Monkeypox Cases Rise, Spread To 26 States, FCT

EMERGENCY DIGEST- Cases of monkeypox have spread to 26 states and the Federal Capital Territory (FCT), raising fears among citizens.

This is just as experts have called for increased efforts by all stakeholders towards curbing the situation. Monkeypox is a viral disease transmitted from animals to humans and from humans to humans.

From January to August this year, 473 suspected cases and 172 confirmed cases have been recorded.

An analysis of situation reports from the Nigeria Centre for Disease Control (NCDC) shows that the number of cases recorded in the country so far this year is higher than those recorded each in 2017, 2018, 2019, 2020 and 2021. In the whole of 2017, there were 88 confirmed cases, 49 in 2018, 47 in 2019, 8 in 2020 and 34 in 2021.

Since the beginning of this year, several countries have also witnessed an unprecedented outbreak of monkeypox, prompting the Director-General of the World Health Organization, Tedros Adhanom Gebreyesus, to, July 23, declared monkeypox a public  health emergency of international concern. 

Spike in cases across states

The disease has been spreading across states and the FCT over the last few months.

As of May 29, a total of 21 confirmed cases with one death were reported from nine states and the FCT. The cases rose to 36 and spread to 15 states and the FCT by June 12. Less than two weeks later, the cases grew to 41. In the epidemiological week 25 alone (June 20 to 26 2022), there were 21 positive cases out of 42 suspected cases.

By July, the number of cases had hit 157 out of 413 suspected cases with the number of affected states also rising to 25 states and the FCT.

Between July 25 and 31, a total of 24 confirmed cases of monkeypox were recorded.

As of August 7, the disease had spread to 27 states and confirmed cases risen to 172 since the beginning of the year out of 473 suspected cases. The number of deaths had also risen to four with Delta, Lagos, Ondo and Akwa Ibom recording one case each.

The latest NCDC situation report showed that in the first week of August alone, 60 suspected cases were recorded from 10 states out of which 15 new confirmed cases were recorded.

The states that have recorded monkeypox cases since the beginning of the year are Lagos (20), Ondo (16), Adamawa (13), Rivers (13), Delta (12), Bayelsa (12), Edo (9), Nasarawa (9), Anambra (7), Imo (7), Plateau (6), Taraba (5). 

Others are Kwara (5), Kano (5), Abia (4), Cross River (3), Borno (3), Oyo (3), Gombe (3), Katsina (2), Kogi (2), Ogun (2), Niger (1), Bauchi (1), Akwa Ibom (1) and Ebonyi (1) as well as FCT (7).

Experts’ views

An epidemiologist and microbiologist with the African Field Epidemiology Network, Dr Muhammad Shakir Balogun, stressed the need to quickly act to reduce the spread of monkeypox.

He advised Nigerians on precautionary measures: “To protect yourself, avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox; don’t touch the rash of a person with monkeypox; don’t kiss, hug, cuddle or have sex with someone with monkeypox; avoid contact with objects and materials that a person with monkeypox has used; don’t share eating utensils or cups with a person with monkeypox; don’t handle or touch the bedding, towels, or clothing of a person with monkeypox. 

“In addition, avoid contact with animals that can spread monkeypox virus, usually rodents and primates. Also, avoid sick or dead animals as well as bedding or other materials they’ve touched”. 

According to him, though there are vaccines for monkeypox, they’re not widely available yet and “where they’re available, they’re given to people at high risk.” 

A professor of Virology, Sunday Omilabu, urged the Federal Government to acquire smallpox vaccines to stem the tide of monkeypox. 

In his interview with Arise TV, monitored by our correspondents, he said: “Government should negotiate for smallpox vaccine as other European countries are doing to prevent more cases of the virus.” 

Director-General, NCDC, Dr Ifedayo Adetifa, said since the re-emergence of monekypox in 2017, the agency had made investments to increase surveillance, diagnostics, risk communications and research capacity despite limited resources.

“These investments, coupled with an awareness of the ongoing global outbreak, have increased Nigerians’ awareness of the disease leading to an increase in the number of monkeypox cases detected in Nigeria,” he said.

He commended state epidemiologists and local government area disease surveillance notification officers for facilitating the timely detection of monkeypox cases that might have been missed in other years. He enjoined Nigerians, particularly those with immunocompromised or underlying health conditions, to be aware of the symptoms of monkeypox and its associated risks.

He also advised the citizens to “promptly report to their nearest health facility if they or their relatives observe such symptoms including rash containing pus on the body surfaces such as the face, hands, soles of feet etc.”

On the fears over the spread of monkeypox, Adetifa, however, said no cause for alarm as the variant in circulation tends to resolve on its own spontaneously or without any specific treatment.

He said: “The monkeypox virus in circulation (clade IIa formerly known as the West African clade) is the same as before and has not changed in virulence. Research has shown that this variant is self-limiting.”

He said the NCDC-led national monkeypox Emergency Operations Centre continued to work with states to support ongoing monkeypox response activities in surveillance, risk communications, laboratory diagnostics, case management and infection prevention and control. 

What to know about monkeypox

Animal-to-human transmission of Monkeypox may occur by direct contact with blood, body fluids, skin or mucosal lesions of infected animals such as monkeys, squirrels and rodents.

Symptoms include fever, body pain, weakness, sore throat and rashes on the face, palms, soles of the feet and other parts of the body.

Polymerase chain reaction (PCR) of lesions is the mainstay of monkeypox diagnosis. Swabs and scabs from skin lesions are sent to the designated reference laboratory in dry containers. Serum samples can also be taken; however, these often yield negative results due to the transient viraemia.

Lagos State Commissioner for Health, Professor Akin Abayomi, noted that there are two types of monkeypox virus: the West African and Central Africa variants.

According to him, infections in the current global outbreak are from the West African type and are less fatal; while the Central Africa variant is more fatal and confined to the Democratic Republic of Congo.

Director, Public Health, Edo State Ministry of Health, Stephenson Ojeifo, said the state had carried out contact tracing of about 200 persons who had contact with the positive cases and they were all declared negative after laboratory investigations.

He said the state had put in place a surveillance mechanism while also reactivating its health education unit to sensitise the public on the zoonotic disease.

Ojeifo said the patients were treated in the state’s isolation centres.

Some of the residents of the state, who spoke to Daily Trust, suggested that sensitisation programmes on monkeypox be taken to rural areas. 

The Ebonyi State Commissioner for Health, Daniel Umezurike, said someone who tested positive to monkeypox recently had been moved to an isolation centre and was responding to treatment.

He said seven contacts and line listed individuals had been identified and were currently being followed up to avoid the spread of the virus.

“Active case search has been heightened across all the LGAs in the state to strengthen case finding.

“We’re also using this opportunity to appeal to Ebonyians to report to any nearest hospital in your area if they notice any symptoms like that of monkeypox,” he said.