One death recorded as Nigeria confirms 21 cases of Monkeypox
*NCDC activates Monkeypox Emergency Operations Centre
By BASHIR ADEFAKA
Weeks after United States, United Kingdom and other nations of the West reported being hit by a new disease called Monkeypox and suggestions, although at lower cadre, had come for Nigeria to do something about restricting flights from affected Western countries towards mitigating the effect in the Africa’s most populous country, information reaching us says it has finally found its way here and this has been officially acknowledged and confirmed.
The DEFENDER’s enquiry to the Nigeria Centre for Disease Control (NCDC) headquarters in Abuja, with a view to getting its confirmation of the death, cases and what the impediment was that the country did not stop the disease entering its territory, was yet to be responded to as at time of filing this report.
But in a peep into a verified Twitter handle of the Centre revealed a wider view of the true situation indicating that whatever suggestions came few weeks ago about what to do to prevent its entry into Nigeria might be of no effect as, according to the fact-sheet on ground, the disease was here some five months back.
In a statement posted Sunday on the social media handle and dated May 29, 2022 signed by Dr Ifedayo Adetifa, the Director General of Nigeria Centre for Disease Control (NCDC), Nigeria was said to have recorded 21 confirmed cases of the Monkeypox disease in the last five months with one death.
The NCDC further disclosed that in the month of May, only six new confirmed positive cases were reported from four States with Bayelsa (2), Adamawa (2), Lagos (1) and Rivers (1).
Also 20 suspected cases were reported from eleven States with Lagos (5), Bayelsa (2), Adamawa (2), Rivers (2), Niger (2), FCT (2), Delta (1), Oyo (1), Kaduna (1), Edo (1) and Gombe (1).
A 40- year-old man with renal co-morbidity and on immune-suppressive drugs died from the disease.
The agency revealed that from September 2017 to May 29th, 2022, 578 suspected cases have been reported from 32 States.
Of the reported cases, 247 (42.7 per cent) have been confirmed in 22 states – Rivers (53), Bayelsa (45), Lagos (34), Delta (31), Cross River (16), Edo (10), Imo (9), Akwa Ibom (7), Oyo (6), FCT (8), Enugu (4), Abia (3), Plateau (3), Adamawa (5), Nasarawa (2), Benue (2), Anambra (2), Ekiti (2), Kano (2), Ebonyi (1), Niger (1) and Ogun (1).
Also, nine deaths have been recorded (case fatality ratio (CFR) = 3.6 per cent) in six states, namely Lagos (3), Edo (2), Imo (1), Cross River (1), FCT (1) and Rivers (1) from September 2017 to May 29th, 2022.
The NCDC was notified by the United Kingdom (UK) International Health Regulations (IHR) focal point about the case of exported monkeypox from Nigeria on 7 May 2022. The case was confirmed on 6 May 2022. The patient visited Nigeria between April 20th and May 3rd 2022.
The NCDC disclosed that although Nigeria’s risk of exposure to the Monkeypox virus is high based on the recent risk assessment conducted, however, the current situation in-country and globally has shown no significant threat to life or the community that can result in severe disease or high case fatality rate.
While stating that its Emergency Operations Center (EOC) will continue to monitor the evolving situation to inform public health action accordingly, the NCDC emphasises that members of the public should remain aware of the risk of Monkeypox and adhere to public health safety measures – specifically, report to the nearest health facility if they notice the known signs and symptoms of the disease.
It also urged healthcare workers to maintain a high index of suspicion for Monkeypox and report any suspected case to the relevant state Epidemiology Team for prompt public health intervention, including sampling for confirmatory testing.
“The One Health Animal Surveillance team including Federal Ministry of Agriculture and Rural Development, Federal Ministry of Environment, National Veterinary Research Institute and partners commenced operational research on Monkeypox virus prevalence in small mammals at the human-animal interface since October 2018. This research has been completed in 7 states with a planned roll out in all other states to commence soon,” it said.
Globally, according to reports from the World Health Organization (WHO), as of 26 May, there have been a cumulative total of 257 laboratory confirmed cases, with around 120 suspected cases reported, from 23 non-endemic countries. However, no deaths have been reported.
The countries are – Argentina, Canada, French Guiana, United States of America, United Arab Emirates, Sudan, Austria, Belgium, Czechia, Denmark, Finland, France, Germany, Israel, Italy, Netherlands, Portugal, Slovenia, Spain, Sweden, Switzerland, United Kingdom of Great Britain, Northern Ireland, and Australia.
The WHO noted that while the situation is evolving rapidly, it expects that there will be more cases identified as surveillance expands in non-endemic countries, as well as in countries known to be endemic who have not recently been reporting cases.
Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms very similar to those seen in the past in smallpox patients, although it is clinically less severe.
Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding. The incubation period of monkeypox is usually from 6 to 13 days, but can range from 5 to 21 days.
The WHO stated that various animal species have been identified as susceptible to the monkeypox virus. Uncertainty remains on the natural history of the monkeypox virus and further studies are needed to identify the reservoir(s) and how virus circulation is maintained in nature. Eating inadequately cooked meat and other animal products of infected animals is a possible risk factor.
