A rare disease known as Monkey pox has raised its ugly head in Akwa Ibom State.
The disease which envelopes infected people with rashes that has semblance of chicken pox but with fever, malaise, and headache usually more severe than chicken pox infection has been discovered in three communities of Ikot-Akpaden, Ikot-Enin and Ndon, all in Mkpat Enin Local Government Area of Akwa Ibom State. Owing to the outbreak of this disease which is known to spread quickly, as expected, your instinct may cause you to panic. However, this time, you really don’t have to.
The reason is simple. The Commissioner for Health, Akwa Ibom State, Dr Dominic Ukpong who announced the outbreak of the disease on Friday, 25th October, 2019 during a press conference in Uyo assures Akwa Ibom people that the Epidemiological Unit of the State Public Health had moved in immediately to test and contain the infection right from when one suspected case was noticed on September 3, 2019. He adds that since the outbreak, the Akwa Ibom State Ministry of Health through Public Health Department had activated its Infectious Control procedure to control the epidemic and has successfully confined it to the affected Local Government so far. But how did this skin ravaging disease find its way to the State?
Sadly, no one can really tell. Nevertheless, Dr Ukpong says that the disease is mostly found in tropical region. Akwa Ibom State is a tropical region thus her people are not immune to the disease. The Commissioner narrates that although the first case was clinically suspected to be monkey pox, the disease could not however be
confirmed as the test result came out negative.
He notes however that by the end of September, 11 people were suspected in some health facilities in the local government area out of which only one was confirmed positive by test. With only a case recorded positive, does this that suggest the disease prevalence is not high? That may not necessarily be the case.
Ukpong mentions that currently, the State has recorded 11 suspected cases, six people tested negative, one positive, making a total of 18 persons. Yet, those may not be the only persons affected. He says that the result of five persons are being awaited.
Notwithstanding, are those tested negative really free from the disease? The Commissioner explains that the result can appear negative owing to the period of time they may have been tested. He notes that if the persons affected avail themselves for test during the time their body system recuperates from the disease, there is a strong likelihood that they may test negative.
Yet, with the limited number of recorded cases, and controlled measures taken so far, is the State not free from the risk of monkey pox? Sadly, the Commissioner for Health answers in the negative. He notes ” It must be stated, however, that the disease is present in our neighbouring states, We are therefore still at risk of new cases”. But how true is this statement?
It could be recalled that as at October 24th 2019, 93 suspected cases have been reported in Nigeria, 43
confirmed, with one death reported in Lagos State. 10 States reported to be affected are Lagos, Bayelsa, Delta, Cross River, Akwa lbom, Rivers, Delta, Imo, Oyo, Enugu and Anambra States.
Report has it that of the total number of 93 cases in the country, 59% are from two States: Delta, (28%), and Lagos State (26%). Since the beginning of the outbreak in 2017, 176 confirmed cases were reported and nine deaths before the outbreak in year 2019. Be that as it may, this is not the first time the State has witnessed outbreak of the disease. The Commissioner notes that the cases in Akwa-lbom State in 2018 were also from Mkpat Enin LGA. But what really is monkey pox, what’s its origin and how does it operate?
Understand the disease
Monkey pox is a rare viral zoonotic infectious disease ( which is an infection
transmitted from animals to humans) that occurs sporadically, primarily
in remote villages of Central and West Africa, near tropical rainforests. Human monkeypox was first identified in humans in 1970 in the Democratic Republic of Congo (then known as Zaire). Experts say that it is caused by the monkey pox virus from the family of viruses which also cause smallpox, and cowpox. Case fatality in outbreaks has been between 1% and 10%, With most deaths occurring in younger age groups.
Transmission
The exact reservoir of monkey pox is unknown although African
rodents are suspected to play a part in transmission. Experts posit that the virus can spread both from animal to human and from human to human with
transmission occurring when a person comes into contact with the virus
from an infected animal, human, or materials contaminated with the virus such as bedclothes. It is reported that the virus enters the body through broken skin (even if not visible), the respiratory tract, or the mucous membranes of the eyes, nose, or mouth.
