Rising Mpox Infections in South Africa Prompt Health Department Warning

South Africa is facing a worrying surge in mpox (monkeypox) infections, and public health officials are scaling up interventions to fight the trend. There have been over 22 reported cases since the first confirmed case in May 2024, and two new cases as of July 2025. The National Department of Health has intensified its vigilance and urges the public to stay informed and vigilant.

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Mpox Outbreak in South Africa

The majority of the cases have been among men aged 17 to 43 years, some of which have been caused by the Clade Ib variant. The outbreak, which began in 2024, extended to 2025, with new cases emerging in Gauteng. In light of these occurrences, the World Health Organization (WHO) has declared mpox a Public Health Emergency Of International Concern due to its wide impact in 15 African Union countries.

Transmission and Symptoms

Mpox mainly spreads by way of physical contact, such as skin-to-skin contact or extended contact with infected persons. Local transmission has been confirmed in South Africa.

Mpox causes signs and symptoms which usually begin within a week but can start 1–21 days after exposure. Symptoms typically last 2–4 weeks but may last longer in someone with a weakened immune system. 

Common symptoms of mpox are: 

• rash 
• fever 
• sore throat 
• headache 
• muscle aches 
• back pain 
• low energy 
• swollen lymph nodes.  

For some people, the first symptom of mpox is a rash, while others may have fever, muscle aches or sore throat first.  

The mpox rash often begins on the face and spreads over the body, extending to the palms of the hands and soles of the feet. It can also start on other parts of the body where contact was made, such as the genitals. It starts as a flat sore, which develops into a blister filled with liquid that may be itchy or painful. As the rash heals, the lesions dry up, crust over and fall off. 

Some people may have one or a few skin lesions and others have hundreds or more. These can appear anywhere on the body including: 

• palms of hands and soles of feet 
• face, mouth and throat 
• groin and genital areas 
• anus.

Some people also have painful swelling of their rectum (proctitis) or pain and difficulty when peeing (dysuria) or when swallowing. 

People with mpox can pass the disease on to others until all sores have healed and a new layer of skin has formed. Some people can be infected without developing any symptoms. Although getting mpox from someone who is asymptomatic (not showing symptoms) has been reported, information is still limited on how common it is.  

Children, pregnant people and people with weak immune systems, including people living with HIV that is not well controlled, are at higher risk for serious illness and death due to complications from mpox. 

Some people with mpox become very sick. For example, the skin can become infected with bacteria, leading to abscesses or serious skin damage. Other complications include pneumonia; corneal infection with loss of vision; pain or difficulty swallowing; vomiting and diarrhoea causing dehydration or malnutrition; and infections of the blood (sepsis), brain (encephalitis), heart (myocarditis), rectum (proctitis), genital organs (balanitis) or urinary passages (urethritis). Mpox can be fatal in some cases.  

The Department of Health recommends that anyone who is experiencing symptoms isolate immediately and consult a doctor to avoid spreading the disease further.

How Mpox Spreads

Mpox can spread from animals to people, between people and from the environment to people. The virus can spread through:

• contact with lesions on the skin or infectious bodily fluids  
• contact with contaminated materials such as clothing, linen or sharps injuries in healthcare settings  
• contact with respiratory droplets, from an infected person’s mouth or throat
• contact with infected animals  
• pregnant women can pass the virus on to their unborn baby.

Children can be exposed at home or in the community through close contact with people who are symptomatic with mpox including parents, caregivers, or other family members.

Vaccination and Treatment Initiatives

South Africa has no access to an in-country mpox vaccine yet. However, 10,000 vaccine doses for African countries will be ready in September 2025. The distribution of the vaccines will prioritize:

• Healthcare workers
• Laboratory personnel
• Close contacts (for post-exposure prophylaxis)

In addition, Tecovirimat, an antiviral drug, should be available soon to help reduce the severity of mpox infections. The National Department of Health is working with the WHO and international partners to acquire these resources and develop an equitable distribution plan.

The rising cases signal a possible resurgence of the virus, which has instigated accelerated public health responses.

Government Response and Public Guidance

The Department of Health has scaled up the following activities:

• Contact tracing and screening
• 21-day surveillance period for suspected cases
• Awareness creation campaigns to facilitate early reporting and identification of symptoms

While the WHO does not recommend travel restrictions for people who have mpox symptoms or have been diagnosed with mpox, individuals with symptoms are advised to avoid unnecessary travel and close contact with others.

Challenges and Way Forward

The response to mpox is still hampered by some key issues:

• Delayed access to vaccines
• Stigma, particularly among MSM communities
• Availability of healthcare among marginalized and rural communities

To address these issues, public health communication must be inclusive and based on facts. Avoiding discriminatory language and promoting coordination is essential to effectively containing the spread of the outbreak.

Stay Alert

The surge of mpox cases in South Africa calls for early detection, swift response, and public cooperation. With the vaccines and medications set to be rolled out, South Africa’s public health officials are doing all that is required to contain the virus and protect the public.