Mpox Outbreak: SA Health Department Moves to Provide Vaccines to MSM

Following the death of a man in Gauteng, South Africa’s Health Department has announced plans to procure mpox (formerly known as monkeypox) vaccines for at-risk groups, including gay and bisexual men and other men who have sex with men (MSM).

A new outbreak in South Africa has seen five confirmed cases of the disease. Mpox is a disease found in several animal species in central and western Africa but can be transmitted to and between humans.

In 2022, there was a global outbreak largely among MSM in countries outside the typical regions, including Europe, the US, and Australia. While several cases occurred in South Africa, the spread was limited. Many countries offered vaccines to MSM at risk, such as those with multiple partners, but these vaccines were not available in South Africa.

On Wednesday, the Minister of Health, Dr Joe Phaahla, held a media briefing in Pretoria to provide an update on the latest mpox outbreak and outline the government’s actions to stem the spread of the disease.

Five Cases Confirmed in South Africa

Phaahla revealed that the five South African cases confirmed since May involved men aged between 30 and 39, two in Gauteng and three in KwaZulu-Natal. One individual passed away at the Tembisa Hospital in Gauteng this week. None of the individuals reported having travelled abroad.

“All five cases were classified as severe per the WHO (World Health Organization) definition and required hospitalisation,” said Phaahla. Two have since been discharged. He explained that the patients were all immunocompromised and had been “identified as being part of what we regard as key populations, which include men who have sex with men”.

The government, he added, is working with key stakeholders to implement targeted communication and raise awareness about the outbreak.

The minister confirmed that the government is sourcing funding and procuring vaccines that will be provided to the most at-risk populations, identified as sex workers, MSM, and healthcare workers. These vaccines are expected to arrive in the country within days.

An antiviral treatment that has shown some effect on severe cases is also expected to become available in South Africa after special approval was granted by the South African Health Products Regulatory Authority.

Stigma May Hamper Efforts to Stop Mpox

While recent outbreaks of mpox have predominantly been diagnosed among MSM, anyone, regardless of their sexuality, can contract mpox if they have close contact with someone infected with the virus.

The department earlier warned that the fear of stigma and discrimination might prevent people from coming forward for testing or care.

There are also concerns that those infected, especially closeted men, may not be open with health authorities about their contacts, hampering contact tracing and efforts to stop the disease’s spread.

In a statement, the Department applauded the patients, “whose honesty and courage during the investigation process assisted officials in tracing suspected cases.”

Dr Jacqueline Weyer, Head of the Centre for Emerging Zoonotic and Parasitic Diseases at the National Institute for Communicable Diseases, urged the media to report responsibly to avoid fuelling any stigma associated with the disease.

Mpox Symptoms and How It Spreads

Common symptoms of mpox include a rash lasting two to four weeks, fever, headache, muscle aches, back pain, low energy, and swollen glands.

The rash can be painful and looks like blisters or sores, affecting the face, palms of the hands, soles of the feet, groin, genital, and/or anal regions. People living with HIV who are not under ongoing treatment and are immunocompromised may be more susceptible to the disease.

Mpox is not considered a sexually transmitted infection but can spread during any close or intimate physical contact between people. This contact can occur during sex, including oral, anal, and vaginal sex, or touching the genitals or anus of a person with mpox.

It can also be spread through hugging, massage, kissing, or talking closely, or by touching fabrics, shared surfaces, and objects, such as bedding, towels, and sex toys, used by a person with mpox.

The WHO recommends that MSM reduce the number of sexual partners; avoid group sex; avoid sex-on-premises venues (cruising bars, saunas, and darkrooms); and avoid using alcohol or drugs in sexual contexts (including chemsex).

An infected person is contagious from the onset of the rash/lesions through the scab stage. Once all scabs have fallen off, a person is no longer contagious. While the disease usually resolves on its own, it can, in rare cases, be fatal.

If you have any symptoms, you are urged to isolate from others and see a doctor or healthcare provider.

Details on where, when, and how the mpox vaccines will be provided have yet to be confirmed.