The Monkeypox Virus Returns to Nigeria

By: Julian Mok

Lexington — The Lagos state government in Nigeria is taking steps to prevent another outbreak of monkeypox, an infection closely related to smallpox. Their last outbreak occurred in 2017, first appearing in the Nigerian state of Bayelsa.

During that period, the Center for Disease Control and Prevention (CDC) recorded 115 confirmed cases and seven deaths. The disease was neutralized by September 2018; however, monkeypox reappeared in Nigeria in November 2019, with 81 cases reported across the country and one fatality.

While reports of monkeypox have been infrequent in the past, experts agree that it is no longer a rare disease, as cases have appeared consistently since its reemergence in 2017. Prior to the 2017 outbreak, there had not been a single recorded case of monkeypox in Nigeria since 1978.

Cases are rare outside of the West African country, with the Democratic Republic of Congo seeing its most recent case in 1970. No country has seen more than 105 confirmed cases in one year except Nigeria.

Monkeypox was first discovered in 1958 in colonies where monkeys were kept for research. There are two distinct clades of monkeypox, known as the Central African and West African clades. The Central African clade is typically more severe and more easily transmitted.

After ten days, pox-like rashes begin to appear on the face and spread down the body of those infected by monkeypox. Source: withinnigeria.org — After ten days, pox-like rashes begin to appear on the face and spread down the body of those infected by monkeypox. *Source:* *withinnigeria.org*

The disease typically incubates for twelve days, with patients exhibiting initial symptoms fever, headache, muscle aches, swollen lymph nodes and exhaustion - after 10 days, pox-like rashes begin to appear on the face and spread down the body. The fatality rate is estimated to be up to 10% of those who contract the disease.

Transmission of the disease had been shrouded in uncertainty until recently. Experts previously believed that monkeypox only occurred in animal-human transmission, typically from bites, scratches or ingestion of infected rodents or monkeys.

It is not uncommon in Nigeria for people to kill or purchase wild animal meat (also known as “bushmeat”), but if this meat is undercooked, they run the risk of contracting several zoonotic viruses like monkeypox. It was only recently that epidemiologists confirmed secondary person-to-person transmission in both clades of monkeypox. Humans can contract the disease through body fluids, skin lesions or via respiratory droplets from infected individuals.

*A 38-year-old Nigerian man was quarantined in Singapore after he was diagnosed with a monkeypox strain caught by eating bushmeat. The first Source: Al Jazeera*

Lagos, which is among the four Nigerian states most affected by monkeypox, has joined forces with the Federal Ministry of Agricultural, National Centre for Disease Control and African Field Epidemiology Network to begin surveillance of livestock and bushmeat markets to test animal products for components of monkeypox.

Organs and tissue samples will be collected and transported to labs where they will be tested for monkeypox, Lassa virus and other zoonotic viruses. It is their mission to detect and isolate the disease before it becomes a public health emergency.

Lagos authorities insist that these are precautionary measures and ask citizens not to panic. As the most populated country in Africa with more than 1.8 million annual visitors, Nigeria is taking an important step in achieving early detection and prevention of the disease.

While monkeypox vaccines are available, they are limited in Nigeria, so experts encourage citizens to practice good hygiene and ensure that they are careful when consuming wild animal products. Citizens are also strongly encouraged to immediately report suspected cases of monkeypox to health workers.