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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

UFS institute set to contribute to transformation in South Africa
2011-01-23

The UFS launches it's new International Institute for Studies in Race, Reconciliation and Social Justice.
- Photo: Dries and Henco Myburgh

Today (Thursday, 27 January 2011), almost three years after the Reitz affair, the University of the Free State (UFS) is launching its International Institute for Studies in Race, Reconciliation and Social Justice. This international institute will be inaugurated by Archbishop Emeritus Desmond Tutu, Nobel Peace Prize Laureate and Chairperson of the former Truth and Reconciliation Commission, who received an honorary doctorate in Theology from the university earlier today.

According to Mr John Samuel, Interim Director of the institute and former Chief Executive Officer of the Nelson Mandela Foundation, the institute seeks to establish itself as a premier international site for research on race, reconciliation and social justice.

“It is encouraging to see the UFS bringing to the fore such an initiative, which combines a study in race, reconciliation and social justice, all of which are indispensible elements in the process of rebuilding our nation,” said the Deputy President of South Africa, Mr Kgalema Motlanthe, in his message of congratulations to the university.

“I am confident that on the strength of its stature, coupled with its eminent experience as an academic institution, the UFS will further assist our country advance towards a united, non-racial, non-sexism, just and prosperous future.

“I wish the institute well in its arduous but noble task of contributing to the building of a better human society,” he said.

Prof. Jonathan Jansen, Vice-Chancellor and Rector, stated during his official inauguration in 2009 that the university would be an example of a place where reconciliation, forgiveness and social justice would not only be studied, but where it would also be applied in practice. “Students and scholars from across the world will come to the UFS to study the theory and practice about the building of societies across the boundaries of race, as well as religion, gender, disabilities and national origin,” Prof. Jansen said.

The institute is a critical space where engaged scholarship, public discussion, community engagement and teaching are innovatively integrated towards exploring and finding solutions to the complex and challenging work of social transformation in South Africa.

The institute furthermore works towards the realisation of its mission through a multiplicity of approaches and methods, informed by the notion that deep and complex social challenges require courageous and challenging scholarship, supported by innovative organisational forms and institutional arrangements.

Working from the inside to the outside, the institute will firstly serve the needs of the university, its staff and students. Through its research, the institute will endeavour to understand the challenges facing the UFS better, as well as how to address these challenges. For this reason, the concept of the UFS as a “live laboratory” and the use of evidence-based practice remain important for the university.

The institute will also reach out and empower its stakeholder communities through research and ongoing involvement on issues of race, reconciliation and social justice. Furthermore the institution expects to contribute to the creation of national and international networks and dialogue platforms pertaining to race, reconciliation and social justice.

For the first five years, the themes of 1) Values, Faith and Social Justice; 2) Development and Social Cohesion; 3) Teaching and Learning for Social Justice; and 4) Provincial, National, Global Perspectives and Leadership will direct the institute’s work.

The UFS will make a substantial contribution to the pursuit of reconciliation, greater social cohesion and equity in South Africa. The university is thus prepared to continue to engage the difficult, practical and trying work of building a strong, quality institution as it promotes racial healing and addresses the structural imbalances of the past. It is at this nexus that the institute commits to enabling change at the university as well contributing to transformation in South Africa.

Deputy President Kgalema Motlanthe's message of support to the University of the Free State (PDF format)

Media Release
27 January 2011
Issued by: Lacea Loader
Director: Strategic Communication (actg)
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: news@ufs.ac.za

 

 

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