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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

Qwaqwa Campus opens: Prof. PA Mbati's speech
2005-01-22

Official welcome speech by Prof. PA Mbati for 2005 first year students held on Saturday 22nd January 2005. Program Director, The Chief Director Operations Rev. Kiepi Jaftha, Dean of Students Dr. Natie Luyt, Program Head of the Faculty of Humanities, Dr. Elias Malete, Program Head of Faculty of Natural and Agricultural Sciences, Prof. Riaan Luyt, Acting Program Head of the Faculty of Economics and Management Sciences Prof. Andries Venter, Deputy Director Student Affairs Mr. Teboho Manchu, Coordinator Finance: Mrs. Elizabeth Nchapi, Senior Librarian Mr. Stoffel Kok, Senior Magistrate Mr Saul Mohosho, SRC President Mr. Tello Motloung, members of staff, invited guests, parents, guardians, my dear students, ladies and gentlemen.

It is indeed my pleasure to welcome you to the official welcoming ceremony of the UFS-Qwaqwa Campus 2005 first year students. Our Rector and Vice Chancellor Professor Frederick has requested me to pass to you his warmest wishes and regards on this special occasion. I am confident that the orientation exercise in which you have participated has achieved the desired effect of introducing you to your new way of life here on campus, and that you are now sufficiently prepared to get on with the rigors of being a student at this University.

Following the restructuring of the higher education landscape, the Qwaqwa campus was incorporated into the University of the Free State with effect from January 1 2003 . As a consequence, Management was faced with a whole complex series of challenges including, primarily making the campus financially viable, but also ensuring that it remains relevant in it’s core business as a satellite campus of the University of the Free State in terms of its teaching, learning, research and community service responsibilities.

A whole series of strategic planning workshops were conducted last year with both internal and external stakeholders. Various important strategic objectives were flagged out, and the next level of consultation will take place soon. I know that there is a lot of eagerness, sometimes to the level of impatience to see this process completed as quickly as possible. But again on the other hand, due to the far reaching consequences of any hasty decisions, plus the need for a carefully planned process, we need to be a little more patient before the implementation of the strategic objectives is implemented. You will be kept informed as this important and critical aspect in the evolution of our campus takes place.

As a response to the need for a more effective governance model on the Qwaqwa campus, a review of the governance structure was completed towards the end of 2004 and will soon serve before the Executive of the Executive Management for approval.

Due to the importance that top management attaches to the development of an effective governance on the Qwaqwa campus, the process was facilitated by an internationally acclaimed consultant. Again the contents of the revised governance model will be made known to the campus and the broader community once it is approved.

I am glad to report that in recognition of the need to improve the infrastructure on campus to provide a conducive learning atmosphere to our students, a total of 8.2 million rands was made available towards the end of 2004 for recapitalization of specifically our student residences and lecture venues. The first phase of the residence renovation is completed and residences C, D and E have now been officially handed over to the University by the Contractor. Among the features of the renovated residences is that they will now computer rooms, kitchenettes for cooking, and a redesigned TV room. The rooms have even been fitted with heaters. Our challenge will now be to maintain our newly acquired facilities and to ensure that they do not again deteriorate to an un-acceptable level. The second phase of renovation will start soon.

As indicated in my address during the orientation week, our obligation to you as a campus is to offer you quality training to the best of our ability, and to disseminate this knowledge to you within a conducive atmosphere worthy of good learning. On the other hand, our students have to take advantage of this opportunity to acquire the necessary skills and training in the various academic programs that we offer on campus.

We have a very simple agenda on this campus – our vision is to continuously strive to build and develop the Qwaqwa campus of University of the Free State into a truly quality institution of higher learning in our country. To develop a tradition and culture in which we are proud of who we are, and constantly and tirelessly working towards excellence in our academic programs, and other non-academic but core and important aspects in your growth and development such as sport and community service. To nurture young conscientious citizens who are aware of their duties and responsibilities. Ultimately to produce hard working young people who fully exploit their potentials, and who will serve this country with diligence when unleashed into the real world in effectively managing their roles and responsibilities in society, whether in private or government civil service.

I would like to encourage that the various stake holders of this campus, the students, academic, administrative and support staff, and our broader community, to work together in harmony for the well being of our campus. For this campus to continue to be relevant in the environment that we find ourselves, there is a need for continuous engagement of its various stake holders, and genuinely listening to each other. We must continuously and regularly keep our feelers on alert in order that we can remain relevant.

I am particularly inviting our parents and guardians, the alumni of this campus, and leaders from our community to join hands with us in seeking solutions to the various challenges that we continue to face on campus. I am open for frank and honest discourse on the best way forward for our campus.

The University of the Free State is committed in making tertiary education accessible to as many students as possible. In this regard, students who do not have the required ‘M’ score to gain entry into main stream classes are given an opportunity to study in the highly successful ‘bridging program’ in which learners are integrated with main stream students but with fewer courses to tackle in order to ensure success. This is done on the premise that such students have the potential to pursue a degree course, and that therefore within a well structured program, they can make a success of their lives.

The University is conscious of the fact that in many instances several academically deserving students fail to be admitted into university due to financial reasons. For students who are academically deserving but who because of reasons of poverty cannot pay the requisite fees, the university is able to assist such students through the National Financial Aid Scheme – commonly known as NSFAS, and University Merit Awards. Other incentives such as Sports bursaries are also available.

Please remember that it is important to balance your life on campus and the phrase ‘a healthy mind in a healthy body’ aptly describes this statement. Ensure that you participate in sport and cultural activities of this campus so that you can develop and strengthen the various God-given talents that you have been blessed with.

A second major ingredient for your success on campus is discipline and respect for rules, policies and procedures that govern the University of the Free State , and respect for your fellow students. Good discipline is a major contributory factor to success in life, and more so in your formative academic life at University. This means for example that you must attend all your lectures, complete your assignments on-time and visit the library frequently. Please manage your time wisely and responsibly. Remember that as a university student, you are basically the master and architect of your own destiny.

Think very carefully when you are confronted with difficult situations, be they negative peer pressure, or temptations to indulge in intoxicating drugs, and make the right choice.

The University has well trained personnel including a social worker, a psychologist and counselor, and members of the student affairs division under the leadership of Mr. Teboho Manchu, Deputy Director Student Affairs, who are available to assist whenever you require their help.

Today is also a special day because we have officially inaugurated the SRC President and the rest of the SRC leadership. I am sure that you all join me in congratulating the SRC for being elected to their leadership roles for 2005. Mr. SRC president and your team, please remember that you now have a huge responsibility in carrying out the aspirations of the student body on campus. I want to wish you luck and success as you champion the rights of your constituents, which I believe and trust will be compatible with management’s expectations with regard to quality teaching and learning on campus. As you are aware, Management values the input that the student leadership makes in the operational management of the affairs of this campus, and we look forward to a cordial, non-confrontational working relationship with a view of rendering un-paralleled service on campus.

Mr. Program Director, allow me to wish everyone here a successful and prosperous year. May the good Lord give us the strength and courage to overcome any obstacle that may be placed in our way in the course of our work in 2005.

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