Read full statement by NCDC:
NCDC Activates Monkeypox Emergency Operations Centre to Strengthen In-country Preparedness and Contribute to the Global Response
Sunday, May 29, 2022
29 May 2022 | Abuja – NCDC Activates Monkeypox Emergency Operations Centre to Strengthen In-country Preparedness and Contribute to the Global Response
On 26th May 2022, the Nigeria Centre for Disease Control and Prevention (NCDC) activated a national multisectoral Emergency Operations Centre for Monkeypox (MPX-EOC) at level 2 to strengthen and coordinate ongoing response activities in-country while contributing to the global response. This was based on the report of a preliminary risk assessment done by a group of Subject Matter Experts from the NCDC, relevant government Ministries Departments and Agencies and partner agencies.
This year, as at 29th May 2022, a total of 21 confirmed cases with one death have been reported from 9 states and the FCT – Adamawa (5), Lagos (4), Bayelsa (2), Delta (2), Cross River (2), FCT (2), Kano (2), Imo (1), Rivers (1). The death was reported in a 40-year-old patient who had underlying co-morbidity and was on immunosuppressive medications. Genomic surveillance is ongoing at NCDC’s National Reference Laboratory in Abuja and so far all of the cases have been confirmed to be caused by West Africa clade Monkeypox virus. The May 2022 Monkeypox situation report can be assessed via https://ncdc.gov.ng/themes/common/files/sitreps/fe6bfb6b22289ff41303bcee6a93eefc.pdf
Among the 21 cases reported in 2022 so far, there has been no evidence of any new or unusual transmission of the virus, nor changes in its clinical manifestation documented (including symptoms, profile and virulence).
Prior to the activation of the MPX-EOC, a multi-agency Technical Working Group (TWG) coordinated at the NCDC led Nigeria’s efforts to improve the detection, prevention and control of Monkeypox. Nigeria’s national surveillance system, the Surveillance Outbreak Response Management and Analysis System (SORMAS) was first deployed in response to the 2017 Monkeypox outbreak to improve the timeliness and completeness of case reporting, as well as facilitate the overall response (access relevant publication here – http://hdl.handle.net/10033/622144). In addition, this pilot project informed the nationwide scale-up of SORMAS to enable real-time reporting of surveillance data for prompt public health response to infectious disease outbreaks including COVID-19.
Following the detection of the index case on September 22, 2017 and the effective containment of the 2017 outbreak in Nigeria, the NCDC through the Monkeypox TWG worked on various interventions to gain a better understanding of the epidemiology of the virus to inform preparedness and response in-country (access NCDC-affiliated Monkeypox publications via https://ncdc.gov.ng/research).
The TWG coordinated the development of national Monkeypox guidelines, capacity building of healthcare workers and surveillance officers on case detection, sample collection, laboratory testing for confirmation and sequencing of the virus at NCDC’s National Reference Laboratory and intensified public awareness through risk communication. The national Monkeypox response guidelines can be accessed via – https://ncdc.gov.ng/themes/common/docs/protocols/96_1577798337.pdf.
Furthermore, a national One-health risk surveillance and information sharing (NOHRSIS) group has been inaugurated to facilitate timely information exchange on all prioritised zoonotic diseases. NOHRSIS will also strengthen the collaborative efforts of the One health/IHR Unit at the Point of Entry to intensify surveillance for the disease in animals as well as ensure minimal contact with suspected animals.
In addition, the One Health Animal Surveillance team including Federal Ministry of Agriculture and Rural Development, Federal Ministry of Environment, National Veterinary Research Institute and partners commenced operational research on Monkeypox virus prevalence in small mammals at the human-animal interface since October 2018. This research has been completed in 7 states with a planned roll out in all other states to commence soon.
Although Nigeria’s risk of exposure to the Monkeypox virus is high based on the recent risk assessment conducted at NCDC, the current situation in-country and globally has shown no significant threat to life or the community that can result in severe disease or high case fatality rate. The EOC will continue to monitor the evolving situation to inform public health action accordingly.
Symptoms of monkeypox include sudden fever, headache, body pain, weakness, sore throat, enlargement of glands (lymph nodes) in the neck and under the jaw, followed by the appearance of a rash (often solid or fluid-filled at the onset) on the face, palms, soles of the feet, genitals and other parts of the body. The Monkeypox public health advisory can be accessed via – https://ncdc.gov.ng/news/367/public-health-advisory-on-monkeypox.
The NCDC emphasises that members of the public should remain aware of the risk of Monkeypox and adhere to public health safety measures – specifically, report to the nearest health facility if you notice the known signs and symptoms of the disease. Healthcare workers are to maintain a high index of suspicion for Monkeypox and report any suspected case to the relevant state Epidemiology Team for prompt public health intervention including sampling for confirmatory testing.
About the NCDC
The Nigeria Centre for Disease Control is the country’s national public health institute, with the mandate to lead the preparedness, detection and response to infectious disease outbreaks and public health emergencies. The Bill for an Act to establish NCDC was signed into law in November 2018, by President Muhammadu Buhari. The mission for the NCDC (2017-2021) is ‘To protect the health of Nigerians through evidence-based prevention, integrated disease surveillance and response activities, using a One Health approach, guided by research and led by a skilled workforce’.
Contact
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Signed:
Dr Ifedayo Adetifa
Director General
Nigeria Centre for Disease Control
