Mpox in South Africa: What Black Communities Need to Know
Mpox, the viral infection formerly known as monkeypox, is spreading in ways that demand our attention. While the disease can affect anyone, its impact on our communities is shaped by the same inequalities that have always determined who gets sick and who gets care. This is not just a health story. It is a story about access, stigma, and the legacy of a system that still leaves Black South Africans behind.
Most people recover from mpox within weeks, but the infection can be severe for some. Understanding how it spreads, what symptoms to watch for, and when to seek help is essential. Here is what you need to know, grounded in the facts and framed for our reality.
What is mpox?
Mpox, previously called monkeypox, is caused by the monkeypox virus, a member of the Orthopoxvirus family. It produces a rash or skin lesions, often accompanied by fever, headache, muscle aches, back pain, tiredness, and swollen lymph nodes. The virus has two main groups, or clades, known as Clade I and Clade II. Both can infect humans, but their patterns of spread differ.
Mpox does not discriminate by age, race, or background. Anyone can contract it. But the conditions we live in, our access to healthcare, and the way we are treated by medical systems can make all the difference in outcomes.
How does mpox spread?
The virus spreads primarily through close physical contact with an infected person. That includes skin-to-skin contact with lesions, kissing, face-to-face interaction, sexual contact, and contact with bodily fluids or contaminated objects like clothing, bedding, or towels. Prolonged close contact involving respiratory particles can also transmit the virus.
In some regions, mpox can spread from infected animals to humans. However, it does not spread as easily as colds or flu. Close contact remains the key route of transmission.
What are the symptoms of mpox?
Symptoms can appear anywhere from one to 21 days after exposure, according to the World Health Organization. Common signs include fever, headache, muscle aches, back pain, sore throat, tiredness, swollen lymph nodes, and a rash or skin lesions. For some, the rash is the first sign. For others, general symptoms come first.
The rash can appear on the face, hands, feet, mouth, groin, or genital area. It evolves from flat spots to raised lesions, blisters, and pus-filled sores before crusting over and healing. The rash can be painful or itchy, lasting two to four weeks, and may leave scars.
Because mpox can look like chickenpox, herpes, scabies, or bacterial skin infections, a rash alone is not enough for diagnosis. Medical assessment is critical.
Who is at greater risk of severe mpox?
Most people recover without specific treatment. But certain groups face higher risks of complications: young children, especially infants; pregnant people; those with weakened immune systems; people living with poorly controlled HIV; and individuals with other immune-compromising conditions. In South Africa, where HIV prevalence remains high, this is a particular concern for our communities.
If you are worried about symptoms or have been exposed to someone with mpox, seek medical advice without delay.
How is mpox diagnosed?
Diagnosis cannot rely on symptoms alone. A healthcare professional must assess you and arrange testing. Laboratory confirmation typically involves a PCR test on material from a skin lesion. This is why access to clinics and laboratories is so important. In a country where public health facilities are overstretched, we must push for equitable access to testing and care.
How is mpox treated?
There is no routine treatment that makes mild mpox disappear instantly. Care focuses on managing symptoms, protecting the skin, controlling pain, and preventing complications. Most people recover within weeks without specific treatment. Antiviral medicines may be used for severe cases or high-risk individuals, depending on local health systems and clinical guidance.
What should you do if you think you have mpox?
If you develop an unexplained rash, fever, or other symptoms, especially after close contact with someone infected, contact a healthcare professional. While waiting for assessment, reduce the risk to others:
- Avoid close physical contact with other people.
- Do not share towels, bedding, clothing, or personal items.
- Wash hands regularly with soap and water or use hand sanitiser.
- Do not touch or scratch lesions.
- Follow medical advice about isolation while infectious.
People with mpox remain infectious until lesions heal and new skin forms. This can take weeks, so patience and caution are vital.
Anyone can get mpox, but stigma must not stop care
Mpox is not limited to any one group. Anyone with close contact to an infected person can be infected. Stigma has no place in our response. Fear or shame should never stop anyone from seeking medical care. In our communities, where we have seen how discrimination can harm health, we must stand together and encourage each other to get tested and treated.
If you think you have been exposed or have symptoms, speak to a healthcare professional. Your health matters. Our health matters.
Zanele Mokoena is a health journalist committed to documenting the realities of Black South Africans.