Amid an outbreak of mpox, Health Minister Dr Joe Phaahla said the actual number of infections could be higher than the reported laboratory cases and deaths recorded so far.
This past week, the department said they had 16 laboratory cases and three deaths, but Phaahla warned: “The actual number of infections is likely much higher.”
As the health sector implement steps to prevent it reaching pandemic levels, there is fear that that it may already be out of control.
Mpox, first diagnosed by the government’s laboratory last month, is caused by the monkeypox virus. It spreads mainly through skin to skin contact.
The first reported case in South Africa was of a man from Gauteng who said he had not travelled outside the country prior to contracting the virus; within a week another case was confirmed in KwaZulu Natal.
Being a mainly person-to-person transmitted disease, it spread through direct contact with body fluids, lesions on the skin, or internal mucosal surfaces, such as the mouth, throat respiratory droplets and contaminated objects, according to the World Health Organisation (WHO).
Speaking on condition of anonymity, one public sector doctor said they suspected the number of cases were much higher than reported.
She said: “Mpox is highly contagious and spreads fast. If one person has it and they do not live alone, the chances that others within their space have it too.”
There was much more that needed to be done to trace contacts, she said, because it was too late to isolate it. “Gauteng, KwaZulu Natal and Cape Town have reported cases, so this means it has travelled along the length of the country.”
The doctor said, if those infected had not travelled out of the country or had contact with someone who did, then it meant the virus was live locally.
“There are people probably presenting in health facilities with symptoms other than the obvious, while there are likely cases which have gone unreported.”
With the high HIV and Aids rate in the country, most or all of the infected, reportedly had compromised immune systems, she said.
“Looking at the this and the rate at which people do not even test for HIV or any other disease which threatens the immune system, or if they know, choose to ignore it as stigma still exists, what we are sitting on is much bigger that we can imagine.”
Last week the country reported having obtained doses of antiviral drugs for mpox, in a world where they were highly licensed.
Phaahla said the government was waiting for donations from global stockpiles, which could take days or weeks to arrive. These, the department explained, would target the four most at-risk groups - men who had sex with men, sex workers, lab workers, and health workers.
The public health doctor commented: “It is sad and unfortunate that efforts did not kick off when the first case was reported, because as health professionals we understand it cannot be ‘caught from the air’. Someone else had it and had also spread it further, and so, in May, it could have been arrested, to a certain degree rather than being allowed to spread further.
Her opinion was that with many of the most vulnerable groups either dying undiagnosed as they were shunned at public health facilities, or because of health workers failing to report even mild cases as they were not conscientised about mpox, the country was most likely already dealing with a pandemic.