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The History of Monkey Pox in Nigeria: Key Outbreaks and Epidemiological Insights

The history of monkey pox in Nigeria can be traced back to the early 1970s, when the first cases were reported. Over the years, outbreaks have occurred sporadically, with the most recent re-emergence in 2017 highlighting the need for continued public health vigilance.



Introduction to MPox (formerly Monkeypox)

MPox is a viral zoonotic disease caused by the Orthopoxvirus, first discovered in laboratory monkeys in 1958, hence the name. However, its primary reservoirs are rodents. MPox can spread to humans through contact with infected animals or humans, and it presents symptoms similar to those of smallpox, though less severe. The symptoms include fever, rash, muscle aches, swollen lymph nodes, and respiratory symptoms.


Epidemiology of MPox in Nigeria  

Nigeria has faced several outbreaks of MPox since the first recorded human case in 1970. It re-emerged in 2017 after a nearly 40-year hiatus, causing concern due to its rapid spread and the increased number of confirmed cases. Nigeria remains one of the few African countries with reported cases of MPox, highlighting its public health significance.


 Key Epidemiological Facts:


1. Incidence and Prevalence

   The re-emergence of MPox in Nigeria has resulted in hundreds of confirmed cases, with a significant proportion affecting the country's rural and urban populations. According to the Nigeria Centre for Disease Control (NCDC), as of 2023, over 600 suspected cases and several confirmed cases have been reported in different states, primarily in the southern and central regions.


2. Geographical Distribution

   The MPox outbreaks in Nigeria have been geographically diverse, affecting multiple states across different regions. States such as Bayelsa, Rivers, Delta, Lagos, and the Federal Capital Territory (Abuja) have reported the most cases. The prevalence of MPox in both rural and urban settings suggests the possibility of zoonotic transmission from wildlife reservoirs.


3. Transmission

   MPox is primarily transmitted through close contact with the blood, bodily fluids, or cutaneous/mucosal lesions of infected animals or humans. Human-to-human transmission can also occur via respiratory droplets, physical contact with skin lesions, or contaminated objects like clothing and bedding. Nigeria’s agricultural and rural settings, where people come into contact with wild animals or bushmeat, provide opportunities for zoonotic transmission.


4. Demographics 

   MPox in Nigeria affects people of all age groups, though it has been noted to have a higher incidence in males and children. Adults, particularly those living in rural areas where contact with wild animals is common, are also at higher risk. Immunocompromised individuals, such as those living with HIV/AIDS, are more susceptible to severe disease.


5. Fatality Rate  

   While MPox generally has a lower fatality rate than smallpox, the Nigerian outbreaks have had varying case fatality rates (CFR). The 2017 outbreak had a CFR of approximately 3%, though this number has fluctuated with subsequent outbreaks depending on factors like access to healthcare, comorbidities, and severity of the viral strain.


6. Vaccine and Treatment  

   The smallpox vaccine, which was part of the global eradication campaign, has shown cross-protection against MPox, offering up to 85% efficacy. However, with smallpox eradicated, routine vaccination has ceased. In Nigeria, there is no mass vaccination for MPox, but vaccination is considered for high-risk individuals. Supportive treatment and isolation remain the primary control measures during outbreaks.


Challenges in Managing MPox in Nigeria


1. Surveillance and Reporting

   Nigeria faces challenges with timely reporting and surveillance of MPox cases. Underreporting is common due to inadequate healthcare infrastructure in rural areas, lack of awareness, and the stigma surrounding the disease.


2. Public Health Response

   The NCDC, in collaboration with international health organizations like the World Health Organization (WHO), has been actively involved in public health campaigns, epidemiological surveillance, and containment efforts. However, limited healthcare resources, inadequate training of healthcare professionals, and competing health priorities, such as malaria and Lassa fever, hamper MPox response efforts.


3. Zoonotic Transmission Risk  

   With Nigeria's dependence on agriculture and bushmeat consumption, the potential for zoonotic transmission remains high. The country's porous borders also increase the likelihood of cross-border transmission.


4. Mental Health Impact

   The fear and stigma surrounding MPox outbreaks can lead to significant mental health issues, including anxiety, depression, and social isolation. The visible nature of MPox lesions can also cause psychological distress in affected individuals, especially in communities where infectious diseases carry a heavy stigma.


Conclusion  

MPox remains a public health concern in Nigeria, particularly due to the potential for zoonotic transmission and the challenges in healthcare infrastructure. Effective control measures require a multifaceted approach, including public awareness campaigns, vaccination of high-risk groups, and improved healthcare services. With better surveillance and response strategies, Nigeria can mitigate the spread and impact of MPox on its population.

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