Nigeria: 2017 Monkey Pox - suspected cases in 15 states - Government confirms 61 cases in 14 states

[Shiloh]

Source: https://www.thenewsguru.com/monkey-pox-outbreak-hits-bayelsa-as-doctors-10-others-are-quarantined/


?Monkey Pox? outbreak hits Bayelsa, doctors, 10 others quarantined
Governor Seriake Dickson of Bayelsa State.
Olaotan Falade
2 hours ago

Information reaching TheNewsGuru.com now has it that a new viral epidemic known as ?monkeypox? has broken out in Bayelsa State.

A medical doctor and 10 other persons who came down with the monkeypox had been quarantined in an isolation centre created at the Niger Delta University Teaching Hospital (NDUTH) Okolobiri, Yenagoa local government area of the state.

The isolation centre was reportedly created by the Nigerian Centre for Disease Control (NCDC) and the epidemiological team of the state?s Ministry of Health to stop the spread of the disease.

It was learnt that the NCDC and the epidemiological team were tracking 49 other victims, who had come in contact with the infected persons...

 

[Pathfinder]

Press Release: SUSPECTED MONKEYPOX OUTBREAK IN BAYELSA STATE

Thursday, October 05, 2017

05 October 2017 | Abuja ? SUSPECTED MONKEYPOX OUTBREAK IN BAYELSA STATE

On the 22nd of September, 2017, the Nigeria Centre for Disease Control (NCDC) was notified of a case of suspected Monkeypox in an 11 year old male patient who presented to the Niger Delta University Teaching Hospital (NDUTH) in Yenagoa, Bayelsa State. Subsequently, 11 other cases were identified. All the cases are currently receiving appropriate medical care. All the patients are improving clinically and there have been no deaths. As at 1st October 2017, 32 close contacts of the cases have been identified, advised appropriately and are being monitored.

A Rapid Response Team from NCDC was immediately deployed to support the Bayelsa State Government in the investigations and public health response to the outbreak. The team has been supporting the Bayelsa State Department of Public Health and the State Epidemiologist to respond to the outbreak. As the outbreak investigation and response continues, the Bayelsa State Government has started an aggressive public enlightenment campaign to advise clinicians and the public on the symptoms of the disease and the steps required to manage the cases and to prevent further spread. NCDC has also collected appropriate clinical samples from the cases and these are being analysed through the National Reference Laboratory in Abuja.

Monkeypox infection is a relatively rare disease that has previously been reported in Nigeria in the 1970s. It is primarily a zoonotic infection i.e. transmitted primarily from animals to humans, with limited subsequent person-to-person transmission. The most common animal hosts are squirrels, rats and sometimes, monkeys. The Monkeypox virus can cause an illness with the following symptoms; a generalised vesicular skin rash, fever, and painful jaw swelling. In previous outbreaks, it has led to death in about 1-10% of infected cases. Although there is no specific medicine to treat the disease, when intensive supportive care is provided most patients recover fully.

Measures that can be taken to prevent infection with Monkeypox virus include avoiding contact with the animals listed above, especially animals that are sick or found dead in areas where Monkeypox occurs. The public is advised to always wash hands with soap and water after contact with animals or when caring for sick relatives humans or soiled beddings.

Nigerians are advised to remain calm and supportive of public health authorities, avoid self-medication and report to the nearest health facility if feeling unwell or notice any of the above symptoms in anyone around you.

Health care workers are strongly advised to practice universal precautions while handling patients and/or body fluids at all times.
They are also urged to be alert, be familiar with the symptoms and maintain a high index of suspicion. All suspected cases should be reported to the Local Government Area or State Disease Surveillance and Notification Officers.

The Chief Executive Officer of NCDC, Dr. Chikwe Ihekweazu has advised that health workers must continue to manage their patients without fear. He advised, ?As long as universal infection prevention and control practices are strictly adhered to by all clinical staff, the chances of transmission are minimal.?

