Monkeypox: How it spreads, symptoms, prevention and more

What is mpox?

Mpox, formerly known as monkeypox, is a viral disease that has been around for a long time. Mpox is caused by the monkeypox virus.

There are two different virus clades (also known as strains or variants) of mpox, namely clade 1 and clade 2. Clade 2 was behind the global mpox (at the time called 'monkeypox') outbreak that began in 2022. Clade 1 results in more severe illness and higher death rates than clade 2. Post the 2022 outbreak, a new offshoot of clade 1 called clade 1b, was found - first reported on in 2023.

How has the latest outbreak affected South Africa?

In South Africa, the National Department of Health announced that the total number of positive mpox cases recorded as of 18 August 2024, was 24. Nineteen of these cases had recovered, three had died, and two active cases were isolating at home.

How does mpox spread from animals to humans and between humans?

People can get the mpox virus from contact with an infected animal, human, or materials contaminated with the virus.

1. In endemic countries (endemic means it's long been present in an area or population), the mpox virus may be spread from handling infected bush meat (such as during hunting or cooking), an animal bite or scratch, body fluids and contaminated objects. In Africa, mpox infection has been found in many animal species. However, some species of rodents (not monkeys as the name implies) are suspected of being the main disease carrier.
2. Cases of mpox spreading through animals, outside of the endemic areas, are very rare. In non-endemic countries person to person transmission is evident. People are most likely to be exposed to mpox through close contact with a person who has it.

The virus infects humans through broken skin, the respiratory tract, or the mucous membranes (eyes, nose, or mouth).

• Person to person transmission happens mainly through very close contact with the skin and mucosal lesions, body fluids, respiratory droplets and also contaminated materials such as bedding.
• The risks of infection appear to be increased in people who have multiple sexual partners, and there have been reports of increased spread at large social events where there is close physical contact.
• To date, the outbreak has been primarily in men who have intercourse with men.
• The virus can also spread during pregnancy to the foetus, during or after birth.

What are the symptoms of mpox?

• The symptoms of mpox can vary, but they typically follow a similar pattern.
• Mpox usually presents with an acute illness characterised early by fever and general flu-like symptoms like headaches, muscle aches, chills, back pain, low energy and swollen glands.
• Within one to three days of the onset of the above symptoms, blister-like lesions resembling chickenpox, appear on the face, hands, and feet, and may spread to other areas. The lesions can be painful, especially those in sensitive areas like the genitals.
• Not everyone will have every symptom. Some may have a mild illness with very few lesions while others may have a more severe rash or symptoms.
• The time from infection to symptoms (incubation period) for mpox is on average seven to 14 days but can range from five to 21 days.
• Mpox is a self-limiting disease with symptoms typically lasting from two to four weeks. The disease is rarely fatal, and cases typically resolve without requiring treatment.
• Mpox can cause severe illness in newborn babies, children, pregnant woman and people with immune system deficiencies, but these sorts of cases are rare.

How do we prevent mpox infection?

The risk of coming into contact with mpox is low. However, it's important to be cautious and aware. The best ways to prevent mpox infection are to:

• Avoid contact with infected animals, especially rodents and primates, in areas where mpox is endemic
• People with mpox should isolate.
• Avoid contact with people who are suspected or known to be infected with the virus.
• Healthcare workers and those caring for people with mpox at home should use protective equipment like masks and gloves to prevent exposure.
• Avoid contact with bedding and other materials that may be contaminated with the virus.
• Avoid sexual contact with individuals showing symptoms of mpox.
• Children and immunocompromised adults may experience more severe forms of the disease so it's important to limit their exposure to infected individuals.
• Wash your hands frequently with soap and water.

The South African government, guided by World Health Organization (WHO) recommendations, is working to secure mpox vaccines. These will be administered to people at high risk of contracting the disease once they become available. Vaccines used for smallpox can also provide protection against mpox.

Stay informed to avoid anxiety around mpox. Help stop the spread of misinformation and break the stigma associated with mpox to ensure that those affected seek medical attention without fear.

What should you do if you think you have mpox?

The WHO urges individuals with possible or confirmed mpox to avoid close contact with others until all lesions have healed, and scabs dried off. This should include staying at home and self-isolating (unless you need medical assessment or care - also for other urgent health and wellbeing issues). Isolation stops transmission to others.

• Wear a mask if you need to be around other people. This helps reduce the spread via respiratory droplets.
• Use a separate room and bathroom if possible if you have mpox.
• Avoid physical contract with others including sexual contact.
• There is no specific treatment for mpox. However, those with mpox should get rest, stay hydrated, use pain and fever medicine if necessary, and use skin care treatment for the lesions.
• South Africa's Health Department will make antivirals available to manage people who are admitted to public or private hospitals with severe mpox disease.
• Inform anyone you have been in close contact with recently if you are known to have mpox, so they can monitor for symptoms and help stop the disease from spreading further.

Get the facts from reliable sources

For the most accurate and up-to-date information, consult the National Institute for Communicable Diseases (NICD) in South Africa and the World Health Organization.