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South Africa’s mpox outbreak cases rise to 20, death toll at three

South Africa’s mpox outbreak cases rise to 20, death toll at three
(Photo: (Facebook: Gauteng Health Department)
Naledi Sikhakhane
By Naledi Sikhakhane
4 Jul 2024
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The Department of Health said on Thursday that South Africa had recorded 20 cases of mpox since May, with three deaths. However, 15 of those 20 people had since received a clean bill of health.

The World Health Organization (WHO) is shipping mpox medication to South Africa following an outbreak of the infectious disease in the country.

WHO team leader Dr Joseph Wamala said stocks of the mpox medication currently available in the country, Tecovirimat, were only sufficient to treat 15 people with a two-week dose. 

The Department of Health said on Thursday that South Africa had recorded 20 cases of mpox since May, with three deaths. Of those 20 cases, 15 people had since received a clean bill of health while five remained hospitalised due to severe health complications compounded by underlying conditions such as HIV.

The department said mpox was treatable if diagnosed early.

“People are urged to seek healthcare once they experience mpox-like symptoms or come into direct contact with someone who tested positive. The department, working with various stakeholders, continues with efforts to curb the spread/transmission of mpox in the country,” said the department.

Photo: (Facebook: Gauteng Health Department)



Read more in Daily Maverick: Mpox: what to watch out for, treatment and what to worry about

In the last week, the country recorded four more laboratory-confirmed mpox cases in Gauteng and KwaZulu-Natal: a 17-year-old man from Hillbrow in Johannesburg, a 37-year-old man from Pretoria East, a 29-year-old man from West Rand and a 19-year-old man from Durban.

In total, 10 cases have been recorded in Gauteng, nine cases in KwaZulu-Natal and one in Western Cape. Outbreak response teams have been activated for the newly diagnosed cases. 

“The number of cases is also expected to rise due to intensified contact tracing, risk communication and community engagement activities in the affected communities. The National Institute for Communicable Diseases (NICD) has received over 130 test requests since the outbreak of mpox in South Africa,” said the department.

Meanwhile, in the rest of Africa, there have been 3,473 confirmed cases since the start of the year, which resulted in 35 deaths.

Socioeconomic issues 


Dr Jean Nachega, an associate professor of medicine, infectious diseases, microbiology and epidemiology, said: “In impoverished areas, mpox disproportionately affects vulnerable groups like those in poverty, sex workers and sexual minorities. Such vulnerable groups of individuals often have limited access to healthcare services, including testing, treatment and vaccines, and are likely to face stigma, leading to delayed diagnosis and treatment and increased virus spread.”   

His research, published in Nature Medicine in June, highlights the impact of economic inequality on the mpox outbreak in Kamituga, a gold mining town in the Democratic Republic of Congo (DRC).

“Of the 108 individuals who tested PCR-positive for mpox, the median age was 22 years, 51.9% were female, and 29% were sex workers, indicating a new mode of human-to-human sexual transmission, contrasting with the historical animal-to-human transmission pattern,” said Nachega.

He said South Africa had a relatively well-developed healthcare system compared to many other African nations, but still faced significant challenges.

“Access to mpox vaccines and treatments can be limited, especially in resource-constrained settings. Global supply chain issues and prioritisation of vaccines for more affluent countries can exacerbate these challenges.”  

New variant


Nachega said the new MPXV clade I variant in the DRC, reported in Nature Medicine by his research team, posed increased risks due to it being transmitted sexually. “Therefore, the likelihood of it reaching the pandemic level of HIV should not be underestimated.”

Nachega said there was a need for enhanced surveillance, public health communication and adequate access to healthcare to curb the spread of mpox. 

“Targeted vaccination campaigns, particularly among high-risk groups like healthcare workers, children, pregnant women, HIV-infected individuals, sex workers and men who have sex with men along with developing effective communication strategies to educate the public, reduce stigma and combat misinformation are some of the key measures to prevention.

“Addressing economic and healthcare inequalities is essential for improving global readiness and response to such outbreaks.” DM

Recommendations for reducing the spread of mpox



  • Wash hands frequently with soap and water for at least 20 seconds, or use an alcohol-based hand sanitiser if soap and water are not available.

  • Avoid close physical contact with people who have a rash that looks like mpox. This includes not touching their rash or scabs and not sharing personal items like clothing, towels or bedding.

  • Practise safe sex to reduce the risk of sexual transmission.

  • If you are caring for someone with mpox, wear appropriate personal protective equipment, such as gloves and a mask, to avoid direct contact with the virus.

  • Avoid contact with animals that could harbour the virus, particularly rodents and primates in areas where mpox is endemic.

  • Avoid consuming or handling bushmeat. If you must handle animal products, cook them thoroughly and practise good hygiene.

  • Regularly clean and disinfect surfaces and objects that could be contaminated with the virus, especially in shared living spaces.

  • Be aware of the symptoms of mpox, which include fever, headache, muscle aches, swollen lymph nodes, chills, exhaustion and a rash that can look like pimples or blisters.

  • If you suspect you have been exposed to mpox or develop symptoms, seek medical advice promptly. Early diagnosis and isolation can help prevent the spread of the virus.

  • If you are in a high-risk group or have been exposed to mpox, consider getting vaccinated. The MVA-BN vaccine can help prevent infection or reduce the severity of symptoms. Consult with healthcare providers to determine if vaccination is appropriate for you.

  • Follow travel advisories and guidelines issued by health authorities, especially if travelling to areas where mpox is known to be present. Avoid contact with animals and people who are sick. DM


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