For further information, contact:
NCDC toll-free number: 0800-970000-10
SMS: 08099555577
Whatsapp: 07087110839.
Twitter/Facebook: @NCDCgov
SIGNED
Dr. Chikwe Ihekweazu
National Coordinator/Chief Executive Officer
Nigeria Centre for Disease Control

http://ncdc.gov.ng/news/104/press-release:-suspected-monkeypox-outbreak-in-bayelsa-state

 

[Gert van der Hoek]

Press Release: Update On Suspected Monkeypox Outbreak

Monday, October 09, 2017

---

09 October 2017 | Abuja – UPDATE ON SUSPECTED MONKEYPOX OUTBREAK

Following the notification of a suspected monkeypox outbreak on the 22nd of September, 2017 in Bayelsa State, other suspected cases have been reported from six more States, bringing the total number of suspected cases so far to 31 across 7 States - Bayelsa, Rivers, Ekiti, Akwa Ibom, Lagos, Ogun and Cross River States. Samples have been collected from each suspected case for laboratory confirmation. Results are still awaited. So far, there have been no deaths recorded. It is unlikely that many of the suspected cases are actually monkeypox, but all are being investigated.

All the suspected cases are currently receiving appropriate medical care, and the patients are all improving clinically in their various States. The Federal Ministry of Health through the Nigeria Centre for Disease Control (NCDC) is supporting the affected States to ensure the outbreak is brought under control and to limit further spread.

NCDC has activated an Emergency Operation Centre (EOC) to coordinate the outbreak investigation and response across the affected States. The EOC is currently supporting State Ministries of Health in their response to the outbreak through active case finding, epidemiological investigation and contact tracing. Measures have been put in place to ensure effective sample collection and testing to enable laboratory confirmation. Risk communication activities have been heightened to advise the public on preventive measures. All 36 States and the FCT have been notified for preparedness.

 

[Pathfinder]

Monkeypox: Nigeria to receive confirmatory test results Friday ? Official

October 12, 2017Kemi Busari
...
Results of laboratory tests to confirm or refute the outbreak of monkeypox in Nigeria will be out on Friday, the national coordinator, Nigeria Centre for Disease Control, NCDC, Chikwe Ihekweazu, has disclosed.
...
While intimating the senators on the job done so far, Mr. Ihekweazu said there is no confirmation yet if the over 30 suspected cases in three states were monkeypox.
...
?Monkeypox is a very rare disease. It last occurred in Nigeria in the 70s. So, most laboratories don?t have the capacity to make this diagnosis. It is only one lab in Redeemers University that has capacity to do the diagnosis in Nigeria. The other lab in West Africa is in Dakar. So, we have split the samples, sent half to Redeemers and half to Dakar.

?At the moment we have 33 cases, 17 in Bayelsa, out of that 17, we think we may have monkeypox victims but we haven?t confirmed yet. Other cases across other states are most likely not monkeypox, but until we have the result, we can?t be very clear on that.?
...
https://www.premiumtimesng.com/news...onfirmatory-test-results-friday-official.html

 

[alert]

At least some of the cases have now been diagnosed as chickenpox, not monkeypox. It remains to be seen whether both illnesses are responsible, or whether the entire outbreak is due to chickenpox:
Published Date: 2017-10-14 15:15:17
Subject: PRO/AH/EDR> Monkeypox - Africa (09): Nigeria, hospital cases NOT, other states' cases susp.
Archive Number: 20171014.5380964
MONKEYPOX - AFRICA (09): NIGERIA, HOSPITAL CASES NOT, OTHER STATES' CASES SUSPECTED
***********************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Thu 12 Oct 2017
Source: Ripples Nigeria [edited]
https://www.ripplesnigeria.com/seven-suspected-monkey-pox-cases-recorded-abuja/


The Federal Capital Territory Administration (FCTA) on Thursday [12 Oct 2017] revealed that 7 suspected cases of dreaded monkeypox have been recorded in 4 hospitals in Abuja, with samples of 6 victims taken and sent to Senegal for testing and confirmation. This was disclosed by the Secretary, Health and Human Services Secretariat (HHSS) of FCTA, Amanda Pam, while briefing newsmen on Thursday [12 Oct 2017].

