By Derrick Bangura

The Nigeria Center for Disease Control (NCDC) said it has activated a national multisectoral Emergency Operations Centre for Monkeypox (MPX-EOC) at level 2 to strengthen and coordinate ongoing response activities in-country.

It said that genomic surveillance is ongoing at NCDC’s National Reference Laboratory in Abuja and so far all of the cases have been confirmed to be caused by the West African clade Monkeypox virus.
A statement issued by the center Sunday night said that the measure was based on the report of a preliminary risk assessment done by a group of Subject Matter Experts from the NCDC, relevant government Ministries Departments Agencies, and partner agencies.

According to the statement obtained from the website of the NCDC, it said that: “0n 26th May 2022, the Nigeria Centre for Disease Control and Prevention (NCDC) activated a national multisectoral Emergency Operations Centre for Monkeypox (MPX-EOC) at level 2 to strengthen and coordinate ongoing response activities in-country while contributing to the global response. This was based on the report of a preliminary risk assessment done by a group of Subject Matter Experts from the NCDC, relevant government Ministries Departments and Agencies, and partner agencies”.

It said that, as of 29th May 2022, a total of 21 confirmed cases with one death have been reported from 9 states and the FCT – Adamawa (5), Lagos (4), Bayelsa (2), Delta (2), Cross River (2), FCT (2), Kano (2), Imo (1), Rivers (1). The death was reported in a 40-year-old patient who had underlying co-morbidity and was on immunosuppressive medications. NCDC said that genomic surveillance is ongoing at NCDC’s National Reference Laboratory in Abuja and so far all of the cases have been confirmed to be caused by the West African clade Monkeypox virus. The May 2022 Monkeypox situation report can be assessed.

Among the 21 cases reported in 2022 so far, there has been no evidence of any new or unusual transmission of the virus, nor changes in its clinical manifestation documented (including symptoms, profile, and virulence).

Before the activation of the MPX-EOC, a multi-agency Technical Working Group (TWG) coordinated at the NCDC led Nigeria’s efforts to improve the detection, prevention, and control of Monkeypox. Nigeria’s national surveillance system, the Surveillance Outbreak Response Management and Analysis System (SORMAS) were first deployed in response to the 2017 Monkeypox outbreak to improve the timeliness and completeness of case reporting, as well as facilitate the overall response.

In addition, it said that the pilot project informed the nationwide scale-up of FORMAS to enable real-time reporting of surveillance data for prompt public health response to infectious disease outbreaks including COVID-19.

“Following the detection of the index case on September 22, 2017, and the effective containment of the 2017 outbreak in Nigeria, the NCDC through the Monkeypox TWG worked on various interventions to gain a better understanding of the epidemiology of the virus to inform preparedness and response in-country.

“The TWG coordinated the development of national Monkeypox guidelines, capacity building of healthcare workers and surveillance officers on case detection, sample collection, laboratory testing for confirmation and sequencing of the virus at NCDC’s National Reference Laboratory, and intensified public awareness through risk communication.

“Furthermore, a national One-health risk surveillance and information sharing (NOHRSIS) group has been inaugurated to facilitate timely information exchange on all prioritized zoonotic diseases. NOHRSIS will also strengthen the collaborative efforts of the One health/IHR Unit at the Point of Entry to intensify surveillance for the disease in animals as well as ensure minimal contact with suspected animals.

In addition, the One Health Animal Surveillance team including the Federal Ministry of Agriculture and Rural Development, the Federal Ministry of Environment, the National Veterinary Research Institute, and partners commenced operational research on Monkeypox virus prevalence in small mammals at the human-animal interface in October 2018. This research has been completed in 7 states with a planned rollout in all other states to commence soon.

According to NCDC, although Nigeria’s risk of exposure to the Monkeypox virus is high based on the recent risk assessment conducted at NCDC, the current situation in-country and globally has shown no significant threat to life or the community that can result in severe disease or high case fatality rate. The EOC will continue to monitor the evolving situation to inform public health action accordingly.

Symptoms of monkeypox include sudden fever, headache, body pain, weakness, sore throat, enlargement of glands (lymph nodes) in the neck and under the jaw, followed by the appearance of a rash (often solid or fluid-filled at the onset) on the face, palms, soles of the feet, genitals and other parts of the body.

The NCDC emphasizes that members of the public should remain aware of the risk of Monkeypox and adhere to public health safety measures – specifically, report to the nearest health facility if you notice the known signs and symptoms of the disease. Healthcare workers are to maintain a high index of suspicion for Monkeypox and report any suspected case to the relevant state Epidemiology Team for prompt public health intervention including sampling for confirmatory testing.