ALREADY ravaged by several other deadly diseases, the report of 46 cases and one death arising from the monkeypox virus this year adds to Nigeria’s daunting health challenges. As of May 29, said the Nigeria Centre for Disease Control, 21 of the cases had been confirmed, occurring in nine states and the Federal Capital Territory. The only death was that of a 40-year-old patient who had a prior underlying sickness. The federal and state governments need to activate their anti-disease mechanisms to contain this and other diseases.
Nigeria is engaged in health wars on multiple fronts, assisted by poor health infrastructure, insufficient investment in healthcare, inaccessibility of quality health services and a stagnating health workforce. Across the country, diseases are spreading. These include Lassa fever, cholera, and measles. It has been caught up also in the COVID-19 pandemic. Recently, monkeypox too announced its fearsome presence.
Described by the World Health Organisation as a sylvatic zoonosis with incidental human infections, it usually occurs in forested parts of Central and West Africa. The disease is caused by the monkeypox virus. It is transmitted by one person to the other by droplet exposure via exhaled large droplets, and by contact with infected skin lesions or contaminated materials.
The usual incubation period of monkeypox is six to 13 days, or five to 21 days;the disease is often self-limiting with symptoms usually resolving spontaneously within 14 to 21 days. Symptoms can be mild or severe, and lesions can be very itchy or painful. The animal reservoir remains unknown, although rodents are prime suspects. Contact with live and dead animals through hunting and consumption of wild game or ‘bushmeat’ are known risk factors.
The NCDC says Nigeria has been having sporadic incidents of monkeypox since2017: 88 cases were confirmed that year. In 2018, there was a decline with 49 confirmed cases; 47 cases were reported in 2019.In 2020, only eight cases were reported, but 34 confirmed cases were reported in 2021.
Of the cases reported so far this year, 15 occurred in six states and the FCT – Adamawa (three), Lagos (three), Cross River (two), FCT (two), Kano (two), Delta (two), and Imo (one).
It is a global scourge. By June 1, the Director-General of the WHO, Tedros Ghebreyesus, said 550 confirmed cases had been reported in 30 countries where the virus is not endemic. While it is endemic in Central African Republic, Congo DR, Nigeria, and Cameroon and in several other countries, it is making its malignant debut in the United States, the United Kingdom, Canada, Israel, and Italy, among others. Global health authorities are yet to identify the cause of the recent surge in infections. But some countries are not waiting.The US and Canada have already begun investigations into the cause of the latest outbreak. Nigeria should ramp up its collaboration with the WHO and other countries to tap from the emerging pool of knowledge.
The WHO recommends strengthening surveillance and ending its transmission. It said, “We’re in a situation where we can use public health tools of early identification, supported isolation of cases. We can stop human-to-human transmission.” The NCDC and the federal and state health authorities should take that message seriously. They should step up awareness programmes and activate anti-epidemic procedures at every level. The country’s health system is already stretched fighting COVID-19, measles, Lassa fever, cholera, and the ubiquitous malaria.
In May, the UK linked a confirmed case of the monkeypox on its soil to Nigeria. This adds to Nigeria’s worries, suggesting a possible spread at home and the possibility of foreign countries imposing another round of travel restrictions or stringent entry requirements onNigerian travellers. The Director-General of the NCDC, Ifedayo Adetifa, insists that there is so far no widespread outbreak in the country yet. Already, among other measures, China has issued alerts to all its entry points, stepped up checks at airports and arrangements for testing, Xinhua news agency reported.
Nigeria Should not repeat the carelessness of its government and officials that allowed coronavirus to enter the country despite weeks of advance warning to put proactive preventive firewalls in place. Between the first reported COVID-19 case in February 2020 and June 2, Nigeria recorded 256,202 confirmed cases and 3,143 deaths. The country endured full or partial lockdowns in its most productive states and spent billions combating the disease and providing services to ameliorate its impact. Such blunders, including failure to procure, store and make adequate arrangements to administer vaccines, should be avoided. Last month, the European Centre for Disease Prevention and Control rolled out a raft of measures, including isolation of suspected cases, stockpiling of smallpox vaccine and community-based awareness campaign.
Although scientists have ruled out general vaccination for now, governments should promptly acquire drugs and isolation centres to manage monkeypox. The habit of relying almost entirely on donor intervention should be stopped.
There is no single proven cure for monkeypox yet, but experts recommend using the drugs used to treat smallpox and other remedies. Some doctors put much hope that the smallpox vaccine will be effective against monkeypox.
The government should urgently heighten surveillance response and ensure the adequacy of all necessary medications. It should not wait for a drastic surge in the number of cases and deaths but a set up a similar, but smaller task force to the Presidential Steering Committee on COVID-19 to coordinate the anti-monkeypox fight.
States reporting cases should take containment measures while those free of the disease should mount effective surveillance to keep it out.Government at all levels should partner with other agencies, religious bodies, communities, and the media to ensure that citizens are informed and sensitised on the monkeypox disease.
Citizens should learn to take responsibility for their health by observing all hygiene and anti-disease protocols. The NCDC advice to avoid eating bushmeat should be taken seriously, while ensuring that foods are properly cooked, hands are washed regularly, and the use of hand sanitisers sustained.
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