It has in the meantime denied rumours that there is an outbreak of monkeypox in Abuja in the nation's capital. According to the Secretary, "3 suspected cases were recorded in National Hospital, 2 in Gwarinpa Hospital, one each in University of Abuja Teaching Hospital, Gwagwalada and Nyanya General Hospital."

She said the recorded cases were that of chickenpox, which shares a similar appearance to monkeypox. On Wednesday [11 Oct 2017], there were a rumoured 2 cases of monkeypox at Gwarinpa General Hospital, Abuja.

"Though we have some suspected cases, samples were collected and sent to the lab, so we are waiting for the results, but from all indications, it is not monkeypox. But I think I like the suspicion, because it's better to suspect than to ignore it and it later turns out to be positive. The truth now is that there is no confirmed case of monkeypox disease in FCT," she stressed.

Explaining further, Acting Director, Public Health, FCT Humphrey Okoroukwu disclosed that he had already visited the said hospital on Wednesday [11 Oct 2017], reaffirming that no case of the virus was found.

He said surveillance officers from the public health department of the FCTA are being deployed to the 62 wards of the territory, as a precautionary measure against threatening health issues.

The federal government had, through the Nigeria Centre for Disease Control (NCDC) on Monday [9 Oct 2017], confirmed a suspected outbreak of monkeypox in 7 states in Nigeria, which included Bayelsa, Rivers, Ekiti, Akwa Ibom, Lagos, Ogun and Cross River states.

Meanwhile, the National Coordinator, National Centre For Disease Control (NCDC) Dr. Chikwe Ihekweazu on Thursday [12 Oct 2017] informed lawmakers that 33 cases of monkeypox infection had been reported in 7 states of the federation. The NCDC scribe said that 17 out of the number manifested in Bayelsa state alone. According to him, other states where the disease has manifested are Rivers, Ekiti, Akwa Ibom, Cross River, Lagos, and Ogun. He, however, pointed out that it was not certain whether all the victims reported to have been afflicted by monkeypox were actually infected by the virus or by other diseases with similar symptoms.

Senators have also described as a national embarrassment and shame the lack of a public diagnostic centre for detection of the current outbreak in some states of the federation.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[The Secretary, Health and Human Services Secretariat indicated that the 7 cases in the 4 hospitals were chickenpox, not monkeypox. The diagnosis of chickenpox apparently was made on the basis of clinical presentation. She pointed out that the clinical picture of chickenpox and monkeypox were similar but she implied are differentiable. The status of the other cases in the 7 states reported as monkeypox have not been laboratory confirmed yet.

As noted in comments in the previous posts, laboratory confirmation of the 31 suspected monkeypox cases is essential. Rapid appearance of the disease across 7 states in less than 3 weeks is unusual for monkeypox. Isolated and scattered cases are more common. Monkeys are not the reservoirs of the virus, despite the name that the virus has received. Although not determined, the main reservoirs of monkeypox are suspected to be rodents, including rope squirrels (_Funisciurus_ spp; an arboreal rodent) and terrestrial rodents in the genera _Cricetomys_ and _Graphiurus_). The current outbreak appears to be more characteristic of direct transmission between individuals rather than spillover from a wild rodent reservoir, raising the question about involvement of some other transmissible pathogen such as varicella (chickenpox).

 

[Pathfinder]

Press Release: HMH Update On Monkeypox

Monday, October 16, 2017

---

UPDATE ON MONKEYPOX - Government Confirms 3 Cases

On the 22nd of September 2017, the Nigeria Centre for Disease Control (NCDC) received a report of a suspected case of Monkeypox virus disease from the Niger Delta University Teaching Hospital (NDUTH), Okolobiri, Bayelsa State. The Bayelsa State Ministry of Health initiated an outbreak investigation and response, supported by a team from NCDC, which was immediately deployed to the state.

As at 13th of October 2017, there were 17 SUSPECTED cases reported from Yenagoa LGA in Bayelsa State. We have received laboratory confirmation for Monkeypox virus from three of these cases from the WHO Regional Laboratory in Dakar, Senegal. Samples from 12 others from Bayelsa were negative, and we are awaiting two results.

