AS Nigeria continues to battle with the spread of Mpox, data from the Nigeria Centre for Disease Control (NCDC) reveals that between the first and 35th epidemiological week of 2024, the country has recorded 935 suspected cases, with 55 confirmed.
While the virus has spread across 21 states and the Federal Capital Territory (FCT), affecting 39 local government areas (LGAs), there has been a significant silver lining, with no deaths recorded maintaining a 0.0 per cent case fatality rate (CFR).
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 such as bedclothes.
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.
This year’s data contrasts with that of 2023 when 1,182 suspected cases and 98 confirmed cases were recorded over 52 weeks.
Between that period in review, two deaths were recorded, representing a 2.0% CFR. The reduced death rate in 2024 signals progress, though the high number of cases shows the virus remains a significant threat.
New cases
Data from the centre has further shown that 53 new suspected cases were reported in epidemiological as of September 1, (week 35), which was a slight drop from the 68 cases reported the previous week (34).
Alongside these new suspected cases, five (5) confirmed cases were also recorded in the same week, compared to ten confirmed cases reported in week 34.
Despite these fluctuations, the Mpox outbreak remains a significant public health concern, with experts debating whether it warrants being declared a global public health emergency, given the numbers recorded so far in the Africa region.
However, when compared to the cumulative data for 2023, the data showed a possible surge in 2024, with Nigeria recording 1,182 suspected cases, 98 confirmed cases and two deaths across 25 states and the FCT.
Since September 2017, Nigeria has reported a total of 4,752 suspected cases, with 1,141 confirmed cases spread across 35 states and the FCT.
The virus has claimed 17 lives since its then, predominantly affecting males, who make up around 70 per cent of confirmed cases.
Congo, Morocco, other Africa cases
In the Africa region, the Africa Centres for Disease Control, at least 14 African countries, including previously unaffected nations like Burundi, Kenya, Rwanda, and Uganda, have reported mpox outbreaks.
On September 12, the centre confirmed the first Mpox case in North Africa for 2024, reported by Morocco’s Ministry of Health and Social Protection on 12 September.
This development marks the spread of Mpox across all five African regions since the Africa CDC declaration of PHECS on 13 August 2024
As of the end of week 35 in 2024, Mpox has impacted multiple regions across Africa. A total of 26,544 cases have been reported, including 5,732 confirmed cases and 724 deaths, translating to a case fatality rate (CFR) of 2.73 per cent.
The distribution of cases across African Union (AU) Member States is Central Africa: 23,761 cases (5,588 confirmed); 720 deaths, Eastern Africa: 1,644 cases (19 confirmed); no deaths. Southern Africa: 24 cases (24 confirmed); 3 deaths, Western Africa: 1,114 cases (100 confirmed); 1 death and Northern Africa: 1 confirmed case; no deaths.
Meanwhile, Congo has reported the highest cases of Mpox. Since the start of 2024, DRC has reported over 4,901 confirmed mpox cases, with more than 629 associated deaths,
This, according to Africa CDC, represents a sharp escalation in both infections and fatalities compared to previous years.
Controversies surrounding the declaration of mpox as global health emergency
Following the declaration of the mpox as a global public health emergency, some experts have criticised the move, noting that there is a need to review the present response mechanism.
The declaration followed an outbreak of the viral infection in the Democratic Republic of Congo that has spread to neighbouring countries.
This was as Africa’s top public health body, the Africa Center for Disease Control and Prevention (CDC) warned on Tuesday, August 8, of an alarming rate of spread of the viral infection, which is transmitted through close contact and causes flu-like symptoms and pus-filled lesions.
However, according to a report by Premium Times, a coalition of Civil Society Organisations in a press conference themed “The WHO Declaration of MPOX as a Global Health Crisis: A Civil Society Response,” argued that the outbreak does not meet the criteria of being declared PHEIC.
Edet Williams, one of the speakers quoted in the report stated that “Is the public health impact serious? In terms of the seriousness to morbidity and mortality, is the event unusual or unexpected?” he queried.
Obielumani Ideh, a representative of Doctors’ Health Initiative argued that for the disease to be categorised as PHEIC, it has to be “serious, sudden, unusual or unexpected; carry implications for public health beyond the affected state’s national border, and may require immediate international action.”
Meanwhile, 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 definition, according to WHO, indicates a situation that is serious, sudden, unusual, or unexpected, has public health implications beyond the borders of the affected state, and may require urgent international action.
The Director-General, with input from the Emergency Committee, State Parties, scientific experts, and an evaluation of risks to human health, the international spread of disease, and potential disruption to global travel, makes the final decision on declaring a PHEIC and issues Temporary Recommendations to address the situation.
Nigeria receives 10,000 doses of vaccine
On August 27, the United States, donated 10,000 doses of Jynneos vaccine to Nigeria as part of efforts to combat the spread of mpox in the country.
Jynneos, approved by the U.S. Food and Drug Administration (FDA), is used to prevent smallpox and mpox in adults aged 18 and older who are at risk of infection.
During the official handover ceremony in Abuja, the Coordinating Minister of Health and Social Welfare, Muhammad Pate, a professor, expressed gratitude to the U.S. government for its timely support.
Pate, represented by the Permanent Secretary of the ministry, Daju Kachollom, emphasised the federal government’s commitment to improving the health and well-being of Nigerians.
“This is a spirit of cooperation and collaboration through the years, and this vaccine will be of great help to us. The Federal Ministry of Health understands the importance of having a healthy nation, so all the policies that we implement and the collaborations are focused on ensuring our citizens’ health.
“The minister emphasises that all health matters are important to him, and Nigeria is very fortunate to have such a dedicated Coordinating Minister and Dr Tunji Alausa as the Minister of State for Health. Together, we are transforming the health sector.”
Usman Mustapha is a solution journalist with International Centre for Investigative Reporting. You can easily reach him via: [email protected]. He tweets @UsmanMustapha_M