Containing Mpox

IN a sad development, Nigeria is currently being threatened by the Monkey pox (Mpox), a virus that is on the loose in sub-Saharan Africa. The Mpox is an infectious viral disease that occurs in human beings and animals and can be transmitted through close contact, including sexual activities. The list of cases is growing in Nigeria and in fact the international credit ratings firm, Fitch, has said that the Mpox outbreak could hurt economic activities in African countries and weaken their fiscal positions. In a recent commentary, the ratings firm said that a potential acceleration in the spread of Mpox in sub-Saharan Africa could raise the risk of the virus and efforts to curb its impact could hurt economic activities and weaken fiscal metrics in the affected sovereigns,  in addition to the suffering of those affected. It however noted that any fiscal impact under such a scenario would probably be partially offset by additional financing from donors, officials and multilateral partners. According to the National Agency for control of HIV/AIDS, people living with HIV/AIDS are at higher risk of Mpox infection because of their compromised immune systems.

Across Africa, there has been a rapid increase in Mpox cases. According to Dr. Jean Kaseya, head of the Africa Centre for Disease Control and Prevention (NCDC), 81 deaths were reported in Africa penultimate week, bringing the total number of cases to 22,863 and 622 and deaths respectively. Last week, there were nearly 4,000 reported cases. This was as the most affected country, Congo, bemoaned the non-arrival of the long-awaited vaccines. Last week, the Nigeria Centre for Disease Control (NCDC) reported that it had recorded a total of 48 confirmed cases of Mpox out of the suspected 868 cases across the country. It said: “Fifty-seven new suspected cases were reported in Epi week 34, 2024, compared with 25 cases reported in the previous week (Epi week 33). Eight confirmed cases were reported in week 34 compared with one (1) confirmed case reported in week 33, 2024. Twenty states and the FCT have recorded at least one confirmed case across 35 local government areas in 2024.” Happily, though, the United States government, through the United States Agency for International Development (USAID), has donated 10,000 doses of the vaccines to the Nigerian government to support its efforts in responding to the current mpox outbreak. Ambassador Richard Mills, who led the U.S. delegation, said: “We are pleased to know that this is a timely donation that will reach the affected areas across the country and those who are most vulnerable to the Mpox infections. We encourage the Nigerian government to act more to mobilise domestic resources to secure more vaccines to combat Mpox  Nigeria is actually the first African country to receive the vaccines. The National Primary Health Care Development Agency (NPHCDA) has said it will begin the Mpox vaccination on October 2024.

To say the least, the situation is precarious. It is bad enough that Nigeria is the global capital of poverty, open defecation, out-of-school children and worst electricity access. Adding a growing Mpox scourge into the mix when the country is still battling malaria, tuberculosis, Lassa fever and meningitis, is portentous. Between  October 2023 and March this year,  Nigeria recorded an outbreak of Neisseria meningitidis (meningococcus) serogroup C outbreak that led to 1742 suspected meningitis cases, including 101 confirmed cases and 153 deaths in Gombe, Yobe,  Jigawa, Adamawa, Bauchi,  Katsina and Zamfara states. Commendably, though, the government responded with a vaccination campaign in March with the aim of initially reaching more than a million people aged 1-29 years. It is also worthy of note that in the present instance, as in others, the NCDC has been up and doing, providing weekly updates and mounting advocacy campaigns. It has, in fact, provided a checklist of measures to contain the virus. These include ensuring that all animal food products are properly cooked before eating, using appropriate protective clothing and gloves while handling sick animals or their infected tissues and during slaughtering procedures, and reporting all cases with the associated symptoms mentioned above to the nearest health facility for care, and/or call the NCDC toll-free line on 6232. It further advised healthcare workers to always follow standard safety measures, including precautions against droplets, regardless of their diagnosis when caring for patients, as these steps will protect both patients and healthcare workers.

Other preventive measures are to wash hands with soap and water after contact with patients and/or their environment, and maintain a high index of suspicion for Mpox, especially for patients presenting with fever and vesicular/pustular rash in all parts of the country at this time. During triage, health workers are to use precautionary measures such as placing a surgical mask over the nose and mouth of suspected patients and covering any exposed skin lesions with a sheet or gown; isolate all patients suspected of having Mpox as soon as possible, and wear personal protective equipment before close contact with suspected cases and dispose of it properly. They are to correctly disinfect all contaminated equipment (including bedding) using bleach unless otherwise indicated, and dispose of all waste properly, and report all cases to the State Epidemiologist/LGA Public Health Department immediately or call the NCDC toll-free line at 6232. The recommendations are indeed timely and appropriate, but whether they have the required dissemination is another question.

The government certainly has a compelling reason to mount a comprehensive campaign to defeat the Mpox outbreak. Vaccination is an effective measure for high-risk groups and individuals of 18 years of age. Older people are also at high risk for Mpox infection and are better off taking the vaccine, which is two doses for people who have never received smallpox vaccine and a single booster for those previously vaccinated. The government should act fast, treat the Mpox outbreak as an emergency, and deploy the structures used to contain COVID-19. It will be utterly foolish to continue contending with another epidemic in the face of the acute hunger in the land.

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