On Thursday, the Nigeria Centre for Disease Control (NCDC) announced that the number of Mpox cases in Nigeria had reached 39. The agency issued a health advisory notifying Nigerians about the disease and provided a list of referral isolation and treatment centers across the six geopolitical zones in the country.

Jide Idris, the NCDC Director General, stated that the agency had heightened surveillance at major ports and in states including Lagos, Enugu, Kano, Rivers, Cross River, Akwa Ibom, Adamawa, Taraba, and the Federal Capital Territory, Abuja.

This announcement came just a day after the World Health Organisation (WHO) declared Mpox a global public health emergency, following a review by a panel of experts.

This isn’t the first time Mpox (formerly known as Monkeypox) has been declared a public emergency. In 2022, the WHO issued a similar declaration following a significant outbreak in Europe and America.

However, the current situation differs slightly from that of 2022. A new, less-treated strain of the Mpox virus known as Clade 1b has emerged. Given the emergence of this new strain, here are some of the most important things to know about the disease.

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DEADLIER THAN THE FIRST STRAIN

Unlike Clade II, the original strain from which more than 99.9% of those infected survived, Clade 1b — the new variant — is a sub-strain of Clade 1 which is endemic to Central Africa.

This strain has caused fatalities in up to 10% of infected individuals during some outbreaks, according to the US Centers for Disease Control and Prevention (CDC).

Clade 1 is known to cause more severe disease and has the potential to spread faster than the milder Clade II strain. So far, over 2,800 cases and 520 deaths have been reported this year alone due to the recent outbreak.

The 1b sub-strain, which was detected in the Democratic Republic of Congo in 2023, has been reported to have a case fertility rate between 3% and 6%. Cases of infection have also been reported in countries such as Sweden, Burundi, Uganda, Kenya, Pakistan and Rwanda.

DRIVEN BY SEXUAL TRANSMISSION?

During the Mpox outbreak of 2022, the virus was primarily spread through sexual transmission, according to reports by the BBC. But Mpox can be transmitted through simple physical contact with an infected person too.

Therefore, sex is simply a key factor in the virus’s spread due to the extent of physical contact and exchange of fluids involved. Although, WHO has detected the Mpox virus in semen, it remains unclear whether it can be transmitted through the fluid.

As a result, condoms may not provide the same level of protection against Mpox as they do with sexually transmitted infections like HIV. Recent reports from the BBC and France 24, for instance, have also pegged sex as a main driver for the spread of the new sub-strain.

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HOW TO RECOGNISE IF YOU ARE INFECTED

Mpox infections are typically characterised by mild symptoms such as fever, rashes, and lesions. In fact, infections caused by Clade II strains of the virus are usually self-limiting and tend to resolve on their own after a few days.

However, the situation is somewhat different with the new variants and sub-strains of the virus. According to WHO, common symptoms include muscle aches, rashes that may last for about four weeks, swollen glands, headaches, and other similar signs. In severe cases, the rashes can spread and develop into serious blisters and lesions.

Infected individuals may experience pain in their genitals and develop lesions in the anal tract, rectum and mouth. In the worst cases, complications can arise from infected lesions, potentially affecting the heart, brain, lungs and eyes.

EASILY MISDIAGNOSED

It is remarkably easy to misidentify infections from the new variants of Mpox, even for trained professionals, due to two interrelated reasons.

First, the symptoms and signs exhibited by an infected person closely resemble those of other viral pox diseases.

Second, the variants implicated in the recent outbreaks are new, and studies on them are not yet comprehensive.

WHO recommends a specific type of laboratory test that detects viral DNA strains. Blood tests and antibody tests are generally not very effective in identifying the virus.

THERE ARE THREE VACCINES BUT THEY ARE LIMITED IN NIGERIA

There are currently three vaccines for Mpox: MVA-BN, LC16, and OrthopoxVac. These vaccines were originally developed to address smallpox cases but have also been approved by WHO to prevent Mpox.

WHO recommends vaccination only for those vulnerable to Mpox due to recent exposure or for individuals at high risk. Due to various uncertainties, mass vaccination is not recommended.

Vaccine distribution remains limited globally. Only recently on August 7, Tedros Adhanom Ghebreyesus, the Director-General of WHO, launched an emergency authorisation procedure for Mpox vaccines.

The aim was to allow countries that have not yet approved the available vaccines to use them to protect vulnerable populations. The global community is currently prioritising vaccine distribution to hotspots like DR Congo.

For instance, the US Department of Health announced on Wednesday that it would donate 50,000 doses of an Mpox vaccine to DR Congo and 10,000 doses to Nigeria. Additionally, the African CDC has dedicated about $10 million to improving the response to the outbreak in Africa.

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WHO CAN BE INFECTED?

Children and individuals with compromised immune systems are highly susceptible to Mpox infection. The European Union has reported that children younger than 15 years old make up 70% of the total cases in DR Congo, which is the virus’s hotspot.

Children in this age group also account for approximately 88% of the deaths caused by the virus. Pregnant women are another group susceptible to infection.

Generally, anyone who has had contact with an infected person is at risk of contracting Mpox.

Mpox cases have currently been reported in several Nigerian states. Bayelsa and Cross River each have five confirmed cases.

In southwest Nigeria, Ogun and Lagos have four cases each. Ebonyi also has three confirmed cases of the virus in the southeast.
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