Press Conference: Statement of the NCDC DG on the Declaration of Mpox as a Public Health Emergency of International Concern

Friday, August 16, 2024

The Nigeria Centre for Disease Control and Prevention (NCDC) has been closely monitoring several endemic diseases including Mpox which has been declared a Public Health Emergency of International / Continental Concern (PHEIC / PHECC) by both the WHO and the Africa Centers for Disease Control and Prevention (Africa CDC).

So far, about 2,863 confirmed cases and 517 deaths across 13 African countries have been reported in 2024 alone. This alarming increase is linked to a new strain of the Mpox virus which emerged in eastern Congo and has since been detected in Kenya, Rwanda, and Uganda.

In Nigeria, a total of 39 confirmed cases and zero deaths have been recorded across 19 States + FCT from the beginning of the year 2024. Noting the significant concern of the ease of cross-border transmission, this press conference is part of the effort to intensify our coordination and communication with stakeholders to manage the spread of the virus and prevent disease importation.

What you need to know about Mpox

Mpox is a rare viral zoonotic infectious disease (i.e., disease of animals transmitted from animals to humans) that is endemic in several African countries including the tropical rainforests of Central and West Africa. The exact reservoir of the virus is still unknown although rodents, squirrels and monkeys are suspected to play a part in transmission.

The Mpox virus can spread both from animal to human and from human to human. Animal-to-human transmission may occur by direct contact with the blood, body fluids, skin or mucosal lesions of infected animals (e.g., monkeys, squirrels, and rodents). This can happen through a bite, scratch, handling of, or eating inadequately cooked or other products of infected bushmeat. Human-to-human (person-to-person) transmission occurs when a person comes into contact with the virus from an infected human, or materials contaminated with the virus such as clothing and beddings.

Sign and Symptoms

Symptoms of the illness include fever, headache, body aches, weakness, swollen lymph nodes (glands) and a rash. After about 1 to 3 days of fever, the rash erupts, beginning on the face and then spreading to the body with the face and palms/soles being mostly affected. They can also occur in and around the genitals which is why contact during sex is another mode of transmission.

Public advisory

To prevent the spread of Mpox, we strongly urge members of the public to adhere to proven infection prevention and control measures. These practices are essential in limiting the transmission of the Mpox virus. This includes:

● Avoid contact with animals that could harbour the virus including sick or dead animals in areas where MPX has been confirmed

● Avoid contact with any material that has been in contact with a sick animal.

● Avoid unnecessary physical contact with persons infected with MPX

● Isolate potentially infected animals from other animals

● Practice frequent handwashing with soap and water especially after caring for or visiting sick people

● Ensuring all animal food products are properly cooked before eating

● Use of appropriate protective clothing and gloves while handling sick animals or their infected tissues and during slaughtering procedures

● Report all cases with the associated symptoms mentioned above to the nearest health facility for care, and/or call the NCDC toll-free line on 6232

● The Nigerian government is making an effort to make vaccines available to the public, especially hotspot areas. The vaccine has been shown to have a favourable safety profile,

Healthcare workers (both private & public) are further advised to:

● When caring for patients, always follow standard safety measures, including precautions against droplets, regardless of their diagnosis. These steps are crucial for protecting both patients and healthcare workers.

● Wash hands with soap and water after contact with patients and/or their environment

● Maintain a high index of suspicion for MPX, especially for patients presenting with fever and vesicular/pustular rash in all parts of the country at this time.

● During triage, use precautionary measures such as placing a surgical mask over the nose and mouth of suspected patients and covering any exposed skin lesions with a sheet or gown

● Isolate all patients suspected of having MPX as soon as possible

● Wear personal protective equipment (gloves, gown, and masks) before close contact with suspected cases and dispose of it properly

● Correctly disinfect all contaminated equipment (including bedding) using bleach unless otherwise indicated and dispose of all waste properly

● Report all cases to the State Epidemiologist/LGA Public Health Department immediately or call the NCDC toll-free line at 6232.

● Samples taken from humans for investigation of the mpox virus should be handled by trained staff and sent to the Nigeria Centre for Disease Control and Prevention.

● RESPECT PATIENTS' PRIVACY always:

○ Seek informed consent from patients before their photographs are taken and state the intended use of such photographs if taken

○ Do not photograph a patient or any part of their body without their knowledge and if consent is not given to do so

○ When consent has been secured do not take a patient’s photograph with the patient’s face in it. If unavoidable, conceal the patient's face before using the image for any purpose.

○ It is advised to get closer to the patient taking a shot that fills the frame; avoid wide-frame pictures that may capture other identifiable items/structures in the frame

○ Do not share photographs taken on social media

The National Mpox Technical Working Group (TWG), a multi-sectoral body housed within the NCDC, continues to coordinate Mpox response activities. As part of the government's ongoing efforts, we have intensified surveillance across Nigeria to swiftly detect and respond to any new cases. This includes putting all port health services across all 5 international airports, 10 seaports, and 51 land/foot crossing borders on high alert. Diagnostic protocols according to the IDSR are now distributed to these locations and port health officers are on high alert and screening for suspected cases. Some states have also been put on high alert including Lagos, Abuja, Enugu, Kano, Rivers, Cross-River, Akwa-Ibom, Adamawa, and Taraba. We are also conducting contact tracing and monitoring for confirmed cases to prevent further spread. This will now also include declarations by travellers who have been to any of the countries where there is an ongoing outbreak of MPX in the last 90 days. Additionally, we continue to provide healthcare workers and the public with updated guidance on infection prevention and control measures and train SURGE staff as part of our preparedness and readiness for an MPX public health event. The NCDC is also notifying public and private hospitals about the MPX alert and sending a list of referral isolation/treatment centres across the 6 geopolitical zones and reference laboratory networks which include the National Reference Laboratory Abuja (NRL), Central Public Health Laboratory, Lagos (CPHL), Nigeria Institute of Medical Research (NIMR), Centre for Human and Zoonotic Virology, Lagos (CHAZVY), African Centre of Excellence for Genomics of Infectious Diseases, Osun (ACEGID), University of Nigeria Teaching Hospital, Enugu (UNTH), University of Port Harcourt Teaching Hospital (UPTH).

We are also considering vaccination efforts for high-risk groups, as Nigeria expects to receive 10,000 doses of the Jynneos vaccine.

We remain committed to sharing updates based on new findings and recommendations by the WHO, Africa CDC and the National Mpox TWG. We urge the public to avoid sharing unverified information and only share information shared by either the NCDC or other official health authorities.

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