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Mpox: Halting a growing public health concern in Nigeria

The recent confirmation of two new Mpox cases in Calabar Municipality Local Government Area by Cross River Epidemiologist, Mrs Inyang Ekpenyong, has brought the total number of reported cases in Nigeria to 1,136 since 2017.

Muhammad Ali Pate
Muhammad Ali Pate, the Coordinating Minister of Health & Social Welfare

This development has raised concerns about the spread of the disease, particularly among children and vulnerable populations.

Mpox, also known as monkeypox, is a rare and infectious disease caused by the monkeypox virus.

It is primarily spread through close contact with infected animals or people and can also be transmitted through contaminated surfaces and materials.

Experts say the disease has been reported in 19 African countries, with the Democratic Republic of Congo as the epicentre, accounting for over 95 per cent of cases.

Nigeria has experienced recurrent Mpox outbreaks since 2017, with 4,685 suspected cases and 17 deaths reported as of August 25, 2024.

The Nigerian Infectious Diseases Society (NIDS) has urged the federal and state governments to intensify financial investment and surveillance response to the disease outbreak.

The NIDS in a statement issued in Abuja by Professors Dimie Ogoina and Mukhtar Adeiza its president and secretary said as of Aug. 28 Mpox has killed 630 persons cross 19 African countries.

It said the figure represents a 160 per cent increase compared to the same period in 2023.

The society said of concern was the emergence of a new sexually transmissible strain, referred to as clade Ib emerging.

From different parts of the country the disease is spreading. The number of those infected is rising.

Mr Samuel Etuk, the Disease Surveillance and Notification Officer, Akwa Ibom Ministry of Health, says the state, at the time of filing this report, had recorded five cases.

Etuk said in Uyo, the state capital, that the state government had earlier announced four outbreaks.

He said that a total of 30 samples were collected across different local government areas for diagnosis, and that four of them tested positive to Mpox.

“Four cases were confirmed, three of them are male, and one female, they are aged two, four, 12 and 41 years respectively,” he said.

“This confirmation was by the Breakthrough Action Nigeria in collaboration with the Tuberculosis and Leprosy Control Programme.

“We have another positive case of Mpox, this latest case brings the total number of confirmed cases in the state to five,” he said.

Etuk said that contact tracing for any transmission was being conducted while the affected persons had been kept in isolation.

The disease surveillance officer said that 10 community-based informants had been engaged to work in catchment areas.

“They will be reporting to the health facility focal person who will communicate with the local government disease surveillance and notification office.

“The full report will later be submitted to the state ministry of health for prompt actions,” he said.

The officer said that Mpox could be prevented by avoiding contacts with infected persons or animals.

The World Health Organisation has declared Mpox a global public health emergency, and an international concern in Africa.

Dr Francis Sanwo, said reducing the risk of human-to-human transmission, surveillance and rapid identification of new cases are critical to addressing the challenges posed by Mpox.

Sanwo is the Managing Director of Our Lady of Apostles Catholic Hospital, Ibadan.

Oluyoro said in Ibadan that there should be standard infection control measures for health workers caring for patients with suspected or confirmed Mpox virus infection.

“If possible, persons previously vaccinated against smallpox should be selected to care for the patient,” he said.

The physician advised that patients with the disease should physically isolate themselves until all of the pox lesions had healed, while caregivers should obtain a smallpox vaccination.

“This because smallpox and Mpox are so closely related, studies have suggested that people vaccinated against smallpox have about an 85 per cent chance of being protected from Mpox.

“Although vaccination against smallpox was protective in the past, today persons younger than 40 to 50 years of age, depending on the country, may be more susceptible to Mpox.

“This is due to cessation of smallpox vaccination campaigns globally after eradication of the disease.

“Patients with depressed immune systems and those who are allergic to latex or smallpox vaccines should not get the smallpox vaccine.

“Anyone else who has been exposed to Mpox in the past 14 days should get the smallpox vaccine, including children under one year of age, pregnant women, and people with skin conditions,” he said.

Sanwo said that clinical care for Mpox should be fully optimised to alleviate symptoms, manage complications and prevent long-term sequelae.

He said patients should be offered fluids and food to maintain adequate nutritional status while secondary bacterial infections should be treated as indicated.

“An antiviral agent known as tecovirimat that was developed for smallpox was licensed by the European Medicines Agency (EMA) for Mpox in 2022, based on data in animal and human studies.

“But it is not yet widely available,” the medical expert said.

The AIDS Healthcare Foundation (AHF) has advocated urgent action to increase access to Mpox vaccines and to prioritise public health over profits to ensure health security.

Dr Echey Ijezie, AHF’s Nigeria’s Country Programme Director was quoted by the media as saying that the recent Mpox outbreak posed a serious health threat in Africa.

He said that there was the need for urgent global action to address vaccine inequity which had hampered the continent’s ability to respond effectively.

“The Africa Health Founder (Nigeria) is calling on governments, international organisations, and pharmaceutical companies to prioritise public health over profits.

“This is not just about Mpox or Africa; it is about global health security. Inequity anywhere is a threat to health everywhere,” he said.

IJezie raised concerns over the current response to the Mpox outbreak, which he said mirrored the inequalities witnessed during the COVID-19 pandemic.

He, therefore, urged Western countries and Japan to expedite the donation of Mpox vaccines to Africa.

He also called on the World Health Organisation (WHO) to fast-track the approval of other viable vaccine options.

“We started our push for equity during the COVID-19 pandemic, where we saw the devastating impact of vaccine hoarding on African nations.

“Now, we are seeing similar challenges play out with Mpox.

The WHO declared Mpox a global health emergency on 14th August 2024, which spread primarily through skin-to-skin contact, and symptoms included rashes and lesions on the skin.

Experts say Africa’s severe Mpox outbreak, driven primarily by the new clade Ib variant, is particularly deadly for children.

Africa wide, it has impacted at least 13 countries, with more than 22,800 confirmed cases and more than 620 deaths reported this year.

To prevent the spread of Mpox, health authorities recommended enhanced surveillance, intensify contact tracing, listing, and monitoring, educating the public on the risks and modes of transmission.

They also recommended administering Mpox vaccine doses to high-risk populations and implementing hand hygiene and infection control measures in healthcare settings.

By Abiemwense Moru, News Agency of Nigeria (NAN)

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