Political activities towards the 2023 Presidential Election and the many incidents of insecurity have taken attention away from other challenges such as Lassa fever and the more recent outbreak of Monkeypox in the country.
As the pressures from the COVID-19 pandemic wanes and Nigerians are gradually going back to business as usual, the sudden resurgence of monkeypox is of concern to health authorities in the country.
So far in 2022, 41 cases of monkeypox have been confirmed in Nigeria by NCDC and a total of 2,103 laboratory confirmed cases have been reported worldwide, according to the World Health Organisation.
What is Monkeypox and where did it come from?
Monkeypox is a rare animal (zoonotic) disease caused by the Monkeypox virus and it is similar to smallpox, they are both in the orthopoxvirus genus with similar symptoms although monkeypox is less contagious, and less severe. Other members include cowpox, camelpox, and horsepox viruses.
Monkeypox is dominant in tropical rainforest areas of central and west Africa. The first ever human case reported was back in 1970 in the Democratic Republic of Congo before it spread to other African countries including South Sudan, Côte d’Ivoire, Gabon, Nigeria, Liberia, Cameroon, Sierra Leone, and Central African Republic.
Over the years, it has been exported to other regions by travellers and tourists. The first time cases of the disease were reported outside Africa was in 2003 in the United States.
Humans are infected by the virus through physical contact with a monkey either by being bitten or scratched, referred to as animal-to-human transmission. The disease, like other viral diseases such as Lassa fever, can spread via human-to-human transmission which occurs when a person comes into close or skin-to-skin contact with an infected person, the virus also moves through respiratory droplets.
One can also catch the monkeypox virus from infectious injuries, sores, and body fluids of an infected person and contaminated items like clothing and bedding. As a result, household members or healthcare personnels are more likely to become infected.
Although monkeypox is not categorized as a sexually transmitted disease, according to the W.H.O, it can be transmitted through sexual intercourse and intimate contact such as kissing and touching.
How deadly is Monkeypox and is there a Cure?
The disease manifests in skin rashes similar to smallpox accompanied by intense fever, headaches, muscle aches and exhaustion 7−14 days after infection. According to the Centre for Disease Control and Prevention (CDC), it is fatal in as many as 1 to 10% of people who become infected.
Although monkeypox is treatable, there are no specific treatments for it. Monkeypox is treated with antiviral medications like Tecovirimat (TPOXX) and Brincidofovir (Tembexa) which are used to treat smallpox. The smallpox vaccine was also effective in preventing the monkeypox virus.
The W.H.O Monkeypox fact sheet published on its website on the 19th of May 2022, states that a vaccine, approved two years ago in 2019, can prevent the disease but the availability of the vaccine is still very limited.
Spread to Non-Endemic Regions
Monkeypox has been discovered in 42 countries across Europe, Americas, Eastern Mediterranean, and Western Pacific and the outbreak is causing global panic, the question is, is monkeypox the new COVID-19?
The World Health Organisation has reported 2103 laboratory confirmed cases of monkeypox worldwide between 1 January to 15 June 2022. Out of this number, 2039 were recorded outside Nigeria and Africa as a whole.
64 (3%) confirmed cases and one death were reported in 6 endemic countries including Cameroon, Congo, Nigeria, Ghana, Central African Republic, and Democratic Republic of Congo.
Health experts have however said that the current monkeypox outbreak is unlikely to cause a global pandemic like that of COVID-19. Monkeypox and coronavirus are both viral infections but monkeypox is not as infectious and deadly as coronavirus. Dr. Luis Sigal, an expert in poxviruses at Thomas Jefferson University in Philadelphia explained that monkeypox is a large DNA virus with low mutation rate that mostly spreads through close physical contact, while coronavirus is a tiny RNA virus with higher mutation rates that is transmitted through aerosols. Simply put, Monkeypox cannot spread quite as quickly as Covid19.
Despite this, the World Health Organisation calls for global efforts to contain and stop the spread of monkeypox in both non-endemic and endemic regions. WHO assesses that “the risk at the global level as moderate considering this is the first time that many monkeypox cases and clusters are reported concurrently in non-endemic and endemic countries in widely disparate WHO geographical areas.
Where has Monkeypox been confirmed in Nigeria?
According to data from the Nigeria Centre for Disease Control (NCDC) Nigeria recorded its highest number of monkeypox in 2017 – a total of 88 confirmed cases. The number of confirmed cases dropped to 49 in 2018. A further decline was recorded in 2019 and 2020. But in 2021, the numbers picked up again and continue to cause worry in 2022.
Since January, a total of 41 confirmed cases of monkeypox disease have been documented in the country, according to NCDC Director-General, Dr Ifedayo Adetifa, who confirmed this during a bi-weekly briefing on COVID-19 and other diseases conducted by the Federal Ministry of Health in Abuja on June 19, 2022. Monkeypox has been confirmed in nine states so far this year. Adamawa and Lagos States have the highest number of cases.
From September 2017 to 19 June, 2022 there are a total of 267 confirmed cases reported from 32 states in the country. Since the disease’s resurgence in 2021, just one death – a 40-year-old patient – has been reported, according to the centre’s statement.
The monkeypox outbreak in Nigeria affects more males than females with a ratio of 3:1 and people between the ages of 21-40 years are the most affected with 78% of all the confirmed Monkeypox cases within the age-group.
Mitigating the spread of Monkeypox
On 26th May 2022, NCDC announced on its website that it has activated Monkeypox Emergency Operations Centre (MPX-EOC) to strengthen Nigeria’s preparedness and surveillance, and coordinate ongoing in-country response activities. It noted that MPX-EOC was activated to improve the detection, prevention, and control of Monkeypox cases in the country.
NCDC had previously relied on the Technical Working Group (TWG), a multi-agency group for tracking the spread of the disease but MPX-EOC was activated to better track new Monkeypox cases and improve timeliness of case reporting and to facilitate responses to the disease.
In NCDC’s effort to curb the further spread of the disease, it has urged members of the public to avoid contact with animals that could carry the virus, which includes dead or sick animals in areas where the disease has been identified.
They implored the general public to continue engaging in hygienic practices of washing hands properly with soap and water, avoiding contact with infected individuals, and cooking animal food products properly before eating.
The NCDC has said that “if you feel ill, fever or have an intense headache and you notice a sudden rash on your body, please visit the hospital for diagnosis and treatment”. Members of the public are encouraged to reach out to the NDDC If they or anyone around them is showing symptoms of the disease, especially skin rash that resembles chicken pox.