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Monkeypox: what is it and what do we need to know?

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 Communication and Brand Management receives two prestigious international awards

2015-07-07

Lelanie de Wet, Lacea Loader and Leonie Bolleurs

The Department of Communication and Brand Management at the University of the Free State (UFS) received two of the six Gold Quill Awards – that were awarded to South African companies and institutions - at the International Association of Business Communicator’s (IABC) Excellence Gala ceremony in San Francisco, US on 15 June 2015.

The awards ceremony formed part of the 2015 IABC World Conference, which took place from 14-17 June 2015. The department received a Gold Quill Excellence Award for its social media campaign, UFS #FaceOfFacebook and a Gold Quill Merit Award for the B Safe Take Action campaign.

From the 15 countries that entered, a total of 120 Gold Quill Excellence awards and 189 Gold Quill Merit awards were awarded. Other South African award winners included Barclays Africa Group Limited, Mediclinic and the Cape Peninsula University of Technology (CPUT).

This is the second year in a row that the UFS has been recognised by the IABC for its communication projects. In 2014, the department was awarded the Jake Wittmer Research Award for a Stakeholder Perception Audit conducted in February 2014. The audit was considered – by the IABC - as one of the best breakthrough strategies used by a university to measure the perceptions of its stakeholders.This made the UFS the first tertiary institution in Africa to receive the research award. The stakeholder perception audit also received an Africa Gold Quill in 2014.

"Being recognised by a global association such as the IABC for the second time, is a great honour and I am very proud of what my colleagues have achieved by entering the two campaigns. Winning the awards is a true indication of what can be done when a team of expert communicators is committed towards engaging their target audiences with campaigns that speak of quality and innovation. The fact that the UFS is one of only two tertiary education institutions in the country to receive these prestigious awards, makes it even more special," said Lacea Loader, Director: Communication and Brand Management at the UFS.

IABC World and Africa conferences 2015

The IABC is a global membership association with a network of 12 000 members in more than 80 countries, representing many of the Global Fortune 500 companies. It serves professionals in the field of business communication, bringing together the profession’s collective disciplines.

With the theme: Changing landscape: Informing the future, the 2015 world conference was attended by over 1 200 delegates from across the world. Delegates were offered an opportunity for learning, discovering, and connecting. Loader also made a presentation entitled ‘Award-winning measurement endorses sound reputation management strategy’ at the world conference.

The department will also be receiving two Africa Gold Quill Awards from the Africa chapter of the IABC for the same campaigns on 30 July 2015 in Johannesburg.

UFS #FaceOfFacebook Campaign

The university received a Gold Quill Excellence Award for its social media campaign, UFS #FaceOfFacebook. This initiative originated in the university’s commitment to its Human Project, which sets the standard for good behaviour and care.

Lelanie de Wet, Manager: Social Media and Website Content and project leader of UFS #FaceOfFacebook, said the project was born from the need to communicate with students. Thus a virtual friend, #FaceOfFacebook, was created. “Yearly auditions are being held to choose the new face representing the UFS on Facebook. Short video clips of the #FaceOfFacebook – whether it is attending events or communicating important messages - are posted on the UFS Facebook page. The successful candidate holds the title #FaceOfFacebook for 12 months.

“When I look at a campaign such as #FaceOfFacebook, from the time it took its first tentative steps in 2013, and see how it inspired staff and students alike, my heart swells with pride. Often you can see the impact you have made only in retrospect. The ripples you send into the world will inevitably create waves,” she said.

B Safe Take Action Campaign

The B Safe Take Action campaign of the university received a Gold Quill Merit award from the IABC.

The campaign was activated in September 2013. “It targeted on- and off-campus students and staff, aiming to create social ownership of personal safety, and to raise awareness of the safety measures put in place by the university,” said Leonie Bolleurs, Manager: Internal Communication and project manager of the campaign.

The campaign looked at a number of safety aspects, focusing not only on crime but also on being safe from road accidents and stress/burnout.

It is the second time this year that the BSafe campaign has been recognised for its innovative strategy. Earlier this year it received a PRISM Award (Gold) from the Public Relations Institute of Southern Africa (PRISA). The annual PRISM Awards are about recognising and celebrating great public relations campaigns.

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