Three years after many Nigerians were affected with the Ebola disease which led to many deaths, and Lassa fever also causing more than a scare sometime after, the nation is again battling another deadly viral attack that has infected over 74 people across the nation.
This vicious viral infection called Monkeypox has already registered its footprint in Bayelsa, Rivers, Ekiti, Akwa Ibom, Lagos, Ogun and Cross River states, although it was first reported in Bayelsa state, where 13 patients including a medical doctor, were isolated at the Niger Delta University Teaching Hospital (NDUTH), Okolobiri.
The Bayelsa State Commissioner for Health, Professor Ebitimitula Etebu, who addressed a press conference on October 13 along with his Information counterpart, Mr. Daniel Iworiso-Markson, said that the first index case was reported at Agbura, a rural settlement near Yenagoa, where the victim had killed and eaten a monkey with members of his household and neighbours who later presented symptoms of the Monkeypox virus.
Another case of Monkeypox was recorded in Akwa Ibom State, as confirmed by the State Commissioner for Information, Charles Udoh, who reported a single case. He also said that the state government was investigating two more cases suspected to be Monkeypox.
However, two suspected cases of Monkeypox were also recorded in Lagos State, as disclosed by the Commissioner for Health in the state, Dr. Jide Idris, who at a news conference on October 9 informed the public that the two suspected cases were currently under observation in health facilities in the state.
“Though the suspected cases are still under observation, there is need to sensitise members of the public and provide adequate information on measures for prevention and control of the disease in line with the policy of the state government,” Idris said.
Monkeypox is a rare viral zoonosis (a virus transmitted to humans from animals) with symptoms in humans similar to those seen in the past in smallpox patients, although less stern. Smallpox was exterminated in 1980. However, monkeypox still occurs irregularly in some parts of Africa.
Monkeypox is a member of the Orthopoxvirus genus in the family Poxviridae. It was first identified in the State Serum Institute in Copenhagen, Denmark, in 1958 during an investigation into a pox-like disease among monkeys.
Monkeypox was first discovered in 1958 when two eruptions of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘monkeypox.’ The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of deepened effort to eliminate smallpox. Since then monkeypox has been reported in humans in other central and western African countries.
Like the Ebola crisis of 2014, the Monkeypox epidemic is spreading panic among Nigerians, many of who are afraid that the disease could spread to other states of the federation since there is no cure.
The recent face-off between the Nigerian military and the Indigenous People of Biafra (IPOB) group in the South East geo-political zone has also introduced a dangerous political dimension to the spread of the disease, as it is being claimed in some quarters that members of the Nigerian Army were infecting residents with the disease under the guise of vaccination. While authorities have described the claims as false, their rebuttal has done little to quash the claim.
The low level of awareness of the nature of the disease can also aid its spread, as it was discovered during the Ebola crisis. During human monkeypox outbreaks, close contact with other patients is the most significant risk factor for monkeypox virus infection.
In a statement on October 16, the Nigeria Centre for Disease Control also confirmed that “the most likely source of infection (in recorded cases in the country) is a primary zoonotic transmission, from an animal, with secondary person-to-person transmission.”
In the absence of specific treatment or vaccine, the only way to reduce infection in people is by raising cognisance of the risk factors and educating people about the measures they can take to reduce exposure to the virus. Surveillance measures and rapid identification of new cases is critical for outbreak containment.
According to the American Centre for Disease Control (CDC), in humans, the symptoms of monkeypox are similar to but milder than the symptoms of smallpox. Monkeypox begins with fever, headache, muscle aches, and exhaustion. The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not. The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days.
According to the CDC, quoting scientists, Monkeypox disease occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract or the mucous membranes (eyes, nose, or mouth). Animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding. Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet. So prolonged face-to-face contact is required.
Other human-to-human methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.
In Africa, monkeypox has been shown to cause death in as many as 1 in 10 persons who contact the disease, with most deaths occurring in younger age groups. There is no treatment or vaccine available although prior smallpox vaccination was highly effective in preventing monkeypox as well.
In the continent, monkeypox infection has been found in many animal species: rope squirrels, tree squirrels, Gambian rats, striped mice, dormice and primates. Doubts continue on the natural history of the virus and further studies are needed to identify the exact reservoir of the monkeypox virus and how it is maintained in nature.
In the USA, the virus is thought to have been transmitted from African animals to a number of vulnerable non-African species (like steppe dogs) with which they were co-housed.
As a control measure, Minister of Health, Prof. Isaac Adewole advised Nigerians to stop eating dead animals, bush meat, particularly monkeys, as Nigerian health authorities launch measures to curb the spread of the disease.
The minister also urged anyone with the symptoms of the disease to immediately report to the nearest health facility, while advising health workers to maintain a high index of suspicion and observe safety precautions.
He warned that there is no known treatment or preventive vaccines, hence people should be on the alert and avoid crowded places as much as possible.
Furthermore, the health ministry warned that close physical contact with monkeypox infected people should be avoided, while gloves and protective equipment should be worn when taking care of ill people.
The ministry also recommended that regular hand washing should be carried out after caring for or visiting sick people.