Monkeypox and memories of Ebola Virus Disease

The news first hit the airwaves last Tuesday, where it was initially described as a “strange disease,” while some said it was either chicken pox, or smallpox, which was eradicated world-wide in 1980.

However, by Wednesday, no fewer than 10 people in Bayelsa State had been struck (among them a medical doctor), by the ailment, which was latter identified as monkeypox.

According to the World Health Organisation (WHO), monkeypox is a rare disease that occurs primarily in this part of the world.

Like the Ebola Virus Disease (EVD) before it, monkeypox is beginning to dominate discussions in different parts of the country, as if the days following the outbreak of Ebola are here again, even as government tries to douse tension that it may not be as deadly as the dreaded EVD after all. Both diseases seem to have the same origin and seem to spread along the same route.

The human monkeypox, according to WHO, was first identified in humans in 1970 in the Democratic Republic of Congo (then known as Zaire) in a nine-year-old boy in a region where smallpox had been eliminated in 1968.

Since then, majority of cases have been reported in the rural, rainforest regions of the Congo Basin and western Africa, particularly in the Democratic Republic of Congo, where it is considered to be endemic. In 1996-97, a major outbreak occurred in the Democratic Republic of Congo.

In 2005, a monkeypox outbreak occurred in Unity, Sudan, and sporadic cases have been reported from other parts of Africa. In 2009, an outreach
campaign among refugees from the Democratic Republic of Congo, into the Republic of Congo identified and confirmed two cases of monkeypox.

Between August and October 2016, a monkeypox outbreak in the Central African Republic was contained with 26 cases and two deaths.

The Nigerian Centre for Disease Control (NCDC) in its reaction to the outbreak, explained that monkeypox is also not exactly new in the country, having previously been reported in the 1970s.

The disease was also discovered in the Midwest of the United States of America, in 2003, marking its first reported occurrence outside of the African continent.

On the other hand, the outbreak of Ebola was first reported in 1976, in simultaneous outbreaks- one in Yambuku, Democratic Republic of Congo, and the other in Nzara, South Sudan.

The first occurred in a village near the Ebola River, from which the disease takes its name. It later spread to West African countries from 2014–2016.

Nigeria has been at the receiving end of the two diseases.

There are, however, more deadly similarities between Ebola and monkeypox. They are both fatal illness in humans, though fatality cases in Ebola is far higher.

While the fatality rate in an average Ebola case is around 50 per cent, varying from 25 per cent to 90 per cent in past outbreaks, the fatality rate in cases of monkeypox has been between one and 10 per cent, with most deaths occurring in younger age groups.

They are both transmitted to people from wild animals, and spread in the human population through human-to-human transmission, even though monkeypox is reported to have limited secondary spread through human-to-human transmission.

The somewhat good news, however, is that while there is no vaccine or known treatment for both Ebola and monkeypox, the WHO says prior smallpox vaccination, is highly effective in preventing monkeypox.

As was the case during the Ebola days in the country, the NCDC and the Bayelsa Ministry of Health have set up an isolation centre in the state, while the government, realising how effective public enlightenment campaign helped to stop Ebola on its deadly track, has come up with more information about the emergence of monkeypox in the country, and how it can be prevented.

What is worrisome to many at times like this, is the fact that the country still has to depend on WHO and even foreign countries for the diagnosis, or confirmation of some emerging ailments such as monkeypox.

Indeed, as at last Friday, the cases in Bayelsa were still being referred to as suspected monkeypox cases, as confirmation was still being awaited from the WHO in Dakar, Senegal.

The Minister of Health, Prof. Isaac Adewole, said in a press statement last Thursday that the current outbreak in Bayelsa could not be confirmed until investigation at the WHO lab gets to him.

So far, health officials seem to have agreed, based on the symptoms, that the country is dealing with an outbreak of monkeypox.

For now, as was the case during the Ebola outbreak, it is goodbye again to bush meat for Nigerians, as they are urged to adopt healthy habits and generally become health conscious.

The NDCD in a statement, urged citizens to avoid contacts with animals such as squirrels, rats and  monkeys, especially animals that are sick, or found dead in areas where monkeypox occurs.

“The public is advised to always wash hands with soap and water after contact with animals, or when caring for sick relatives, humans or soiled beddings.

“Nigerians are advised to remain calm and supportive of public health authorities, avoid self-medication and report to the nearest health facility if they feel unwell, or notice any of the above symptoms in anyone around them.

“Healthcare workers are strongly advised to practice universal precautions while handling patients and/or body fluids at all times. They are also
urged to be alert, be familiar with the symptoms and maintain a high index of suspicion. All suspected cases should be reported to the local government area, or state Disease Surveillance and Notification Officers,” the statement said.