With these results, the Monkeypox outbreak in Yenagoa has been confirmed with laboratory evidence. The most likely source of infection is a primary zoonotic transmission, from an animal, with secondary person-to-person transmission.

Since our initial announcement, a total of 43 other SUSPECTED cases have been reported from eight other States (Akwa Ibom, Cross River, Ekiti, Lagos, Enugu, Nasarawa, Rivers, and FCT). Of these, four cases from Lagos have also been tested and confirmed to be negative for the Monkeypox virus. We expect that many of these cases being reported from other states in Nigeria are not caused by the Monkeypox virus, but we will continue to investigate all those cases that fit the case definition.
Further laboratory tests using whole genome sequencing are being carried out by the Africa Centre for Genomics and Infectious Diseases in Redeemers University Ede, Ogun State.

Monkeypox is largely a self-limiting disease, from which all suspected patients that have been reported to date are doing well clinically. Even before this confirmation, all the necessary public health measures have been put in place and will continue to be implemented.

The Federal Ministry of Health through the Nigeria Centre for Disease Control has established an Emergency Operations Centre and will continue to co-ordinate the response across States and test samples from other cases. NCDC will also continue to support all states in their response and will keep the public informed as the situation evolves.
Measures that can be taken to prevent infection with Monkeypox virus include avoiding contact with squirrels, rats and similar animals, especially when these animals are sick or found dead in areas where the Monkeypox virus is circulating. The public is advised to always wash hands with soap and water after contact with animals or when caring for sick relatives.

Monkeypox begins with fever, headache, muscle aches, and exhaustion before the rash on face, palms and soles appears and lymph nodes swell (lymphadenopathy). The incubation period (time from infection to symptoms) for is usually 7-14 days but can range from 5-21 days.

Nigerians are advised to remain calm and supportive of public health authorities, avoid self-medication and report to the nearest health facility if feeling unwell or notice any of the above symptoms in anyone around you. It is important to note that there has been no confirmation of Monkeypox in any other part of the country, and it is likely that many of the other cases being reported are not caused by the Monkeypox virus. Nigerians should continue to be vigilant at all times.

Health care workers are strongly advised to always practice universal precautions while handling patients and/or body fluids at all times. They are also urged to be alert, be familiar with the symptoms of Monkeypox and maintain a high index of suspicion. All suspected cases should be immediately reported to the Local Government Area or State Disease Surveillance and Notification Officers.

More information on the disease can be found in the advisory note on the NCDC website: http://ncdc.gov.ng/news/106/05-octob...eypox-advisory.
However, in case of any suspected case, please call the Emergency Operations Centre on +2348148216538.
Professor Isaac F Adewole, FAS, PSPSP, FRCOG, Dsc (Hons)
Honourable Minister of Health,
16/10/17.

http://www.ncdc.gov.ng/news/109/pres...e-on-monkeypox

 

[Shiloh]

Source: https://www.channelstv.com/2017/10/18/fg-announces-74-suspected-monkeypox-cases-11-states/


FG Announces 74 Suspected Monkeypox Cases In 11 States
Channels Television
Updated October 18, 2017

The Federal Government has announced that there are 74 suspected cases of monkeypox virus in 11 states in the country.

Minister of Health, Professor Isaac Adewole, disclosed this to State House correspondents on Wednesday at the end of the Federal Executive Council meeting in Abuja...

 

[alert]

This is an odd report. Read the entire thing at the link:

https://www.channelstv.com/2017/10/16/monkeypox-patient-commits-suicide/

​[snip] One of the patients receiving medical care for Monkeypox at the quarantine centre in Bayelsa State has committed suicide.

