NewsDesk @bactiman63

Health authorities in Nigeria reported an additional 10 confirmed monkeypox cases in the week ending June 5 alone, bringing the total confirmed cases to 31 in 2022.

The new ten confirmed cases were reported from six states–– Edo (2), Rivers (2), Plateau (2), Lagos (2), Ondo (1) and Imo (1).

Of the 31 confirmed cases, 21, or 67 percent were reported in people ages 21-40.

Monkeypox Image/CDC

From September 2017 to June 5, 2022, Nigeria has reported 257 confirmed cases and nine deaths (1 death in 2022).

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.

NCDC says Monkeypox (MPX) is a rare viral zoonotic infectious disease (i.e., an infection transmitted from animals to humans) that is endemic in areas in and near tropical rainforests in Central and West Africa. It is caused by the Monkeypox virus which belongs to the same Orthopoxvirus genus and Poxviridae family of viruses as the Variola virus (Smallpox virus), the Vaccinia virus (used in smallpox vaccine for eradication programme), and the cowpox virus (used in earlier generations of smallpox vaccines) and some other viruses. There are two types (clades) of the MPX virus: the West African and the Central African clade. Available data suggests human disease with the Central African clade is more severe than with the West African clade

The exact reservoir of the MPX virus is still unknown although rodents are suspected to play a part in transmission. So far, the virus itself has been identified in wild animals in Africa only twice (from a type of squirrel and a type of monkey in the Democratic Republic of Congo and Cote d’Ivoire respectively). Rodents from West Africa (rats, dormice, and squirrels) being sold in a store in the United States contributed to a 2003 outbreak.

The virus can spread both from animal-to-human (which is the first (spill-over) event preceding the detection of cases in humans), and from human-to-human. Animal-to-human transmission may occur by direct contact with the blood, body fluids, the skin or mucosal lesions of infected animals (e.g., monkeys, squirrels, and rodents). This can happen through a bite, scratch, handling of, or eating inadequately cooked or other products of infected bushmeat. Human-to-human (person-to-person) transmission occurs when a person comes into contact with the virus from an infected human, or materials contaminated with the virus such as clothing, beddings. As a consequence, household members or healthcare workers are at greater risk of infection. The virus enters the body through broken skin (even if not visible), the respiratory tract, or the mucous membranes of the eyes, nose, or mouth. Human-to-human transmission may also occur through aerosols/droplets following prolonged face-to-face or close contact. The East African clade is better than the West African clade in human-to-human transmission.

Symptoms of the illness include fever, headache, body aches, weakness, swollen lymph nodes (glands) and a rash. After about 1 to 3 days of fever, the rash erupts, beginning on the face and then spreading to the body with the face and palms/soles being mostly affected. They can also occur in and around the genitals which is why contact during sex is one mode of transmission. It is mostly a self-limiting illness that often lasts for 2−4 weeks.

To prevent MPX, members of the public are urged to practise infection prevention and control measures that have proven to limit the spread of MPX infection. This includes:

• Avoid contact with animals that could harbour the virus including sick or the dead animals in areas where MPX has been confirmed

• Avoid contact with any material that has been in contact with a sick animal.

• Avoid unnecessary physical contact with persons infected with MPX

• Isolate potentially infected animals from other animals

• Practice frequent handwashing with soap and water especially after caring for or visiting sick people

• Ensuring all animal food products are properly cooked before eating

• Use of appropriate protective clothing and gloves while handling sick animals or their infected tissues and during slaughtering procedures

Healthcare workers are further advised to:

• Always practice standard care precautions (including droplet precautions) when caring for patients, regardless of their presumed diagnosis

• Wash hands with soap and water after contact with patients and/or their environment

• Maintain a high index of suspicion for MPX, especially for patients presenting with fever and vesicular/pustular rash in all parts of the country at this time.

• During triage, use precautionary measures such as placing a surgical mask over the nose and mouth of suspected patients and covering any exposed skin lesions with a sheet or gown

• Isolate all patients suspected of having MPX as soon as possible

• Wear personal protective equipment (gloves, gown, and masks) before close contact with suspected cases and dispose of properly

• Correctly disinfect all contaminated equipment (including bedding) using bleach unless otherwise indicated and dispose of all waste properly

• Report all cases to the State Epidemiologist/LGA Public Health Department immediately, or call NCDC toll free line on 6232

• Samples taken from humans for investigation of the MPX virus should be handled by trained staff and sent to the Nigeria Centre for Disease Control

• Provide psychosocial support to all patients.

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