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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

Dr Francois Deacon appears in international film, Last of the Longnecks, due to research on giraffes
2017-04-04

Description: Giraffe research read more  Tags: Giraffe research read more

Dr Francois Deacon was invited by the producer of Last
of the Longnecks
to be part of a panel handling a question-
and-answer-session about the film.
Photo: Supplied

A great honour was bestowed on a researcher at the University of the Free State (UFS) when he was invited to the preview of the documentary film, Last of the Longnecks. Dr Francois Deacon, lecturer and researcher in the Department of Animal, Wildlife and Grassland Sciences at the UFS, who also has a role in the film, attended the preview at the Carnegie Institution for Science’s Smithsonian National Museum in Washington DC, in the US, in March this year. The preview formed part of the DC Environmental Film Festival.

The Environmental Film Festival in the US capital is the world’s leading showcase of films with an environmental theme and which aims to improve the public’s understanding of the environment through the power of film. During the festival, the largest such festival in the US, more than 150 films were shown to an audience of 30 000 plus. 

Dr Deacon was invited by the producer of Last of the Longnecks to be part of a panel handling a question-and-answer-session about the film directly after the show. He described it as the greatest moment of his life. 

Role in the film Last of the Longnecks

“My role in the film was as the researcher studying giraffes in their natural habitat in order to understand them better, so that we may better protect them, and be able to provide better education on the problem in Africa,” says Dr Deacon. 

“Together with Prof Nico Smit, also from the UFS Department of Animal, Wildlife and Grassland Sciences, Hennie Butler from the Department of Zoology, and Martin Haupt from Africa Wildlife Tracking, we were the first researchers in the world to equip giraffes with GPS collars and to conduct research on this initiative,” he says. This ground-breaking research has attracted international media attention to Dr Deacon and Prof Smit. 

“Satellite tracking is proving to be extremely valuable in the wildlife environment. The unit is based on a mobile global two-way communication platform, utilising two-way data satellite communication, complete with GPS systems.

“It allows us to track animals day and night, while we monitor their movements remotely from a computer over a period of a few years. These systems make the efficient control and monitoring of wildlife in all weather conditions and in near-to-real time possible. We can even communicate with the animals, calling up their positions or changing the tracking schedules,” says Dr Deacon.

The collars, which have been designed to follow giraffes, enable researchers to obtain and apply highly accurate data in order to conduct research. Data can be analysed to determine territory, distribution or habitat preference for any particular species.

Over a period of three years (2014-2016), the Last of the Longnecks team from Iniosante LLC captured on film how Dr Deacon and his team used the GPS collars in Africa to collect data and conduct research on the animals.

“With our research, which aims to understand why giraffes are becoming extinct in Africa, we are looking at the animal in its habitat but not only the animal on its own. If the habitat of these animals is lost, they will be lost as well. Therefore, our focus is on conservation and better understanding the habitat. The giraffe is only a tool to better understand the habitat problem,” says Dr Deacon. 

Since the beginning of his research Dr Deacon and his team have had six new collar designs, with animals in four different reserves being equipped with the collars. The collars use the best technology available in the world and make it possible to determine how giraffes communicate over long distances, and how their sleep patterns function. Physiological and biological focus is placed on the giraffe’s stress levels, natural hormone cycles, and milk quality in cows. 

Description: Giraffe 2017 Tags: Giraffe 2017

Photo: Supplied

Experience at the film festival

“Absolutely amazing. Totally beyond our frame of reference as South Africans.” This is how Dr Deacon describes his experience of the three days in Washington DC during the film festival.

“It was an absolute honour to be part of the global preview of the film and to be able to work with Ashley Davison, the director of the film, and his team. I am just a rural farm boy who dreams big, and now this dream is known worldwide!” he says. 

The film, which will be launched in April, will be screened in South Africa on the National Geographic channel in May 2017. Meanwhile, the film will also be shown at eight other film festivals in the US. 

Work will start on a follow-up documentary in October and Dr Deacon is excited about the prospect. A mobile X-ray machine will be available from October. Internal sonars could also be performed on each of the animals. Researchers from around the world will form part of the team which will be led and co-ordinated by Dr Deacon and his co-workers at the UFS.

Former articles: 

18 Nov 2016: http://www.ufs.ac.za/templates/news-archive-item?news=7964 
23 August 2016: http://www.ufs.ac.za/templates/news-archive-item?news=7856 
9 March 2016:Giraffe research broadcast on National Geographic channel
18 Sept 2015 Researchers reach out across continents in giraffe research
29 May 2015: Researchers international leaders in satellite tracking in the wildlife environment

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