 

[Ronan Kelly]

Monkeypox Outbreak in Nigeria
Situation Report (No. 004)
(October 19, 2017)
Highlights
? The Nigeria Centre for Disease Control (NCDC) continues to coordinate the response through its activated
Emergency Operations Centre (EOC)
? Up to Oct. 19, we have confirmed three cases of monkeypox in Bayelsa State only
? Outbreak response coordination in Bayelsa is being strengthened with support from a national
rapid response team
? A total of 22 SUSPECTED cases have been reported in Bayelsa with eight cases still on admission and no
death recorded
? Since the onset of the outbreak, 86 SUSPECTED cases have been recorded from 10 States and the Federal
Capital Territory (FCT). All are being investigated. No confirmation outside Bayelsa State.
? Active engagement with the public is ongoing to increase awareness on preventive measures and allay fear
...
Epi- summary
? Three laboratory confirmed cases from Bayelsa
? A total of 86 suspected cases have been reported from 10
States (Akwa Ibom, Bayelsa, Cross River, Delta, Ekiti,
Enugu, Imo, Lagos, Nasarawa, Rivers) and the FCT
? Epidemiological linkage demonstrated among three cases in
Bayelsa State
? Of the 86 suspected cases, a total of 83 samples have been
received so far at the National Reference Laboratory (NRL)
for investigation
? Male to female ratio is 3:1
? The most affected age group is 21-30 years
...
Key Indicators Number
Total suspected cases 86
Total Deaths 0
Confirmed cases 3
Total samples received for diagnosis 83
States that have reported at least one
suspected case (including FCT) 11
Number of contacts under follow-up 294
...
http://ncdc.gov.ng/themes/common/files/sitreps/e6712d699f98a532ba34219d67c80a61.pdf

 

[Ronan Kelly]

Monkeypox: Six more cases confirmed &#150; Minister of State for Health calls for calm

[FONT=&quot]0[/FONT]​

[FONT=&quot]By Nigeria Health Watch Admin on October 28, 2017Press Release[/FONT]
[FONT=&quot]The Honourable Minister of State for Health, Dr. Osagie Ehanire has announced laboratory confirmation of six additional cases among the suspected cases for Monkeypox. These include two cases each in Bayelsa and Akwa Ibom States, one in Enugu State and one in the Federal Capital Territory. With this, there are nine confirmed cases of Monkeypox in Nigeria.

Announcing this in his office today, Dr. Ehanire noted that investigations are on- going to see if any of the new cases has a link with the Bayelsa cluster, where the outbreak started. He called for calm among members of the public, as the Nigeria Centre for Disease Control (NCDC) is working with all affected States to ensure case finding and adequate management.

He added that as frightening as the manifestation of the ailment may seem, no fatality has been recorded to date. As at the 25th of October 2017, a total of 94 suspected cases have been reported from 11 States (Akwa Ibom, Bayelsa, Cross River, Delta, Ekiti, Enugu, Imo, Lagos, Nasarawa, Niger, Rivers) and the Federal Capital Territory (FCT).

He noted that the newly confirmed cases are patients already being managed by public health authorities and have been receiving appropriate clinical care since onset of the illness.

The Federal Ministry of Health, through the NCDC, is in close contact with all State Epidemiology Teams, as well as the health facilities providing clinical care to both suspected and confirmed cases. State Commissioners of Health have been advised to place all health care facilities and Disease Surveillance and Notification Officers on alert, to ensure early case detection, reporting and effective treatment.

A National-level Emergency Operations Centre (EOC) led by the NCDC with support from our development partners, is coordinating outbreak investigation and response across affected States. The EOC includes the Federal Ministry of Agriculture and Rural Development, as well as experts from partner agencies. The EOC provides daily support to State Ministries of Health in active case finding, epidemiological investigation, contact tracing, case management, psychosocial support and risk communication.

The NCDC has also deployed Rapid Response Teams to the four States with confirmed cases. Measures have been put in place to ensure proper investigation of all reported cases, effective sample collection and testing, as well as case management of all suspected and confirmed cases. Risk communication activities have been heightened to advise the public as well as healthcare workers on preventive measures. A nationwide communications campaign has begun, to inform Nigerians of key preventive measures to take to curtail the further spread of monkeypox.

The NCDC has been working with poxvirus experts from the World Health Organization and the U.S. Centers for Disease Control and Prevention to ensure that every available step is taken to trace how this outbreak may be spreading, and in understanding the links between case clusters, in order to prevent further spread.

