Nigeria - 2018 Monkeypox

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Suspected monkeypox patient admitted in Jos hospital ? Official

May 15, 2018Andrew Ajijah

A patient suspected to have been infected by monkeypox disease has been admitted into the Bingham University Teaching Hospital Jos, Plateau State, a missionary-owned teaching hospital.

The Plateau State commissioner for health, Kuden Kamshak, confirmed the incident to journalists in Jos on Tuesday, adding that the patient was still being treated as a suspected case of the disease.

?Blood samples of the suspected patient have been sent to Abuja for examination, to confirm whether or not it is monkeypox.? Mr Kamshak explained.

He added that ?the results of the lab tests are still being awaited.?
...
https://www.premiumtimesng.com/heal...atient-admitted-in-jos-hospital-official.html

 

[Shiloh]

Source: https://www.healthnews.ng/nigerias-monkeypox-outbreak-hits-15-states/


Nigeria?s Monkeypox outbreak hits 15 states
By David Arome on September 24, 2018
Latest report by the Nigeria Center for Disease Control (NCDC) disclosed that a total of 15 states across the country have been hit by the country?s latest Monkeypox outbreak.

Data showed 76 cases of the disease have been reported in 2018 out of which 37 have been confirmed resulting in one probable and two deaths. NCDC?s report showed the worse hit by the outbreak are males within the age group of 21- 40 years with median age of 31.

The states affected are; River, Akwa-Ibom, Bayelsa, Cross River, Delta, Edo, Enugu, Imo, Lagos, Nasarawa, Oyo, Abia, Anambra, Plateau and the Federal Capital Territory (FCT), Abuja.

Of all the states affected, Rivers accounted for with 34 cases, Bayelsa (20) and Cross River (9). The report also identified a cluster of six suspected cases with epidemiological link to a United Kingdom (UK) case in Rivers...

 

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Outbreaks and Emergencies Bulletin, Week 39: 22 - 28 September 2018
...

Nigeria
269
Cases
7
Deaths
2.6%
CFR

EVENT DESCRIPTION
Since September 2017 Nigeria has been experiencing a large and
sustained outbreak of monkeypox. Although there has been a significant
decline in case incidence since the peak of the outbreak in week 41 of
2017 (week starting on 8 October 2017), sporadic cases have continued
to be reported monthly until now.

Recently, two imported and confirmed cases of monkeypox were reported
in the United Kingdom on 7 and 11 September 2018 (weeks 36 and 37,
respectively). Both cases were linked to the ongoing ou tbreak in Nigeria
through their travel history and the identification of the West African
monkeypox clade as an etiological agent. On 26 September 2018 (week
39), the United Kingdom reported its third confirmed case of monkeypox
in a healthcare worker who had been caring for one of the two imported
cases. A cluster of six suspected cases, with epidemiological linkages
to one of the first two cases reported in the United Kingdom has been
identified in Rivers State, Nigeria. Of these one has been confirmed
positive for monkeypox and is currently in isolation. In addition, two new
confirmed cases have been recorded in Rivers State, but they are not
linked to the cluster described above.

Since the beginning of the outbreak and as of 15 September 2018, a
cumulative total of 269 cases were reported from 27 States in Nigeria. Of
these, 115 cases were confirmed, including seven deaths, four of which
occurred in patients with a pre-existing immune-compromised condition.
In 2018, there has been a total of 76 cases, including 37 confirmed, one
probable and two deaths; all reported across 15 states (Rivers, AkwaIbom,
Bayelsa, Cross River, Delta, Edo, Enugu, Imo, Lagos, Nasarawa,
Oyo, Abia, Anambra, Plateau) and the Federal Capital Territory.
The outbreak mostly affected adults between 21-40 years (median age:
31 years) and males represented 79% of confirmed cases. Two healthcare
workers were identified among confirmed cases. The highest number
of confirmed cases was reported from Rivers (34 cases), Bayelsa (20
cases) and Cross River (9) states.
To date, no epidemiological linkage has been identified between states.
Genetic sequencing suggests multiple sources of introduction of
monkeypox virus into the human population.
...
SITUATION INTERPRETATION
Monkeypox is a re-emerging disease in Nigeria. Before the latest outbreak which started in September 2017, the last monkeypox case was reported in 1978. The current multistate outbreak in Nigeria is the largest reported monkeypox outbreak caused by a West African clade. Since the West African clade is associated with limited human-to-human transmission, the sudden re-emergence and persistence of this large-scale outbreak suggests that the main route of infection is through contact with infected wildlife animals (e.g. squirrels, rodents and monkeys). Additional sporadic imported cases may be expected among travellers returning from endemic areas/ countries. The secondary transmission which occurred in the United Kingdom further illustrates the importance of monitoring and sharing information on monkeypox in endemic countries or countries with re-emergence, in order to raise awareness and improve control measures. Since 2017, seven countries from the African region have reported monkeypox cases (Cameroon, Central Africa, Congo, DRC, Liberia, Nigeria and Sierra Leone). Local and national authorities need to remain vigilant.

