Thursday, September 13, 2018

PRO/AH/EDR> Monkeypox - Africa (13): Nigeria

MONKEYPOX - AFRICA (13): NIGERIA
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Wed 12 Sep 2018
Source: Nigeria Center for Disease Control [edited]
<https://ncdc.gov.ng/news/152/re%3A-monkeypox-cases-in-the-united-kingdom>


The Nigeria Centre for Disease Control (NCDC) is aware of 2 confirmed
cases of monkeypox in the United Kingdom (UK), in patients with a
recent travel history from Nigeria.

Since the re-emergence of Monkeypox in Nigeria in September 2017, NCDC
has continued to receive reports and respond to cases of the disease
from states across the country. Between September 2017 when the
outbreak started and 31 Aug 2018, a total of 262 suspected cases had
been reported from 26 states. Of these, 113 have been confirmed in 16
states with 7 deaths. The highest number of cases have been reported
from states in the South-South region of Nigeria.

Following the recent report of the 2 cases in the UK, NCDC has been
working with the UK's public health agency; Public Health England
(PHE), the public health departments in the affected states and other
partners in Nigeria to investigate these cases. The NCDC has also been
working closely with states across the country to strengthen
surveillance, detection and response to cases of monkeypox. A
Technical Working Group coordinated by NCDC and comprising of partners
from the Federal Ministry of Agriculture and Rural Development, World
Health Organisation (WHO), UNICEF, US Centers for Disease Control (US
CDC), and other agencies, meet weekly to ensure coordination. In
addition, NCDC met with stakeholders recently, including surveillance
officers and case management physicians from all affected states to
review the actions taken so far and strategise on how to strengthen
the country's response.

Monkeypox is a virus that is spread primarily from animals to humans,
with symptoms such as fever, headache, body pain, malaise,
lymphadenopathy (enlargement of glands), sore throat and the typical
generalized vesicular rash. This may last for 2-4 weeks. Transmission
is via direct contact with infected animals, human, or contaminated
materials. The virus does not spread easily between people and the
risk of transmission to the wider public is very low.

Monkeypox is generally self-limiting, which means patients tend to
recover in a couple of weeks. However, supportive care and management
of the condition is required and mostly successful. Control measures
include isolation of suspected or confirmed cases, strict adherence to
universal precautions, especially frequent handwashing with soap and
water and the use of personal protective equipment.

We reassure Nigerians that NCDC has the capacity to effectively
diagnose and respond to cases of monkeypox. The National Reference
Laboratory in Abuja has the capacity to test for cases of monkeypox
with a quick turn-around time. We therefore encourage any healthcare
worker that suspects a case of monkeypox, to reach out to their State
Epidemiology team for appropriate action. Guidelines on the management
of monkeypox cases and outbreaks can be found on the NCDC's website
(<https://ncdc.gov.ng/themes/common/docs/protocols/50_1508912430.pdf>).

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[The report above provides a current update of the monkeypox situation
in Nigeria over the past 13 months. This outbreak has been unusual.
Rather than sporadic or rare cases, there have been over 100 cases
scattered over a large geographic area, 26 states, occurring in a
short period of time. The reasons for this relatively sudden
appearance is not clear. Perhaps there has been an epizootic of
monkeypox virus infections among its rodent hosts, with spillover to
people. Prevention will require a proactive public education effort to
convince local people to take measures to prevent contact with the
infected rodents and their excreta to avoid transmission -- a
difficult task involving so many local people over such a large
geographic area.

Non-human primates are not monkeypox virus reservoirs. The main
reservoirs of monkeypox virus are suspected to be rodents, including
rope squirrels (_Funisciurus_ spp; an arboreal rodent) and terrestrial
rodents (genera _Cricetomys_ and _Graphiurus_). - Mod.TY

Maps of Nigeria:
<http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf> and
<http://healthmap.org/promed/p/62>]

[See Also:
Monkeypox - UK (02): ex Nigeria
http://promedmail.org/post/20180911.6023180
Monkeypox - UK: ex Nigeria
http://promedmail.org/post/20180908.6017005
Monkeypox - Africa (11): Nigeria (PL)
http://promedmail.org/post/20180608.5847036
Monkeypox - Africa (06): Nigeria
http://promedmail.org/post/20180405.5728330
Monkeypox - Africa (04) http://promedmail.org/post/20180327.5712702
Monkeypox - Africa: Nigeria
http://promedmail.org/post/20180120.5572204]
.................................................jh/ty/mj/jh
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