus enters the body through the respiratory tract, mucous membranes, or broken skin.  The disease begins with non-specific symptoms such as fever, headache, muscle pains, and swollen lymph nodes. This is followed by the typical skin rash, which progresses through stages known as macules, then papules, vesicles, pustules, and lastly crusts or scabs. Lesions can also occur on mucous membranes such as the mouth, eye, and genital area.  The infectious period lasts through all stages of the rash, until all the scabs have fallen off. There are a number of other infectious and non-infectious conditions that need to be differentiated; therefore, individuals presenting with these symptoms will need to consult their doctor to determine whether a diagnosis of monkeypox needs to be considered. In the current outbreak, a number of the cases in the United Kingdom and Europe have been detected in men who have sex with men, during visits to sexual health clinics. This pattern of spread has not previously been described and it remains to be determined whether the spread has occurred through close person-to-person contact or through sexual transmission.  

Vaccination against smallpox virus offers 85% protection against monkeypox

To date, no cases have been detected in South Africa, but the recent global spread of the severe acute respiratory syndrome coronavirus 2 (SARS_CoV-2) highlights the ability of pathogens to spread. The National Institute for Communicable Diseases (NICD) in Johannesburg offers a specialised diagnostic service for the monkeypox virus, using molecular assays and electron microscopy. 

Vaccination against the smallpox virus is believed to offer 85% protection against monkeypox, hence older persons should have some protection; however, vaccination against smallpox was phased out globally following the eradication of smallpox during the 1970s. A more recently developed vaccine against monkeypox is available but has very limited availability.  No specific antivirals are available with proven efficacy in clinical trials.

While the monkeypox virus can be spread via the respiratory route, this occurs in the form of large droplets, rather than aerosol transmission, which is seen with SARS-CoV-2 (causing COVID-19). Aerosols are smaller particles that can remain suspended in the air for prolonged periods, facilitating the transmission of SARS-CoV-2. Monkeypox is therefore less contagious than COVID-19, as close contact is required for longer periods.  For this reason, many experts around the world predict that this outbreak will not spread like SARS-CoV-2. The importation of monkeypox to South Africa is a definite possibility, because South Africa is a significant economic and travel hub for Africa. Previous outbreaks of monkeypox in non-endemic areas have been interrupted by contact tracing and isolation, which was very effective in controlling further spread.  Heightened vigilance is therefore needed for the early detection of such cases.

News Archive

Teacher professionalism and status under Commonwealth radar
2010-03-26

 
From the left are: Ms Simone De Cormarmond, Chairperson: Commonwealth Foundation; Prof. Jonathan Jansen, Rector and Vice-Chancellor, University of the Free State (UFS); Mr Samuel Isaacs, CEO: SAQA; and Dr Carol Anne Spreen, Lecturer at the University of Maryland, USA).
Photo: Ian van Straaten


International delegates attending the 5th Annual Commonwealth Teacher Research Symposium held at the University of the Free State (UFS) in Bloemfontein this week unanimously agreed that more research still had to be done on issues of recognition, registration and standards affecting teachers and teaching across Commonwealth countries.

This two-day gathering of researchers, officials and representatives of regional international organisations and higher education institutions agreed that issues of teacher migration, the professionalism of teachers, teacher preparation and the use of teaching standards, as well as the comparability and recognition of teacher qualifications should be further researched.

The delegates agreed on the following based on the research and data that were presented and shared with all the participants:

Teacher migration is recognised as an increasing global phenomenon that requires ongoing research in the Commonwealth.
Recognising that inequalities and differences within and across Commonwealth countries exist, and considering that fair and ethical treatment in the international recruitment of teachers is an important cornerstone of the Commonwealth Teacher Recruitment Protocol.

Teacher training, the recognition of teacher qualifications, the professional registration of teachers and the development of professional teacher standards should be actively encouraged through ongoing pan-Commonwealth research.

An increased acknowledgement of the role of the professionalisation of teachers through an improved understanding of teacher qualifications and standards.
There should be a specific research focus on teacher preparation and the use of teaching standards.

An increased comparability and recognition of teacher qualifications across Commonwealth countries should be actively encouraged.
Advocacy of teachers’ rights, effective protection of the vulnerable teacher, and appropriate strategies should be promoted to uplift the status of teachers and teaching as a profession.

The Commonwealth Teacher Recruitment Protocol, amongst other things, aims to balance the rights of teachers to migrate internationally against the need to protect the integrity of national education systems, and to prevent the exploitation of the scarce human resources of poor countries.

Delivering his keynote address at the symposium, the Rector and Vice-Chancellor of the UFS, Prof. Jonathan Jansen, decried the quality of professional qualifications in South Africa.

“We have become very good at manufacturing outcomes. We actually have become very good at giving an impression of having achieved particular outcomes without having achieved them at all,” he said.
“So what does it mean to talk about outcomes in an unequal country with unequal resources? What does it mean to talk about qualifications when we do not trust the outcomes?”

He suggested that the teaching profession should be subjected to a peer review mechanism and that the practice of setting minimum standards should be dealt away with because it results in minimum outcomes.

Dr Carol Anne Spreen, lecturer at the University of Maryland in the USA, proposed that countries should improve the quality of their own teachers instead of importing teachers from other countries.

The research symposium was organised by the Commonwealth Secretariat and hosted by the South African Qualifications Authority (SAQA) and the UFS.

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za  
26 March 2010

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