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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 Centenary 2004 / 2005 October (centenary) fest Activities
2004-10-08

Friday, 08 October 2004
17:00 – 24:00
Callie Human Centre, UFS
Macufe Rock Concert
With: Rooibaardt, Karen Zoid, The Narrow, F****polisiekar, Stuurbaard Bakkebaard (from the Netherlands), DJ Bob, Ready D, Neva Me.
Cost : R50-00
Bookings : Pacofs (051-447 7772)

Sunday, 10 October 2004
16:00 – 18:00
Callie Human Centre, UFS
Macufe Three Tenors Concert
With: Phillip Kotze, Chris Coetzer and Du Preez Stolz, as well as Angela Kerrison. Free State Symphony Orchestra conducted by Chris Dowdeswell.
Cost :R60-00 (adults), R40-00 (children, scholars, students and pensioners)
Bookings : Pacofs (051-447 7772)

Tuesday, 12 October 2004
11:00 – 15:00
Centenary Complex, UFS
Inauguration of Centenary Complex
Open day with a variety of musical recitals in different rooms
Cost : Free
Enquiries : Elize Rall (051-401 3382)

15:00 – 17:00
Parking area next to the Centenary Complex, UFS
Kovsie Mosaic Day
Collage of the Century, Dance to the beat, Cultural Cartoon,
Who’s line is it anyway?
Cost : Free
Enquiries : Louis Botha (051-401 2819) or
AC Geldenhuys (084 585 3338)

Wednesday, 13 October 2004
19:00
Centenary Complex, UFS
Première of documentary film : The Life and Legacy of  King Moshoeshoe
Note : By invitation only
Enquiries : Elize Rall (051-401 3382)

Thursday, 14 October 2004
18:45 – 21:00
Red Square (in front of Main Building), UFS
Centenary Honorary Doctorate Degree Graduation Ceremony
Conferred on: Me. Antjie Krog, Prof. Jakes Gerwel, Mr. Karel Schoeman, Dr. Frederick van Zyl Slabbert, Prof. Saleem Badat, Dr. Khotso Mokhele, Prof. Robert Bringle, Prof. Leo Quayle, Prof. Jack de Wet, Prof. Kerneels Nel (posthumously), Prof. Boelie Wessels and Prof. Jaap Steyn .
Cost : Free. Please RSVP if you would like to attend.
Enquiries : Elize Rall (051-401 3382)

Friday, 15 October 2004
18:30
Centenary Complex, UFS
Alumni Dinner and Centenary Award Ceremony
Approximately 140 centenary medals will be awarded in acknowledgement of exceptional contributions to the development of the University. The award ceremony is followed by the Alumni dinner in the Callie Human Centre.
Cost : R100-00/person
Enquiries : Elize Rall (051-401 3382)

15:00 (to 12:00, Saturday, 16 October 2004),
UFS campus
Reunion : Momentum Adventure and Expedition Association
Including : Setting up of the Kovsie Momentum base camp, champagne breakfast and abseiling.
Cost : R50-00/person for breakfast
Enquiries : Gerrit van der Merwe (072 4317 153) or
Niel Fraser (082 772 5642)
Website : www.uovs.ac.za/associations/momentum_hrcc.

19:00 (to 11:00 Sunday, 17 October 2004)
Reunion : Cantare Revue Group
Including : Formal dinner, budget show, bring and braai, church service.
Cost : R100-00/person for the dinner
Enquiries : Louis Botha (051-401 2819)

19:00 (to 24:00 Saturday, 16 October 2004
Reunion : House NJ van der Merwe
Including : Senior Student’s Association and concerts
Cost : R5-00/person
Enquiries : Tutu Ntlathi (051-401 4122 / 072 865 2227)

Saturday, 16 October 2004
09:00 – 10:00
Committee Room 120, Faculty of Theology
Founding of Theology Alumni Association
Enquiries: Henna Nel (051-401 2669)

10:00 – 12:00
Parking area, CR Swart Building, UFS
Alumni Campus Tour
Including : Visits to the new physical developments on campus
Cost : Free
Enquiries : Jeanette Jansen (051-401 3594)

10:00 – 12:00
Sonnedou gazellie (next to NJ van der Merwe Residence), UFS
Reunion : Ladies’ Tea
Visit our new gazellie and find out what Sonnedou is up to these days.
Cost : R25-00/person
Enquiries : Anne-Marie Delport (072 109 0507)

12:00 – 16:00
JBM Hertzog Residence (garden in front of Senior Student’s Association), UFS
Reunion : Braai
Cost : Approximately R20-00/person
Enquiries : Hattingh Bornman (084 240 5226)

12:00 Vergeet-my-nie Residence, UFS
Reunion : Braai
Bring and braai. We supply the facilities. Bring old photographs and stories. Enjoy Aunt Juls’ last visit.
Cost : Free
Enquiries : Mari Jordaan (051-444 2832/072 392 4444)

12:00 HF Verwoerd Residence Senior Student’s Association, UFS
Reunion : Spit roast
Cost : R60-00/person
Enquiries : Jan-Chris Landman (051-401 3613 / 082 664 6062)

18:30 Floreat Hall, Bloemfontein Civic Centre (Braam Fisher Building)
Irawa 60 Reunion
For all former editors, former and current main editorial staff and coworkers
Cost : R100-00/person
Enquiries : Sanri van Wyk (072 333 1011)
Elzette Boucher (072 180 6265)

19:00 – 24:00 Red Square (in front of Main Building), UFS
Informal Alumni Reunion
Spit roast and stories in a marquee
Cost : R60-00/person
Enquiries : Elize Rall (051-401 3382)

Sunday, 17 October 2004
10:00 – 11:00
Kovsie Church
Church Service

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