South Africans should be concerned about the spread of mpox in the country with certain variants rapidly spreading between humans, including through sexual contact.
This is according to Professor Salim Abdool Karim, director of the Centre for the Aids Programme of Research in South Africa and member of the World Health Organization’s Science Council, speaking at a the Post-Global Virus Network Annual Scientific Meeting briefing in uMhlanga on Wednesday.
He said he chaired the committee that advised the Director-General of the African Centres for Disease Control to declare mpox a public health emergency last month.
Abdool Karim said what was concerning was the fact that mpox was spreading quite rapidly between humans, and the Clade 1b (variant) seemed to be spreading sexually as well with sex workers hugely impacted.
“We are very concerned, because we know a sexually transmitted infection can spread in Africa. We’ve seen that from HIV. In addition, we are concerned that people who have HIV who get mpox are the ones at the highest risk for getting severe forms of mpox.”
According to the national health department there were nearly 8 million people with HIV in South Africa.
While case fatality rates are generally low, Abdool Karim said in HIV patients, especially those not on treatment, the case fatality rate is high.
“Having so many people in Africa with HIV means we should be concerned about mpox spreading. For all of those reasons, we found that a public health emergency was required at this stage to try to curtail the spread of mpox, particularly in the DRC, and to a lesser extent now in Burundi,” he said.
Professor Rachel Roper, who specialises in microbiology and immunology at East Carolina University in the US, said it was concerning that we now have Clade 1 mpox jumping to humans (from animals) repeatedly, in addition to human-to-human transmission.
“This is the first time we’ve seen that large an outbreak, and it’s continuing. It’s spreading a lot in children as well. So I’m very concerned about it, and we need to get the vaccines out as soon as possible,” she said.
Abdool Karim said South Africa had to be vigilant by having well functioning virology laboratories, virologists and students of virology to continually build capacity to understand and respond to the threat. While the world was doing well in scientific pandemic preparedness, it was failing in political preparedness.
“One of those lessons was very evident with mpox. Here we are dealing with a public health emergency which is spreading in several countries in Central West Africa. Many wealthy countries have vaccine stockpiles, and their decision is they’ll keep it and wait in case the virus lands on their shores.”
For the virus to never reach the shores of these countries, everyone needed to work together and help the countries that have an mpox problem so it does not become a global pandemic, he said.
Commenting on a global analysis which predicted that infections of drug-resistant superbugs could kill nearly 40 million people over the next 25 years, Abdool Karim said with South Africa having more than 5 million people on antiretroviral treatment, resistance to treatment had to be monitored to ensure they received effective treatment, or resistant viruses will spread.
It was concerning because antiviral resistance was fundamentally induced by humans, he said. “It’s about using these drugs correctly, so we reduce the risk of getting resistant forms.”
The total number of positive mpox cases recorded in the country since May is 25, including three deaths.
The Mercury