An Interim National Guideline for Monkeypox has been developed and disseminated to all States for coordination of response activities. This is also available via http://ncdc.gov.ng/themes/common/doc...1508912430.pdf.

Monkeypox is a largely self-limiting disease i.e. a disease that resolves itself. Generalised vesicular skin rashes, fever, and painful jaw swelling are characteristic symptoms associated with an infection. Although there is no specific medicine to treat the disease, when intensive supportive care is provided virtually all patients recover fully, as we have seen with the current outbreak.

It is thought that people could get Monkeypox if they are bitten or scratched by an animal, or contact animal blood in preparing bushmeat or have contact with an infected animal&#146;s body fluids or sores. Monkeypox may also be spread between people through prolonged face-to-face contact, or through contact with body fluids or sores of an infected person, or items that have been contaminated with fluids or sores (clothing, bedding, etc.), Ehanire said.

Measures that can be taken to prevent infection with Monkeypox virus include avoiding contact with animals that could carry the virus such as rodents and bushmeat, especially animals that appear sick or were found dead in areas where Monkeypox occurs.

The public is advised to always wash hands with soap and water after contact with animals or, when caring for sick relatives, or managing soiled beddings. Nigerians are once again advised to remain calm and supportive of public health authorities, avoid self-medication and report to the nearest health facility if feeling unwell or notice any of the above symptoms in anyone around you. It is important to reiterate that supportive care can be provided and full recovery is mostly the case.

Health care workers are strongly advised to take prescribed universal precautions while handling patients and/or body fluids at all times. They are also urged to be alert, be familiar with the symptoms and maintain a high index of suspicion. They are urged to adhere to guidelines stated in the Interim National Guideline for Monkeypox, and to report all suspected cases to the Local Government Area or State Disease Surveillance and Notification Officers (DSNOs).

To call the Emergency Operations Centre: +2348148216538, Email icc@ncdc.gov.ng.
http://nigeriahealthwatch.com/monkey...alls-for-calm/ [/FONT]

 

[Pathfinder]

[FONT=&quot]WHO Nigeria‏Verified account @WHONigeria 22h22 hours ago More


[/FONT]
[FONT=&quot] #Monkeypox Update as of 27th October, 2017
[/FONT]
[FONT=&quot]

[/FONT]
[FONT=&quot] https://twitter.com/WHONigeria
[/FONT]

 

[Pathfinder]

Delta Health Commissioner confirms one monkey Pox case in Delta

By Victor Sorokwu, Asaba | Publish Date: Nov 9 2017 4:53PM

The Delta State Commissioner for Health, Dr Nicholas Azinge has confirmed one case of Monkey Pox in the State.

He said the results of four samples sent to the laboratory are being awaited.
...
He listed the affected Council Areas to include Aniocha South, Ethiope East, Ika North East, Ndokwa East and Sapele Local Government Areas, adding that a total of 45 contact persons were under follow up by relevant authorities and that 16 of such had been completed.
...

https://www.dailytrust.com.ng/delta-health-commissioner-confirms-one-monkey-pox-case-in-delta.html

-------------------------------------------------------------------------------------------------------

Monkey Pox: LG boss warns against eating bush meat

Published November 10, 2017
...
Mukhtar said the call became necessary in view of the dangers associated with monkeypox disease, which remained a threat to the country.
...
?According to experts, the disease is as a result of intake of bushmeat, hence the need to completely avoid it for the sake of our health.?
...
NAN

http://punchng.com/monkey-pox-lg-boss-warns-against-eating-bush-meat/

 

[Shiloh]

