Cases of monkeypox have spread to 26 states and the Federal Capital Territory (FCT), raising fears among citizens.
This is in line with the calls by experts for increased efforts by all stakeholders to curb the situation. Monkeypox is a viral disease transmitted from animals to humans and from humans to humans.
Between January and August of this year, 473 suspected cases and 172 confirmed cases have been reported.
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 in each of the years 2017, 2018, 2019, 2020, and 2021. In 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 Organisation, Tedros Adhanom Gebreyesus, on July 23, to declare monkeypox a public health emergency of international concern.
Spike in cases across states
The disease has spread across states and the Federal Capital Territory (FCT) over the last few months.
Nine states and the FCT reported a total of 21 confirmed cases and one death as of May 29. The cases rose to 36 and spread to 15 states and the Federal Capital Territory (FCT) by June 12. Less than two weeks later, the number of cases had grown 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 have risen to 172 since the beginning of the year out of 473 suspected cases. The number of deaths had also increased 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, with 15 new confirmed cases reported.
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
Dr Muhammad Shakir Balogun, an epidemiologist and microbiologist with the African Field Epidemiology Network, emphasised the need to act swiftly to curb 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 the 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 an interview with Arise TV, monitored by our correspondents, he stated, “The government should negotiate for the smallpox vaccine, as other European countries are doing, to prevent more cases of the virus.”
Director-General of the NCDC, Dr Ifedayo Adetifa, said that since the re-emergence of monkeypox in 2017, the agency had made investments to increase surveillance, diagnostics, risk communication, 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.”
Regarding fears over the spread of monkeypox, Adetifa, however, said there is no cause for alarm, as the variant in circulation tends to resolve spontaneously 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 primary method for diagnosing monkeypox. 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 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 hostile 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 zoonotic disease.
Ojeifo stated that the state’s isolation centres treated the patients.
Speaking to Daily Trust, some residents from states suggested expanding monkeypox awareness programs to rural areas.
The Ebonyi State Commissioner for Health, Daniel Umezurike, said someone who tested positive for monkeypox had recently been moved to an isolation centre and was responding to treatment.
He stated that they had identified seven contacts and line-listed individuals and were currently following up with them to prevent the virus from spreading.
“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.
