Monkeypox: Expert seeks active surveillance in communities

An infectious diseases Expert, Dr Iorhen Akase, says there is the need for an active surveillance and search for suspected cases of monkeypox in communities to reduce the spread of the disease. 

Akase, Head of Infectious Diseases Unit, Department of Medicine, Lagos State University Teaching Hospital (LUTH), made the plea in an interview with the News Agency of Nigeria (NAN) on Wednesday in Lagos.

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals), with symptoms similar to those seen in smallpox patients, although it is clinically less severe.

It typically presents clinically with fever, rashes and swollen lymph nodes and may lead to a range of medical complications.

Akase said that the identification of suspected and confirmed cases of monkeypox should extend beyond cases that present at hospitals for treatment.

“We say monkeypox is endemic in Africa, but we don’t know the number of cases happening in Nigeria at the moment.

“We are not actively looking for the cases; looking for it means we have laboratory capacity and taking samples, which we are not doing, because someone has to pay for those samples to be tested.

“Since we know that the disease is endemic; that means it’s going on in communities, but we aren’t picking them.

“Surveillance goes beyond someone being sick and coming to the hospital for treatment.

”It means, go into the communities, take samples from people who are well and unwell.

“Identify the communities who have risk factors, identify the animals transmitting the virus,” he said.

According to him, active surveillance will assist map out the hotspots, species in the country, population group affected and factors facilitating the spread in communities.

“What’s the exposure pattern like? Is it among hunters, health workers, or laboratory workers? Who are those driving the transmission within communities?

“Without these data, it would be difficult for the country to respond appropriately to the outbreak of this viral infection,” he said.

Akase said that COVID-19 had shown that infection anywhere puts the whole world at risk.

He explained that countries in Europe and North America had also reported cases of monkeypox outbreak.

“Some of the reported cases did not have linkage to Africa or animals, but now through person to person exposure, including sexual intercourse.

“Clearly, we should be concerned, not afraid; and know that we have to put structures in place to counter this outbreak,” he said.

He averred that the effect of the monkeypox outbreak extends beyond hospitalisation.

Akase said that the impact would drain resources, put additional strain on health systems, travels and tourism, among others.

The physician assured that monkeypox is not as fatal as COVID-19 and other viral infections.

He, however, urged that measures should be taken to prevent infection from the virus.

Akase said the measures include: Avoiding contact with animals that could harbour the virus, as well as any material that had been in contact with a sick animal.

He also emphasised the importance of maintaining good hand hygiene practice to prevent infections.

According to the Nigeria Centre for Disease Control (NCDC), from September 2017 to April 30, 2022, some 558 suspected cases of monkeypox were reported from 32 states in the country.

Out of these, 241 were confirmed cases, and eight deaths were recorded.

Also, 46 suspected cases were reported in 2022, of which 15 were confirmed from seven states, and no fatality had been recorded.

According to the World Health Organisation (WHO), monkeypox is most common in remote parts of Central and West Africa and occasionally exported to other regions.

Outside Africa, 20 countries have declared 237 confirmed and suspected cases of monkeypox and health authorities around the world have announced plans to contain the virus.

WHO said vaccines used during the smallpox eradication programme provide protection against monkeypox, and one newly-developed vaccine had been approved for prevention of monkeypox.

It said that the virus could be contained with the right response in countries outside of Africa where it is not usually detected.

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