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He discovered the origin of the monkeypox outbreak — and tried to warn the world

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  • He discovered the origin of the monkeypox outbreak — and tried to warn the world

    Updated July 29, 20225:04 PM ET


    Dr. Dimie Ogoina, professor of medicine and infectious diseases at Niger Delta University in Nigeria. Over the past few years, he has tried to warn health officials that the monkeypox virus had changed, but few listened.

    Five years ago, Dr. Dimie Ogoina saw perhaps the most important patient of his career – a patient whose infection would eventually be linked to the largest monkeypox outbreak in history.

    On Sept. 22, 2017, an 11-year-old boy came to Ogoina's clinic with a strange rash on his skin and sores inside his mouth. "He had very large lesions affecting his face and all over his body," says Ogoina, an infectious disease specialist at the Niger Delta University in Nigeria.

    The rash looked a bit like chickenpox. "But the boy already had chickenpox," says Ogoina. So he knew that wasn't the problem.

    Given the size of the lesions and their location, Ogoina wondered if perhaps the boy had what was then an extremely rare disease: monkeypox. "The suspicion of monkeypox just came up," he says.

    At the time, Nigeria didn't have the ability to test for the disease. "So we had to send our samples to Senegal and even to the U.S. to make a diagnosis," he says. "We had to wait."

    A few days later, the results came back, and Ogoina was correct: The boy had monkeypox.

    "He was the first case of monkeypox in Nigeria in 38 years," Ogoina says. Over the next few months, he and his colleagues detected more than 20 additional cases at their clinic.

    Now scientists, including Ogoina, are just starting to realize this little boy was another first, not just for Nigeria, but also for the entire world. He was the first known case of the international monkeypox outbreak, currently spreading in 78 countries. ...

    Somebody told him to be quiet

    When Ogoina first diagnosed the young boy with monkeypox in 2017, Ogoina thought the virus would act the way it has for more than 50 years in other parts of Africa, the way that scientists described in textbooks. That is, outbreaks typically begin when a person comes into contact with an infected animal. "There was speculation that this young boy played with monkeys around the community," Ogoina says.

    ... Ogoina and other doctors thought the outbreak in 2017 would be the same. "We thought, 'OK, this is the regular monkeypox that we know.' "

    But a few weeks after diagnosing the young boy, Ogoina started to become concerned – quite concerned. The outbreak in Nigeria began to grow rapidly. Cases cropped up in counties not just near this one boy but all over. "Suddenly, we were seeing cases appear across the country," Ogoina says.

    Ogoina knew this shift in transmission had massive implications. It meant the monkeypox virus could more easily spread from person to person, that it no longer needed to jump from an animal into people. That it could possibly sustain human-to-human transmission in a way that it couldn't before. That meant the outbreak in Nigeria would be much more difficult to stop. It could possibly go on for years and eventually spill over into other countries. In many ways, the findings meant that monkeypox was no longer just a threat to communities in West and Central Africa but also a potential threat to the world.

    ... Over the past few years, Ogoina says he has tried to warn health officials and scientists repeatedly that monkeypox had changed and was possibly spreading through sexual contact. At one international meeting, he tried to bring up the possibility of sexual transmission. Somebody told him to be quiet.

    "Yes, someone told me that I should not say it. That I should not say sexual transmission is possible," Ogoina recalls with exasperation in his voice. "He told me, 'We should not worry about sexual transmission.' "

    ... But the international effort to stop the outbreak in Nigeria has paled in comparison to the effort to stop monkeypox elsewhere, both Ogoina and Worobey point out.