Four infectious diseases experts from UKZN’s College of Health Sciences were panellists on an Mpox webinar that was applauded for raising critical awareness on the global outbreak of the disease and its increasing prevalence in African countries, especially Central and West Africa, where most cases have been reported.
Twenty laboratory confirmed cases and two deaths had been recorded in South Africa at the time of the webinar.
Characterised by blister-like lesions that appear as a painful rash and enlarged lymph nodes on the skin after the onset of the condition, its initial symptoms include fever, headache, muscle aches, backache, chills and exhaustion.
Persons experiencing such symptoms were encouraged to be seen by a healthcare professional immediately for early diagnosis, which would also be a preventative measure from potentially spreading Mpox to persons coming into close physical contact with infected individuals and the surfaces they have touched. Abstinence and self-isolation were deemed the best way to prevent the spread of the disease. Once tested and diagnosed with Mpox, health professionals would recommend treatment immediately, and track and trace other people who you may have been in contact with the patient/s.
Graphic images of the lesions were presented by Dr Richard Lessells, an Infectious Diseases Specialist at the KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP) at UKZN’s School of Laboratory Medicine and Medical Sciences (SLMMS), and Honorary Research Associate at the Centre for the AIDS Programme of Research in South Africa (CAPRISA).
Lessels said in parts of Europe and America, once people were exposed to the spread of Mpox, careful considerations started to be taken on how to reduce individual and collective risk. Lessels said some decided on a period of abstinence until they could be protected by vaccination, for example. Lower-middle-income counties, such as in the African continent, are still not privileged enough to easily access such vaccines.
According to available data, more than 90% of reported cases were males with the median age of 34 who identified as men who have sex with men (MSM), with female sex workers also reporting. This was not to say Mpox is sexually transmitted but rather that coming into intimate contact with anybody infected with the condition increases the chance of infection.
‘We don’t want to create the same fear as during the COVID-19 outbreak where you didn’t want to even touch or hug anyone,’ explained Associate Professor, Chief Specialist and Head of UKZN’s Department of Infectious Diseases, Professor Yunus Moosa, when the panel was asked whether handshakes were safe.
The panel explained that at this point, evidence suggests that Mpox is transmitted through direct skin-to-skin or skin-to-mucosa contact, adding that there must be an entry point for the virus to transmit. They said because normal skin is a barrier against pathogens, there needed to be a breach in the skin (however minuscule) for the virus to be transmitted. ‘If you’ve got a normal layer of skin, it’s very unlikely that the virus could enter there but best minimise any contact at all if Mpox is suspected.
Clinical virologist, Dr Nokukhanya Msomi who is also jointly appointed by UKZN and the National Health Laboratory Service to provide clinical and diagnostic virology laboratory services in KwaZulu-Natal, said early detection of the virus was critical because the period of high infectiousness tended to coincide with when the lesions were still fresh on the skin. ‘Once lesions start scabbing and a new layer of skin forms, then risk of transmission is reduced. Telling those close to you and then self-isolating once the virus is detected is the best way to minimise the spread of the virus during the period of infectiousness,’ she explained.
The panel said the decline in cases in many countries had been associated with case-finding, contact tracing, behaviour change, infection-acquired immunity and later, vaccine-acquired immunity. That is why raising public awareness and encouraging testing for Mpox is critical in preventing the scourge of the disease.
It was said during the robust discussion that at this point, the public needed to be more cautious about human-to-human transmission rather than animal-to-human. Regular updates about Mpox can be found on the National Institute for Communicable Diseases website.
The webinar was convened by Academic Leader for Infectious Diseases at UKZN’s SLMMS, Professor Michelle Gordon. The webinar can be accessed via this link.
Words: Lunga Memela