South Africa recently received a batch of mpox treatment for people who experience severe health complications associated with the disease. The medication, Tecovirimat also known as TPOXX or ST-246, is not for sale and will only be available for patients who are hospitalised.  

“It is very difficult to get access to mpox treatment and the country has received limited stock. The treatment is made available by the health department to physicians that deal with patients with severe cases of mpox,” explains Professor Tulio de Oliveira, director of the Centre for Epidemic Response and Innovation (CERI) at Stellenbosch University. 

Tecovirimat was originally developed for the treatment of smallpox. Available research shows that it is also effective to treat severe mpox and is recommended by the World Health Organisation (WHO). However, the medication is not registered for use in South Africa. The batch received from the WHO was imported using section 21 of the Medicines and Related Substances Act. 

Head of the Centre for Emerging and Zoonotic Diseases at the National Institute of Communicable Diseases (NICD) Dr Jacqueline Weyer, explains that, at this stage, there is not a high demand for the treatment. 

“The antiviral treatment for mpox is only required when patients present with severe disease. Typically these are patients with immunosuppression, for example those that are not receiving treatment for HIV and have CD4 counts below 350,” she tells Health-e News. 

In general, treatment for mpox is symptomatic. People with mpox present with symptoms which include a rash that may last for two to four weeks, fever, headache, muscle aches, back pain, low energy and swollen glands. 

According to the national health department the rash is painful and looks like blisters or sores and can affect the face, palms of the hands, soles of the feet and groin. Hand hygiene is one of the effective ways to protect people from getting sick and prevent spreading mpox.

Global outbreak

South Africa joins a growing list of countries currently facing an mpox outbreak. Mpox is a zoonotic disease that’s transmitted from animals that carry the virus to people. It can also spread between people through direct contact with a person with the disease, especially skin-to-skin contact. 

“In the last three years since mpox emerged as a global pathogen a lot of transmission are related to sexual intercourse,” De Oliveira tells Health-e News.  

“We know now by doing genomics that this strain in South Africa comes from the global outbreak of mpox that started in 2022. It was mostly transmitted by men who had sex with other men,” he says. 

Since May 2024,ases of mpox have been recorded in South Africa. The cases are all men between the ages of 27 and 39. Seven of the cases are from KwaZulu- Natal, five from Gauteng and one from Western Cape. Two people have died from mpox disease. 

The department encourages all people regardless of gender, age, sexual orientation with suspected mpox symptoms or who had contact with known cases to present themselves at a healthcare facility. – Health-e News