The health department is working with the World Health Organisation (WHO) to secure vaccines against mpox, formerly known as monkeypox, and expects to receive the first doses “within days”, health minister Joe Phaala said on Wednesday.
It is also seeking to lay in a small stockpile of the WHO-approved treatment tecovirimat in the event of a wider outbreak, he said.
Mpox is a viral disease closely related to smallpox that is spread through close contact, causing flu-like symptoms and painful blisters. While it is usually mild and self-limiting, it can cause severe illness and be fatal to people living with advanced HIV.
SA has the world’s biggest HIV burden, and though testing and antiretroviral medication is free, many people living with the disease are not on treatment.
SA has confirmed 10 cases of mpox since 2022 — five since May this year. All patients in the current outbreak were men who have sex with men and had no travel history to countries where mpox was endemic, indicating there was community transmission of the virus, said the minister.
All five men, one of whom died on Monday, had other underlying health conditions and were admitted to hospital, he said.
Three of the patients were from eThekwini, KwaZulu-Natal, and the other two were from Sedibeng and Thembisa, Gauteng.
“The department is reaching out to organisations working on HIV programmes and with key populations ... to intensify awareness about the outbreak and local transmission of the disease,” the minister said in a press briefing.
“Stigma makes contact tracing difficult,” he said, urging anyone who had mpox symptoms to seek immediate medical assistance. An outbreak response team was conducting contact tracing and case finding in the affected provinces, he said.
Mpox was discovered in research monkeys in Denmark in 1958 and is endemic to several Central and West African countries. The first human case was confirmed in the Democratic Republic of Congo in 1970. Until recently the disease was confined to sporadic outbreaks in endemic countries and travellers to these areas.
But in the past two years cases have been detected in dozens of countries in disparate geographical regions, many with chains of transmission that have no apparent link to endemic countries. The shift prompted global alarm and heightened surveillance by the WHO, which declared it a public health emergency in 2022. It lifted the designation last year, after a sustained decline in global cases.
Discussions were still under way to determine how many vaccine doses SA could obtain and the criteria for administering them, said the minister.
The plan was to vaccinate people at high risk of infection, including sex workers, men who have sex with men, laboratory workers and healthcare staff, he said.
The WHO was in bilateral discussions with Western countries that have stockpiled mpox vaccines beyond their needs and is considering bulk procurement from manufacturers, it said.
No mpox treatments are registered with the SA Health Products Regulatory Authority (Sahpra).
Tecovirmat had been obtained for the five patients affected in the current outbreak, under section 21 authorisation from Sahpra, said the minister.
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