IN 2024, Nigeria battled a resurgence of monkeypox as the country recorded 1,484 suspected cases and 124 confirmed cases across 28 states and the Federal Capital Territory (FCT) by epidemiological week 44, 2024.
This is according to the latest data released by the Nigeria Centre for Disease Control (NCDC).
Mpox is a viral illness caused by the monkeypox virus, with two distinct clades: Clade I and Clade II. The disease can be transmitted through close contact, such as sex, skin-to-skin contact, and talking or breathing close to another person.
While the exact reservoir of monkeypox is still unknown, the virus can spread both from animal to human and from human to human with transmission occurring when a person comes into contact with the virus from an infected animal, human, or materials contaminated with the virus.
The virus enters the body through broken skin (even if not visible), the respiratory tract, or the mucous membranes of the eyes, nose, or mouth.
Symptoms of the disease usually include an acute illness with fever >38.3°C, intense headache, lymphadenopathy, back pain, myalgia, and intense asthenia, followed by a progressively developing rash often beginning on the face and then spreading elsewhere on the body and soles of feet and palms of the hand.
According to the NCDC, children between ages zero to five are mostly affected by the mpox disease outbreak in the country.
The 2024 data contrasts with that of 2023 when 1,182 suspected cases and 98 confirmed cases were recorded over 52 weeks.
But despite the spike in infections, no fatalities have been reported this year, offering a glimmer of hope compared to previous outbreaks that were accompanied by deaths in 2022 and 2023.
The virus, however, remains a significant health concern, with experts warning about its potential to disrupt public health and economic activities.
Nigeria’s mpox outbreak is the largest in West Africa this year, with confirmed cases concentrated in urban centres like Lagos, Ogun, and Rivers states. On Gender distribution, males account for 63 per cent of confirmed cases, while females make up 37 per cent.
The most affected demography is individuals aged 21–35 years, the backbone of the country’s workforce.
This demographic breakdown suggests a significant impact on the working-age population, with potential socio-economic implications. While the virus has been endemic in Nigeria since 2017, the scale of the 2024 outbreak was higher.
Lagos tops cases
Lagos, Ogun, Rivers, and Delta states reported confirmed cases during the most recent week, with Lagos accounting for three of the six cases reported.
NCDC data shows that mpox cases have steadily risen in the past three years. In 2022, the country recorded 762 confirmed cases and seven deaths. The following year, the numbers dropped to 98 confirmed cases and two deaths, but 2024 saw an alarming rise in suspected cases despite no reported deaths.
Regional epidemic
Nigeria’s outbreak is part of a larger epidemic sweeping across Africa, where the disease has been declared a public health emergency. The Africa Centres for Disease Control and Prevention (Africa CDC) reports over 37,000 cases across 15 African Union Member States (AUMS), with nearly 1,500 deaths since the beginning of 2022 and as of 28 July 2024.
In 2023 alone, 14,957 cases and 739 deaths (CFR: 4.9 per cent) were reported from seven AUMS. This is a 78.5 per cent increase in the number of new cases compared to 2022.
However, in its 2025 report, the WHO’s external situation report noted that across Africa, 14,700 confirmed cases and 66 deaths of mpox cases were reported between January 2024 and January 2025.
Central Africa, particularly the Democratic Republic of Congo (DRC), remains the epicentre, contributing over 4,900 confirmed cases and nearly 629 fatalities. Uganda and Burundi also face significant challenges, with 1,552 and 3,035 confirmed cases reported, respectively.
The disease has further spread beyond endemic zones, with Rwanda and Kenya recording smaller clusters of infections. Travel-related cases from affected African countries have been detected globally, highlighting the transnational nature of the epidemic.
In response to this crisis, the World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC) in August 2024.
The WHO in the IHR (2005) defines, a PHEIC as “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”.
The WHO’s criteria emphasise the seriousness, suddenness, and cross-border implications of the situation, prompting the director-general, alongside an emergency committee, to issue temporary recommendations to guide the global response.
Vaccine access challenges
In response to the outbreak, Nigeria launched its vaccination campaign in November 2024 after receiving 10,000 doses of the Jynneos vaccine from the United States.
The campaign targeted three priority groups: frontline healthcare workers, close contacts of mpox cases, and people living with HIV. However, the limited vaccine supply has drawn criticism, with many saying the vaccines were grossly inadequate for a population of over 200 million.
According to ACDC, vaccinations were administered at three sites in each of the selected states, including FCT, Bayelsa, Enugu, Akwa Ibom, Rivers, and Cross River.
The logistical complexities of the cold chain requirements, coupled with Nigeria’s large population, demanded meticulous planning in terms of time, scope, and budget, according the agency’s National Coordinator in Nigeria, Oluyinka Olayemi.
The Africa CDC has pledged to deliver 10 million Mpox vaccine doses by 2025, which marks a significant commitment to strengthening health security across the continent.
Vaccination is an essential component of a comprehensive mpox response strategy, alongside timely testing and diagnosis, effective clinical management, infection prevention measures, and active community engagement. Vaccines are particularly crucial for curbing transmission and controlling outbreaks, according to WHO.
Usman Mustapha is a solution journalist with International Centre for Investigative Reporting. You can easily reach him via: umustapha@icirnigeria.com. He tweets @UsmanMustapha_M