http://apps.who.int/iris/bitstream/h...2228092018.pdf

https://afro.who.int/publications/ou...september-2018

 

[Shiloh]

Source: http://www.who.int/csr/don/05-october-2018-monkeypox-nigeria/en/
[h=1]Monkeypox ? Nigeria[/h] Disease outbreak news
5 October 2018

On 26 September 2017, WHO was alerted to a suspected outbreak of monkeypox in Yenagoa Local Government Area (LGA) in Bayelsa State, Nigeria. The index cluster was reported in a family. All of whom developed similar symptoms of fever and generalized skin rash over a period of four weeks. Epidemiological investigations into the cluster show that all infected cases had a contact with monkey about a month prior to onset.
From the onset of the outbreak in September 2017 through 15 September 2018, a total of 269 suspected cases across 25 states and one territory, including 115 confirmed cases across 16 states and one territory, have been reported. Seven deaths were recorded, four of which were in patients with a pre-existing immunocompromised condition. Two health care workers were among the confirmed cases. The most affected age group is 21?40 years and 79% of the confirmed cases are males.
In 2018, a total of 76 cases have been reported, 37 are confirmed, one probable and two deaths. These cases were reported in 14 states and one territory (Abia, Akwa-Ibom, Anambra, Bayelsa, Cross River, Delta, Edo, Enugu, Imo, Lagos, Nasarawa, Oyo, Plateau and Rivers and the Federal Capital Territory (FCT)).
Genetic sequencing suggests multiple introductions of the monkeypox virus (MPXV) into the population with evidence of human to human transmission. The isolates are closely related to the West African, Nigerian 1971 strain.
Since 2016, the other West and Central African countries reporting sporadic confirmed monkeypox cases are Central African Republic, Cameroon, Democratic Republic of the Congo, Liberia, Nigeria, Republic of the Congo, and Sierra Leone (Figure 1).
[h=4]Figure 1: African countries reporting human and animal monkeypox cases from 2010 through 2018.[/h]

[h=3]Public health response[/h] The Federal Ministry of Health through the Nigeria Centre for Disease Control (NCDC) in collaboration with the State?s Ministry of Health and WHO are investigating suspected cases and monitoring contacts. Enhanced surveillance is ongoing in all states especially in the most affected states and in the FCT. In addition, a national interim monkeypox guideline has been reviewed and a regional monkeypox training is scheduled to commence in October 2018.
Animal surveillance will commence in October 2018 in collaboration with the United States Centers for Disease Control and Prevention. This will begin with a training in a wild life sanctuary and subsequently in some affected states.
[h=3]WHO risk assessment[/h] Monkeypox is a sylvatic zoonosis with incidental human infections that occur sporadically in the rain forests of Central and West Africa. It is caused by the MPXV and belongs to the Orthopoxvirus family, the same group of viruses as smallpox.
Two distinct MPXV clades exist; the Congo Basin and West African. There are differences in human pathogenicity between these two clades in clinical presentation and epidemiological characteristics. The animal reservoir remains unknown, however, evidence suggests that native African rodents may be potential sources. Direct contact with affected live and dead animals through hunting and consumption of bush meat are presumed drivers of human infection. The disease is self-limiting with symptoms usually resolving spontaneously within 14?21 days. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and severity of complications. The case fatality rate has varied widely between epidemics but has been between 1?10% in documented events. There is no specific treatment or vaccine for the MPXV infection.
[h=3]WHO advice[/h] Residents and travellers to endemic areas/ countries should avoid contact with sick, dead or live animals that could harbor MPXV (such as rodents, marsupials, and primates) and should refrain from eating or handling bush meat. The importance of hand hygiene using soap and water or alcohol-based sanitizer should be emphasized. Any illness during travel or upon return should be reported to a health professional, including information about all recent travel and immunization history.
Health care workers caring for patients with suspected or confirmed MPXV infection should implement standard, contact and droplet infection control precautions.
Samples taken from people and animals with suspected MPXV infection should be handled by trained staff working in suitably equipped laboratories.
Timely contact tracing, surveillance measures and raising awareness of imported emerging diseases among health care providers are essential parts of preventing secondary cases and effective management of MPXV outbreaks.
WHO does not recommend any restriction for travel to and trade with Nigeria based on available information at this point in time.
For more information on Monkeypox:

• WHO factsheet on monkeypox

 

[Shiloh]

TITLE: NIGERIA MONKEYPOX MONTHLY SITUATION REPORT
SERIAL NUMBER: 028
DATE:
November 14 - December 13, 2018
OUTBREAK INDICATORS FOR 2018
KEY INDICATORS
NUMBERS
New suspected cases in reporting month - 15
New confirmed cases in reporting month - 6
Total number of cases reported in 2018 - 114
Total confirmed cases in 2018 - 45
Total deaths in 2018 - 1
Confirmed Health worker infections - 2

More at: https://ncdc.gov.ng/themes/common/files/sitreps/caf5c2b9257563dfee0b55cee9a756d8.pdf