Epi Curve of Suspected & Confirmed Monkeypox Cases In Nigeria (2022)
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In the fall of 2017, Nigeria saw their first confirmed Monkeypox outbreak in nearly 40 years, resulting in more than 200 confirmed and suspected cases. While that outbreak was reportedly quelled in February of 2018, a small number of isolated cases have continued to be reported over the past 5 years.
Given the number, and frequency, of exported cases reported among recent travelers from Nigeria (see here, here, here, here, and here) around the world, the assumption has been that Monkeypox is likely spreading more vigorously in the region than local surveillance might suggest.
Fortunately, the West African Monkeypox virus is considered to be less virulent, and less easily transmitted, than its Central African counterpart (cite). But at the same time, infectious disease experts were warning that the dangers from Monkeypox were increasing (see EID Journal: Reemergence of Human Monkeypox and Declining Population Immunity - Nigeria, 2017–2020).
The name `monkeypox’ is a bit of a misnomer. It was first detected (in 1958) in laboratory monkeys, but further research has revealed its host to be rodents or possibly squirrels. Humans can contract it in the wild from an animal bite or direct contact with the infected animal’s blood, body fluids, or lesions.
And as we've discussed often over the years (see `Carrion’ Luggage & Other Ways To Import Exotic Diseases), the consumption and trade in `bushmeat' likely reintroduces the virus into the human population on a regular basis.
In 2005, the CDC’s EID Journal carried a perspective article on the dangers of bushmeat hunting by Nathan D. Wolfe, Peter Daszak, A. Marm Kilpatrick, and Donald S. Burke; Bushmeat Hunting, Deforestation, and Prediction of Zoonotic Disease.It describes how it may take multiple introductions of a zoonotic pathogen to man – over a period of years or decades – before it adapts well enough to human physiology to support human-to-human transmission.
Bushmeat, and `wet markets' are very much a part of the culture in both Africa and much of Asia - and despite the known risks - attempts to close these venues has met with considerable resistance (see Despite Crackdown, `Wild Flavor’ Trade Continues In China)..
And the reality is, for many living with food insecurity, bushmeat may be the only reliable or affordable source of animal protein they they can access.
Earlier this week the Nigerian CDC released an updated Epi report on Monkeypox (see below), which reveals that in the first 5 months of the year, `A total of 66 suspected cases have been reported between January 1
st to May 29
th
, 2022.'
1. Sub-optimal monkeypox surveillance in all states of the Federation2. Non- prioritisation of Monkeypox as a disease of public health importance due to low-risk perception
This update also includes the activation of their Emergency Operations Center (EOC).
ACTIVATION OF EMERGENCY OPERATIONS CENTRE (EOC) The NCDC team and partners conducted a risk assessment to evaluate the current national and global epidemiological reports of Monkeypox. The recommendations from this prompted the activation of the National Multisectoral Emergency Operations Centre at level 2. This EOC will continue to coordinate ongoing response activities in the country while contributing to the global response
Yesterday, the Federal Ministry of Agriculture & Rural Development (FMARD) issued the following press release, where they outline the following `advice', including the halt to trade in bushmeat.
Whether, and how, these measures will be enforced is unknown.
PRESS STATEMENT ON THE RECENT CONFIRMATION OF MONKEY POX DISEASE RESURGENCE IN HUMANS.Following the recent confirmation of Monkey Pox (MP) resurgence in Nigeria on the 29th of May, 2022 involving 21 persons by the Nigeria Center for Disease Control (NCDC), where it was said to have led to the death of one person with co-morbidity.2. The Federal Ministry of Agriculture & Rural Development (FMARD) through the Department of Veterinary & Pest Control Services is actively collaborating with the Nigeria Centre for Disease Control (NCDC) and other stakeholders in the One Health Team to ensure the situation is contained and brought under control.3. In view of the above, The FMARD is hereby giving the following advice:i. People must avoid contact with persons suspected to be infected with Monkey Pox at home and at work places.ii. Hunters and dealers of “Bushmeat” must desist from the practice forthwith to prevent any possibility of “SPILLOVER” of the pathogen in Nigeria.iii. Transport of wild animals and their products within and across the borders should be suspended/restrictediv. Silos, stores and other agricultural storage facilities must institute active rodent control measures to prevent contacts and possible contamination of Monkey Pox Virus with foodstuff.v. All operators of Zoos, Parks, Conservation and Recreational centers keeping non-human primates in their domains must ensure strict compliance with their biosecurity protocols aimed at preventing their contacts with humans.vi. All Veterinary Clinics, Veterinary Teaching Hospitals and other Veterinary Health Institutions across the country must ensure vigilance so as to be able to pick possible signs and symptoms of Monkey Pox in non-human primate (NHP) patients.vii. We must also ensure regular handwashing using strong disinfectant anytime we handle NHP and rodents in our various locations.viii. We must also discourage the act of consumption, trade and keeping of NHP as well as rodents as pets in our homes.ix. The general public are hereby advised to report any pox-like lesions seen on humans or animals to the nearest human or veterinary clinics respectively.x. Lastly, Veterinary epidemiology officers, field surveillance agents and veterinarians should step up their surveillance activities aimed at picking any possible case of Monkey Pox in animals.SIGNEDDr. Mohammad Mahmood AbubakarHonourable Minister
Every year we see outbreaks of Monkeypox, Lassa Fever, and sometimes even Ebola in Africa, many of which are believed tied to the hunting, processing, and consumption of bushmeat.
This from the FAO Bushmeat Sourcebook.
In 2002, the SARS Coronavirus swept across China, and emerged on the world stage, infecting thousands. While the exact origins of the virus and spillover are still not known, it appears to have come from the `wild flavor' craze for exotic meats in Southern China early in the 2000's.
What are the links between bushmeat and human diseases?(Continue . . . )
Hunting and bushmeat consumption entail some risks for emergence of wildlife-related diseases that can be transmitted from animals to humans, also commonly called ‘zoonoses’. It is estimated that approximately 60% of all human pathogens are zoonotic, with some 75% emerging from wildlife. Over one billion cases of human zoonotic disease are estimated to occur annually.
The risk of contracting a disease depends on several factors but may occur even in mosaic landscapes of farms and fragmented forests where human–wildlife interaction is generally indirect or incidental. The lack of personal protection or hygiene during killing, handling and butchering is thought to be the main route of infection. While the process of curing/cooking the meat generally reduces the risk, it also requires consideration.
In 2002, the SARS Coronavirus swept across China, and emerged on the world stage, infecting thousands. While the exact origins of the virus and spillover are still not known, it appears to have come from the `wild flavor' craze for exotic meats in Southern China early in the 2000's.
And while conclusive proof remains elusive, there are many who believe COVID-19 emerged from a similar route in 2019 (see Science Perspective: The Animal Origin of SARS-CoV-2).
While we are dealing with Monkeypox today, the next big global health crisis may vert well be sitting, unnoticed, in a bat, or a rat, or a non-human primate caged a live or `wet' market - or hidden in some traveler's luggage - just waiting for its chance to begin its world tour.
It's just a matter of time.
