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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

Graduates convene with global leaders at the UFS 2015 Winter Graduation ceremonies
2015-07-07

Dr Hendrik Auret, dr Gerhard Bosman en dr Madelein Stoffberg.
Foto: Leonie Bolleurs

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The University of the Free State’s 2015 Winter Graduations, which took place from 1-2 July 2015 on the Bloemfontein Campus offered several highlights. Three global leaders received honorary doctorates. A further 2 000 degrees and diplomas were conferred to graduates in the seven faculties of the university.

For the first time in the history of the UFS, three PhDs in Architecture were awarded simultaneously. Hendrik Auret, Gerhard Bosman, and Madelein Stoffberg’s outstanding achievements are a milestone in the university’s pursuit of academic excellence.

Furthermore, three PhDs were conferred on graduates from the Department of Consumer Science in the Faculty of Natural and Agricultural Sciences. Ismari van der Merwe, Natasha Cronje, and Gloria Seiphetlheng set a precedent when they walked across the Callie Human stage to collect their doctorates at the same graduation ceremony.

This year, the university produced 66 Doctors of Philosophy in various fields of study. Six of these PhDs were awarded in the Department of Physics. Three graduates in the Department of Soil- and Crop- and Climate Sciences received PhDs at the Winter Graduation. They are Tesha Mardamootoo, Elmarie Kotzé, and David Chemei.

Dr John Samuel.
Photo: Johan Roux

Keynote speakers provide enlightenment to graduates

On Wednesday 1 July 2015, Dr John Samuel, SA’s leading education expert, addressed 707 diploma graduates from the Centre for Financial Planning Law and the School of Open Learning. For the graduates’ future reference, Samuel offered invaluable knowledge he had accumulated over the years as Chief Executive of the Nelson Mandela Foundation. “One of the lessons I have learnt was not only the importance of time, but it was in fact what being on time demonstrated,” he said. “Being on time was demonstrating respect, respect for the people you are meeting, and for the occasion.”

On the second day of graduation, Nataniël, South African singer, songwriter, and entertainer spoke to Master’s and doctoral graduates in the Faculties of Economic and Management Sciences, Humanities, Education, Health Sciences, Law, Theology, and Natural and Agricultural Sciences. His keynote spoke to the graduates’ sense of resolve in saying, “nothing is ever accidental. It is always with a purpose, it is your turn to make the world a better place.” He added that “it is important to strive for excellence and to be proud of what you are doing.”

Honorary doctorate recipients in a nutshell

Dr Samuel is one of the three exceptional global leaders to receive honorary doctorates from the university on 1 July 2015. His accolade was presented by the Faculty of Education. He has contributed to the Public Participation Education Network (PPEN) campaign as a founding member. He established the Centre for Education Policy Development, the Joint Working Group (for The National Party Government and the ANC), the National Education Conference, and the National Education and Training Forum. In addition, he made leadership contributions to the First Education and Training White Paper, the first Green Paper on Higher Education, and is the CEO of the Oprah Winfrey Leadership Academy for Girls. The WK Kellogg Foundation in the USA operates under his directorship.

Professor Heidi Hudson, Director of the Centre for Africa Studies at the UFS and Dr Lakhdar Brahimi.
Photo: Mike Rose from Mike Rose Photography

Dr Lakhdar Brahimi received an honorary doctorate from the Centre for Africa Studies. Algerian-born Brahimi was first involved with the United Nations (UN) in 1992, and has since been deployed all over the world on peacekeeping missions. Amongst many other countries, he has worked as a mediator for South Africa, Haiti, Afghanistan, Iraq, Syria, Democratic Republic of Congo, Cameroon, Burundi, Angola, Liberia, Nigeria, Sudan, and Côte d’Ivoire on behalf of the UN. He also played a direct role in South Africa’s democratic transition as a special representative in 1993/4.

Dr Mercy Amba Oduyoye received an honorary doctorate from the Faculty of Theology. Dr Oduyoye is widely regarded as one of the most influential women theologians in Africa. She was the first black woman to receive a degree in Theology in 1965 from Cambridge University in the United Kingdom. She continues to shift the paradigm of gender in theology internationally as the director of the Institute of African Women in Religion and Culture at the Trinity Theology Seminary in Ghana.

Dr Mercy Oduyoye.
Photo: Johan Roux

In closing the academic celebrations

Vice Rector: Academic, Dr Lis Lange, commended the class of 2014 for making their contribution to the educational system. Prof Jonathan Jansen, Vice Chancellor and Rector, also congratulated the graduates in closing.

“This is a day many have worked very hard towards, it is an enormous achievement as well as a development in the quality of research, and the courage to research,” he said in a vote of confidence.

Dr Khotso Mokhele, Chancellor of the UFS, applauded the university in light of the increased number of female graduates who completed their degrees with distinctions. The transcendence of demographics, both in terms of gender and race, on a postgraduate level, increases the hope of achieving gender equality in both the academic arena and South Africa.

More graduation news

A number of distinctions were also awarded during the two-day ceremony. For a list of these distinctions, follow this link.

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