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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 awards honorary doctorates during its centenary week

2004-10-07

The University of the Free State (UFS) will award 12 honorary doctorates on Thursday 14 October 2004 to a diverse group of outstanding South Africans and international experts.

This will be the last in a group of 18 honorary doctorates that the UFS will be awarding in its centenary year.

The awards comprise of a number of well-known language experts and writers, experts in higher education, first-time awards in community service and development studies, as well as music.

“This reflects quality and also diversity, a spectrum of convictions as well as the recognition of persons who played a major role in changing society in the last couple of decades, “ says Prof Frederick Fourie, Rector and Vice-Chancellor of the UFS.

The awards can be grouped in the following categories:

Language and literature:

Mr Karel Schoeman (D Litt (hc)) – well-known Afrikaans author and former student of the UFS. Some of the awards he has received include the Hertzog prize for prose (1970, 1986 and 1995), the CNA prize (1972 and 1994), the Old Mutual prize (1985 and 1991), the SABC prize for best television drama in 1990, the M Net book prize in 1997 and the State President award (former President Nelson Mandela: Order for Excellent Service – silver) in 1999. It is an honor for the UFS to have this gifted and creative person among its former students. This conferment is a fitting recognition of his status as leading South African writer.

Ms Antjie Krog (D Litt (hc)) – well-known South African poet and former student of the UFS. Her popularity as poet is evident in her piercing honesty and unequalled power of expression. Some of the awards she has received include the Eugéne Marais prize in 1973, the Rapport prize in 1987, the Hertzog prize in 1990 and the RAU prize in 2000. Her writing has been translated into seven languages. She has also received numerous honors for her involvement in and journalistic documentation of the Truth and Reconciliation Commission’s (TRC) proceedings. It is therefore an exceptional privilege for her alma mater to honor her with an honorary doctorate.

Prof Jaap Steyn (D Litt (et phil) (hc)) – recently, Prof Steyn again distinguished himself as biographer whose thorough research is apparent in the published biographies of illustrious writers such as NP van Wyk Louw and MER. The numerous awards, among which the Stals prize from the South African Academy of Science and Art for the Van Wyk publication, are a matter of record. He conducted the research for this great prize-winning work as honorary professor at the UFS.

Prof Jakes Gerwel (D Phil (hc)) – Chancellor of the University of Rhodes and Director of Naspers, Old Mutual, Gold Fields and Brimstone. His doctoral thesis was published in The Netherlands under the title Literatuur en apartheid. Konsepsies van “gekleurdes” in die Afrikaanse roman tot 1948 (1983). He received an honorary doctorate from Clark College ( Atlanta), the City University of New York and Missouri in the USA, the University of the Western Cape, the University of Cape Town, the University of Natal, Rhodes University, the University of Stellenbosch and the University of the Witwatersrand. He is also outstanding professor in the Humanities at the University of the Western Cape, honorary professor in the Humanities at the University of Pretoria, and was the chairman of the Human Sciences Research Council (HSRC).

Development Studies:

Dr Frederick van Zyl Slabbert (D Phil (hc)) – for his academic achievements, his endeavors for bringing about a peaceful transition in South Africa and his demonstration of the social investment role of the corporate sector. Dr Van Zyl Slabbert has received honorary degrees from the University of Natal and the Simon Fraser University in Canada. He has published seven books and various academic articles.

Community Service:

Prof Robert G Bringle (D Phil (hc)) – from the Indiana University-Purdue University Indianapolis (IUPUI) in the USA. He is currently Chancellor’s Professor of Psychology and Philanthropic Studies at the IUPUI and also Director of the IUPUI’s Centre for Service Learning. He is honored for his exceptional contribution to several of the UFS’s community service projects as well as his role in the advancement of a multi- and inter-disciplinary approach to academic development and the integration of service learning within the faculties of the UFS. He has also made a valuable contribution to the conceptual framework of the UFS’s unique community service policy and more recently to the advancement of a research culture regarding community service.

Higher education:

Dr Khotso Mokhele (D Phil (hc)), President of the National Research Foundation (NRF) is honored for his contribution to the South African higher education sector. He has also made a substantial contribution to the development of the research capacity of universities and technikons in South Africa. Dr Mokhele was born in Bloemfontein and matriculated at the Moroka High School in Thaba Nchu.

Prof Saleem Badat (D Phil (hc)), the Chief Executive Officer of the Council on Higher Education (CHE). Prof Badat has devoted himself to transforming and building South African higher education, and has constantly challenged the higher education sector to retain the moral basis of higher education and tackle its challenges with intellectual honesty, ingenuity, creativity and courage. He is honored for his intellectual leadership in the development of a equitable, just and quality higher education system in South Africa.

Law:

Prof HA (Boelie) Wessels (D Legum (hc)) – for his contribution to the fields of Roman Law, Legal History at the UFS. He is currently a part-time lecturer at the UFS’s Faculty of Law.

Medicine:

Prof CJC Nel (D Phil (hc) Posthumous) – for the way in which he strived for the advancement of excellent medical education in the country. Prof Nel also did pioneering work in the field of transformation in higher education. Under his guidance the School of Medicine at the UFS became one of the first medical schools to adopt a parallel-medium system of instruction.

Music:

Prof Leo Quayle (D Mus (hc)) – for the significant contributions he has made to the development of music – not only in Bloemfontein, but also on national level and abroad. His initiative, enthusiasm and dedication contributed to the eventual founding of the Free State Musicon, as well as the first symphony orchestra and the first string quartet in Bloemfontein. Prof Quayle is a former head of the Department of Music at the UFS.

Prof Jack de Wet (D Mus (hc)) – well-known for his exceptional contribution to violin tuition in South Africa. As pedagogue of international stature, he still moulds violinists who compete at national and international level. At an advanced stage of his career, he still actively conveys his knowledge, experience and distinctive insight in his field of speciality to yet another new generation of young violin teachers. Today the symphony orchestras in Bloemfontein and Port Elizabeth also stand on the foundations laid by him.

Media release
Issued by: Lacea Loader
Media Representative
Tel: (051) 401-2584
Cell: 083 645 2454
E-mail: loaderl.stg@mail.uovs.ac.za
7 October 2004

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