Epidemiological characteristics of mpox cases and public health response during the first mpox outbreak in South Africa, June – October 2022
1
Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, Johannesburg, South Africa
2
Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, Johannesburg, South Africa
3
School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa
4
Public Health, Communicable Diseases Control and Outbreaks Response, Gauteng Province Department of Health, Johannesburg, South Africa
5
Communicable Disease Control, Western Cape Government Department of Health and Wellness, Cape Town, South Africa
6
Public Health Directorate, Limpopo Provincial Government Department of Health, Polokwane, South Africa
7
Communicable Disease Control,, National Department of Health, Tshwane, South Africa
8
Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa
9
School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3420
ABSTRACT
BACKGROUND:
Since May 2022, mpox has been reported globally from non-endemic countries, affecting mostly males. Sexual contact was the most reported mode of transmission/exposure. In 2022, mpox was not a notifiable medical condition (NMC) in South Africa (SA), a non-endemic country. We describe the epidemiology and public health response in the first mpox outbreak in SA, June-October 2022.
METHODS:
We conducted a descriptive, cross-sectional study. Between May-October 2022, 272 mpox PCR tests were conducted. Whole genome sequencing (WGS) was conducted on the first two PCR-positive cases. Case investigations, contact tracing, and 21-day close contacts symptom monitoring were conducted.
RESULTS:
Five epidemiologically-unlinked laboratory-confirmed cases, with zero deaths, were reported from June-August 2022. WGS clustered in Clade II, B.1 lineage, with viral genomes associated with the 2022 multi-country outbreak. All cases were males, aged between 28-42 years (Median: 27.5; IQR: 16–36), from three provinces (Limpopo: n=1, Gauteng: n=2, and Western Cape: n=2). The first two cases had no documented travel history; the subsequent three cases had travel history (Switzerland, Spain, and both to the Netherlands and Spain). The Limpopo case, a tourist, reported sexual contact with a suspected mpox case in Switzerland. Twenty-eight close contacts were identified. No secondary cases reported.
CONCLUSIONS:
Mpox cases were identified during the peak of the 2022 multi-country outbreak. Although sequencing was performed for two cases, WGS findings suggest a possible linkage of this outbreak to the 2022 multi-country outbreak. These findings are comparable to the 2022 multi-country outbreak. Limitations include sexual self-identification, sexual exposure, travel history, and contact with suspected/probable/confirmed cases, not being established for some cases, except for one. Due to recommendations made to strengthen surveillance, early detection, and reporting, mpox was declared category-1 NMC in February 2023. Further research and surveillance are needed to better understand mpox risk factors and transmission dynamics in SA.
Since May 2022, mpox has been reported globally from non-endemic countries, affecting mostly males. Sexual contact was the most reported mode of transmission/exposure. In 2022, mpox was not a notifiable medical condition (NMC) in South Africa (SA), a non-endemic country. We describe the epidemiology and public health response in the first mpox outbreak in SA, June-October 2022.
METHODS:
We conducted a descriptive, cross-sectional study. Between May-October 2022, 272 mpox PCR tests were conducted. Whole genome sequencing (WGS) was conducted on the first two PCR-positive cases. Case investigations, contact tracing, and 21-day close contacts symptom monitoring were conducted.
RESULTS:
Five epidemiologically-unlinked laboratory-confirmed cases, with zero deaths, were reported from June-August 2022. WGS clustered in Clade II, B.1 lineage, with viral genomes associated with the 2022 multi-country outbreak. All cases were males, aged between 28-42 years (Median: 27.5; IQR: 16–36), from three provinces (Limpopo: n=1, Gauteng: n=2, and Western Cape: n=2). The first two cases had no documented travel history; the subsequent three cases had travel history (Switzerland, Spain, and both to the Netherlands and Spain). The Limpopo case, a tourist, reported sexual contact with a suspected mpox case in Switzerland. Twenty-eight close contacts were identified. No secondary cases reported.
CONCLUSIONS:
Mpox cases were identified during the peak of the 2022 multi-country outbreak. Although sequencing was performed for two cases, WGS findings suggest a possible linkage of this outbreak to the 2022 multi-country outbreak. These findings are comparable to the 2022 multi-country outbreak. Limitations include sexual self-identification, sexual exposure, travel history, and contact with suspected/probable/confirmed cases, not being established for some cases, except for one. Due to recommendations made to strengthen surveillance, early detection, and reporting, mpox was declared category-1 NMC in February 2023. Further research and surveillance are needed to better understand mpox risk factors and transmission dynamics in SA.
| eISSN: | 2654-1459 |
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