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Monkeypox: NICD urges travellers to SA to report on illness, activities

Fifteen countries have collectively reported more than 140 cases.

Fifteen countries have collectively reported more than 140 cases.

Published May 24, 2022

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Cape Town - The National Institute for Communicable Diseases (NICD) has urged travellers entering South Africa to report any illness, including information about all recent travel and attendance at mass gatherings, festivals and parties, following an outbreak of monkeypox in several countries.

The World Health Organization (WHO) reported it was notified of two laboratory-confirmed cases and one probable case of monkeypox, from the same household, in the United Kingdom in March.

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Four additional laboratory-confirmed cases were later reported among sexual health services attendees presenting with a vesicular rash illness. Since then, 15 countries have collectively reported more than 140 cases.

No cases have been detected in South Africa, the NICD said.

The first case in the current outbreak was a traveller who returned to the United Kingdom from Nigeria, a monkeypox endemic area, on May 4, the NICD said.

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Stellenbosch University epidemiologist Dr Jo Barnes said monkeypox begins with a fever, headache, muscle aches and exhaustion.

“The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days, but can range from 5−21 days. Within 1 to 3 days, sometimes longer, after the appearance of fever the patient develops a rash, often beginning on the face then spreading to other parts of the body. The illness typically lasts between 2 and 4 weeks.”

Barnes said the first human case of monkeypox was recorded in 1970 in the Democratic Republic of the Congo during a period of intensified effort to eliminate smallpox.

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“Since that date, monkeypox has been reported in people in several central and western African countries. Monkeypox cases outside of this endemic area are associated with persons who travelled, or with the importation of infected animals. There are no cases of monkeypox diagnosed in South Africa that I am aware of, but that may change at any time,“ said Barnes.

NICD executive director Prof Adrian Puren said the implications for South Africa are that the risk of importation of monkeypox is a reality, as lessons learnt from Covid-19 have illustrated that outbreaks in another part of the world can fast become a global concern.

The NICD said milder cases of monkeypox may go undetected and represent a risk of person-to-person transmission.

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“There is likely to be little immunity to the infection in those travelling or otherwise exposed, as endemic disease is usually geographically limited to parts of West and Central Africa. Although monkeypox, which is related to smallpox, which has been eradicated, sporadically causes small outbreaks, transmission is believed to be inefficient as close contact is required.

"Thus the current outbreak is unlikely to progress to being a global emergency. Monkeypox is usually a self-limiting illness, and most cases will recover within a few weeks without treatment. However, severe disease may be observed in young children, pregnant women, and individuals who are immunocompromised.”

Cape Times

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