Local infectious disease experts have warned people to be more vigilant regarding the new highly infectious mpox variant, Clade 1b, which has been reported in seven African countries, as well as in South Africa.
Infectious disease expert Dr Lior Chernick, at Charlotte Maxeke Academic Hospital, told SABC News the new variant also affects children.
“We saw an outbreak of Clade 2b from 2022, and still see occasional cases around the world, predominantly affecting men. There are some cases of females who were infected probably through sexual contact.
“However, with Clade 1b… this is more like chicken pox… and from closer contact with people who have lesions that are open. So for Clade 1b we also see an equal male and female dominance, and in younger people, because obviously, kids and hygiene…”
Local transmission
In February and March, seven cases were confirmed in Gauteng in two distinct clusters, and while the first could be traced to a patient with international travel history, the second cluster showed no travel history or links to the first patient.
Deputy director CDC surveillance at the Gauteng Department of Health Mzimasi Neti told News24 the second cluster was traced to an e-hailing driver, and indications were that it was a “locally acquired case”, which was “a big concern for us as a province, because it means there is community transmission of mpox”.
The first cluster was traced to a man with a travel history to Uganda, but in the second cluster, the virus was transmitted to the driver’s partner, nephew and sister, Neti added.
The most recent outbreak had distinct differences from previous outbreaks, in that no children or women had previously recorded cases of mpox.
In addition, Neti added, all seven patients tested positive for a variant that had not previously been recorded in South Africa.
The first mpox case recorded in Gauteng was in June 2022. To date, 21 cases have been reported, and one death, in the province.
The National Institute for Communicable Diseases (NICD) has recorded 31 cases across the country, resulting in three deaths.
Head of the Centre for Emerging Zoonotic and Parasitic Diseases at the NICD Jacqueline Weyer said all mpox cases reported this year were associated with the Clade 1b variant.
“Cases associated with Clade 1b have been reported from the DRC, with cases also noted in other African countries as well as countries outside Africa,” she added.
Cases have been reported in people in different age and sex groups.
In May 2022, the first cases of Clade 2b mpox were reported outside Africa and continue to be reported in some locations globally.
“This outbreak has affected predominantly men, many self-identifying as men having sex with men. In other words, the epidemiology of the outbreaks associated with the different variants differ.
“The severity of both infections is affected by the person’s immune status – so for example, in people with unmanaged HIV, mpox can present severely and fatally, as with those who have other comorbidities, and problems with access to basic healthcare.”
Contact tracing had proven vital in the latest outbreak, Neti added.
The WHO’s epidemic, preparedness and response team lead, Dr Joseph Wamala, said more than 130 000 cases with 300 deaths have been reported across 131 countries.
In February alone, 3 000 new cases were reported, most of them from Africa. While this represents a month-on-month decrease of 18%, the drop could be due to conflict in the DRC disrupting testing, as well as the cancellation of funding to African countries.
Wamala said the spread of Clade 1B was “ever increasing”, and had been detected in several countries.
“We have 15 countries outside the African region where this Clade 1B has spread. Most of the deaths reported in the past six weeks have been in patients with Clade 1B.”
The Gauteng Health Department said Charlotte Maxeke and the Steve Biko Academic hospitals had been identified to deal with mpox-related cases.
See more from MedicalBrief archives:
Three new mpox cases in Gauteng