Source: http://www.who.int/csr/don/21-december-2017-monkeypox-nigeria/en/

[h=1]Monkeypox ? Nigeria[/h] Disease outbreak news
21 December 2017

On 20 September 2017, WHO was notified of a suspected outbreak of human monkeypox in Bayelsa State. Laboratory investigations have been conducted by the Nigeria Centre for Disease Control (NCDC) National Reference Laboratory, Institut Pasteur de Dakar and the WHO Collaborating Center for orthopoxviruses, the United States Centers for Disease Control and Prevention (US CDC) in Atlanta.
From 4 September through 9 December, 172 suspected and 61 confirmed cases have been reported in different parts of the country. Laboratory-confirmed cases were reported from fourteen states (out of 36 states)/territory: Akwa Ibom, Abia, Bayelsa, Benue, Cross River, Delta, Edo, Ekiti, Enugu, Lagos, Imo, Nasarawa, Rivers and Federal Capital Territory (FCT). Suspected cases were reported from 23 states/territories including: Abia, Adamawa, Akwa Ibom, Bayelsa, Benue, Cross River, Delta, Edo, Ekiti, Enugu, Federal Capital Territory (FCT), Imo, Kaduna, Kano, Katsina, Kogi, Kwara, Lagos, Ondo, Oyo, Nasarawa, Niger, and Rivers.
The majority of cases are male (75%) and aged 21?40 years old (median age = 30 years old). One death has been reported in an immune-compromised patient not receiving anti-retroviral therapy. Clustering of cases has occurred within states, however there is no known evidence of epidemiological linkages across states. Further, genetic sequencing results of the virus isolated within and across states suggest multiple sources of introduction of the virus into the human population. Further epidemiological investigation is ongoing.
[h=3]Public health response[/h] The NCDC has deactivated its Emergency Operations Centre (EOC) and the response will be coordinated by a technical working group comprised of all existing response partners. The NCDC has also deployed rapid response teams (RRTs) to all states with confirmed cases and remote technical support is being provided by the NCDC to the other states. Surveillance, case investigation, and contact tracing are ongoing. The Surveillance and Outbreak Response Management System (SORMAS) was deployed on 4 November 2017 and is being used to enhance data management and real-time mapping of cases and contacts. Case management facilities, including isolation units, have been established and palliative care is being provided. Healthcare workers have been trained in case management and communication to the public regarding the risk of monkeypox has been communicated via mass media, dissemination of key messages, press releases, and media briefings.
[h=3]WHO risk assessment[/h] Monkeypox, a rare zoonosis that occurs sporadically in forested areas of Central and West Africa, is an orthopoxvirus that can cause fatal illness. The disease manifestations are similar to human smallpox (eradicated since 1980), however human monkeypox is less severe. The disease is self-limiting with symptoms usually resolving within 14?21 days. Treatment is supportive. This is the first outbreak in Nigeria since 1978. The virus is transmitted through direct contact with blood, bodily fluids and cutaneous/mucosal lesions of an infected animals (rats, squirrels, monkeys, dormice, striped mice, chimpanzees amongst others rodents) Secondary human-to-human transmission is limited but can occur via exposure to respiratory droplets, contact with infected persons or contaminated materials.
[h=3]WHO advice[/h] During monkeypox outbreaks, respiratory droplets and direct contact with body fluids, skin lesions of patients or objects as clothing recently contaminated by patient secretions or lesion fluids is the most significant risk factor for infection. In the absence of specific treatment or vaccine, the only way to reduce infection in people is by raising public awareness of the risk factors, such as close contact with wildlife animals including rodents, and educating people about the measures they can take to reduce exposure to the virus. Surveillance measures and rapid identification of new cases is critical for outbreak containment. Public health educational messages should focus on the following risks:

• Reducing the risk of animal-to-human transmission. Efforts to prevent transmission in endemic regions should focus on avoiding eating or touching animals that are sick of found dead in the wild. Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues.
• Reducing the risk of human-to-human transmission. People infected with monkeypox should be isolated and infection prevention and control measures should be implemented in healthcare facilities caring for infected patients. Close physical contact with persons infected with monkeypox should be avoided until they have recovered. Gloves, face masks and protective gowns should be worn when taking care of ill people in any setting. Regular hand washing should be carried out after caring for or visiting sick people.

WHO advises against any restriction on travel or trade on Nigeria or the affected areas based on the available information. There is currently a low risk that international travellers would come into contact with monkeypox in Nigeria.
For more information on monkeypox, please see the link below:

• WHO factsheet on monkeypox