MPOX: What You Need to Know

Recent cases of mpox (previously known as monkeypox) in South Africa have highlighted the importance of remaining alert about this disease, especially within the gay, bisexual and men who have sex with men (MSM) communities. Here is everything you need to know about mpox, including the symptoms and how it’s spread.

1. What is mpox?

Mpox is caused by the mpox virus, which is one of the more than 80 poxviruses known to science. The virus is typically harboured by different animal species and may spill over to people. Poxviruses that may cause human disease include the smallpox (or variola) virus.

2. Where does mpox occur?

Mpox was first discovered in 1958 in Denmark when two outbreaks occurred in colonies of monkeys kept for research, hence the original name ‘monkeypox.’ The first human case of mpox was recorded in 1970 in the Democratic Republic of Congo (DRC). Mpox is endemic (or naturally occurring) in countries in central and western Africa. This is attributed to the fact that it is naturally harboured by animals that are found in this part of Africa. Mpox infections in humans occur in these countries although at a relatively low level.

3. How common is mpox among people outside of central and western Africa?

In 2022, an outbreak of mpox spread among people around the world, including in Europe, the USA, Australia and South Africa. Before that, cases of mpox in other places were rare and usually linked to travel or to animals being imported from regions where mpox is endemic. Many of the cases since 2022 have been among gay, bisexual and other MSM who had been in contact with each other. A new variant of mpox, named “clade 1b,” emerged in April 2024 in Kamituga, a mining enclave within the DRC. This variant exhibits heightened transmissibility, mainly through sexual contact.

4. How is the mpox virus transmitted?

The mpox virus can be transmitted to a person upon contact with the virus from an animal, human, or materials contaminated with the virus. Entry of the virus is through broken skin, respiratory tract, or the mucous membranes (eyes, nose, or mouth). Persons are most likely to be exposed to mpox through contact with an individual that is already sick with mpox. Person-to-person transmission involves close contact with an infected person or materials that have been contaminated by an infected person.

5. Are gay, bisexual or other men who have sex with men (MSM) more at risk of mpox?

While recent outbreaks of mpox were diagnosed among men who have sex with men, anyone, no matter their sexuality, is equally vulnerable to mpox if they have had close contact with someone infected with the virus. Health experts and organisations have condemned any efforts to blame, shame or stigmatise MSM concerning the mpox virus.

6. Can you get mpox from sex?

Even though it is not considered a sexually transmitted infection, mpox can spread during any close or intimate physical contact between people. This contact can happen when you have sex, including:

  • Oral, anal, and vaginal sex, or touching the genitals or anus of a person with mpox
  • Hugging, massage, kissing or talking closely
  • Touching fabrics, shared surfaces, and objects, such as bedding, towels and sex toys, that were used by a person with mpox

Anyone – regardless of gender identity or sexual orientation – can catch mpox if they have close contact with someone infected with the virus. People who have sex with multiple or new partners are most at risk.

The world health organization (WHO) recommends:

  • Reducing your number of sexual partners;
  • Avoiding group sex;
  • Avoiding sex-on-premises venues (cruising bars, saunas and darkrooms);
  • Avoiding using alcohol or drugs in sexual contexts (including chemsex).

7. What are the signs and symptoms of mpox?

The incubation period (time from infection to symptoms) for mpox is on average 7−14 days but can range from 5−21 days. Initial symptoms include fever, headache, muscle aches, backache, chills and exhaustion. Within 1-3 days of onset of disease, a blister-like rash (sores, pimples or blisters) – very much the same as chickenpox – will develop on the face and the extremities, including the soles of the feet and palms of the hands. The lesions may however occur on other parts of the body. The number of lesions will vary and not all lesions will be at the same stage of development. The lesions progress through several stages before scabbing over and resolving. Most cases resolve within 2-3 weeks of onset without side effects. It’s very rare for someone to die from mpox, but children, pregnant women, and individuals that are immunocompromised are most at risk.

8. When is a mpox-infected person no longer contagious?

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.

9. How is mpox diagnosed?

Mpox is diagnosed by a healthcare worker. The rash would be the most telling sign. However, many other diseases, such as chickenpox, may cause similar rashes and are more common. Samples can be tested at the National Institute for Communicable Diseases to confirm a diagnosis of mpox.

10. How is mpox treated?

Most human cases of mpox virus infection do not require any specific treatment and the disease resolves on its own. There are anti-viral drugs that a clinician may consider using for the treatment of more severe cases of mpox on a case-by-case basis.

11. How can mpox be prevented?

The spread of mpox can be stopped by isolating and tracing the people that an infected person has been in contact with.  Anyone that develops the disease should isolate to avoid spreading it. It is important that anyone who is infected with mpox be open with the health authorities about the people they have been in contact with to help stop the spread of the virus. While there is a vaccine for mpox, it is not available in South Africa.

12. What should you do if you think you have mpox?

It is important to seek medical attention promptly if you are suffering from a rash and you think you may have mpox. There are many other causes of rash, many of which can be treated and any discomfort or pain you may be experiencing may be addressed. It is also important to diagnose mpox promptly to aid in the efforts to contain the transmission of the virus and avoid more cases from occurring.

13. Where can I find more information?

  • Guidelines and other useful resources are available on the NICD website.
  • The Centers for Disease Control and Prevention, USA, website.
  • The World Health Organization website.

Source: National Institute for Communicable Diseases