Rising Mpox Infections in South Africa Prompt Health Department Warning

South Africa is witnessing a troubling rise in Mpox (monkeypox) infections, with health officials confirming over 22 cases since May 2024, including two new cases as of July 2025. The National Department of Health has intensified its surveillance and public awareness efforts in response to this emerging public health threat.

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Mpox Outbreak in South Africa

Most cases in South Africa have occurred in men aged 17 to 43, some infected with the Clade Ib variant. The Gauteng province has reported the most new infections. Local transmission has been confirmed.

The World Health Organization (WHO) has declared Mpox a Public Health Emergency of International Concern, with 15 African Union countries affected.

What Is Mpox and Why the Concern?

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 is a viral zoonotic disease that spreads through skin-to-skin contact, exposure to infected bodily fluids, or contaminated materials. Symptoms typically appear within 1 to 21 days of exposure and include:

• Rash (often starting on the face and genitals)
• Fever
• Headache
• Muscle and back pain
• Sore throat
• Swollen lymph nodes
• Fatigue

“We are concerned about the continued rise in cases and urge communities to report symptoms early. Isolation and early treatment are essential,” said Foster Mohale, Health Department spokesperson.

The rash progresses from flat sores to fluid-filled blisters, eventually scabbing over. In some patients, especially those with weakened immune systems, complications can be severe or even fatal, including pneumonia, sepsis, encephalitis, and loss of vision.

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.  

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.

Asymptomatic transmission is rare but possible, making early testing crucial.

“Stigma, especially among MSM communities, hinders detection and response. We need inclusive and stigma-free health messaging,” added Prof. Adrian Puren from the NICD.

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 of infected individuals (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.

“We are working closely with WHO and international partners to ensure fair distribution of vaccines and treatments,” said Health Minister Joe Phaahla.

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

Government Response and Public Guidance

The National Department of Health has scaled up its response through:

• 21-day surveillance periods
• Active contact tracing
• Screening and testing of suspected cases
• Public awareness campaigns to educate on symptoms and prevention

Children, pregnant people, and those with weakened immune systems — including people living with uncontrolled HIV — are especially vulnerable.

WHO Travel Guidance

The WHO does not recommend any travel restrictions but advises symptomatic individuals to avoid unnecessary travel and close contact with others.

Challenges and Way Forward

Despite intensified efforts, several barriers persist:

• Delayed access to vaccines and treatments
• Stigma and misinformation
• Healthcare inequality in rural and under-resourced communities

Officials stress the need for fact-based communication, community involvement, and targeted outreach to prevent misinformation and encourage symptom reporting.

What You Can Do

South Africans are encouraged to:

• Isolate immediately if symptoms develop
• Seek medical attention early
• Practice hygiene and avoid skin-to-skin contact with infected persons
• Stay informed via credible sources

“This is not a time to panic but to act responsibly. We urge citizens to be vigilant, report symptoms early, and support public health efforts,” said Dr. Michelle Groome, NICD Head of Public Health Surveillance.

Stay Alert

The rise in Mpox cases is a wake-up call for all South Africans. While the arrival of vaccines and treatments is promising, public cooperation, awareness, and early detection remain critical. With coordinated efforts between national health departments and international partners, South Africa is working hard to prevent another health crisis.