According to the Commissioner for Health who has practiced as a Medical Doctor for over 45 years, Animal-to-human transmission may occur by direct contact with the blood, body fluids or the skin or mucosal lesions of infected animals ( which are monkeys, squirrels and rodents), such as through a bite or scratch or preparation or eating of inadequately cooked bush meat.
In the same vain, the Medical expert notes that limited human-to-human transmission is thought to occur primarily through prolonged face-to-face contact via large respiratory droplets.
He adds that It can also result from direct contact with the body fluids or skin lesions of an infected person, or objects they have contaminated such as clothing or bed linen. Through this, the Commissioner states that household members or healthcare workers are at
greater risk of infection. But how would people identify someone who is infected hence be able to project themselves.
Symptoms:
Ukpong offers insight to the fact that the incubation period of monkey pox usually lies between 6 to 16 days but can range from 5 to 21 days.
“There are two aspects to the infectious
period, with an initial invasive period in the first 5 days, where the main
symptoms are fever, lymphadenopathy (swelling of lymph nodes), back
pain, intense headache, myalgia (muscle ache) and severe asthenia (lack
of energy)”, he notes.
What is more, the medical expert points out that maculopapular rash (skin lesions with a flat bases) develops 1-3 days after the onset of fever, developing into small fluid-filled blisters (vesicles), which become pus-filled and then crust over in about 10 days.
However, complete resolution takes up to three weeks. He notes that nearly all patients have face lesions, three quarters have palmar-plantar lesions (on the palms of their hands and soles their feet), and 30 per cent have genital involvement.
Yet, the symptoms on the skin is not enough. Ukpong says the eyes are involved in the majority of cases, with 70 per cent having on the oral mucosa, 20 per cent on the eyelid, with some on the cornea.
However, the relieving aspect about the disease is that one must not need to spend money before getting a cure. The Commissioner for Health reveals that monkey pox is usually self-limiting, with symptoms lasting between two and three weeks. While noting that there are no specific treatments, he points out that patients receive supportive care based on the symptoms they present. But there is need for cautious when it comes to young ones. The Health Manager of the State notes that severe cases occur more commonly among children, who he stress have greater mortality especially when they are malnourished or are affected by other sicknesses which limits their immune system to battle the disease. Having identified the manifestations of the disease, how can people safeguard themselves?
Prevention
The Commissioner for Health identifies nine key preventive measures that must be taken against monkey pox virus. They are:
-Avoiding contact with animals that could harbor the virus including sick or dead animals in areas where monkey pox cases have occurred.
-AvoIding contact with any material that has been in contact with a sick
animal.
-Isolating potentially infected animals from other animals
-Quarantine of any animal that might have come into contact with an infected animal, handling them with standard precautions and observing for monkey pox symptoms for 30 days.
-Hand washing with soap and water after contact with infected animals.
-Thoroughly cooking all animal products before eating.
-Isolation of infected patients, including use of personal protective equipment and implementation of standard infection control precautions by health workers.
-Regular hand washing after caring for or visiting sick people and
-Public health education on preventive measures.
The above preventive measures outlined are more of personal effort. Even so, you may desire to know what the State government has really done to control the outbreak in the State thus give assurance that the State is on course against the viral disease.
Government Effort to combat Monkey Pox
The Commissioner for Health notes that there have been meetings held between the Ministry of Health and the team from the Nigeria Centers for Disease Control
(NCDC) coupled with meeting with the staff of Tranex courier services.
But meetings are not enough. Ukpong mentions that there have been adequate surveillance as they have sent alerts to all the 31 LGAs in the State. He further notes that the Local Government Area DSNOS (departure notice for shipment leaving facilitiy), have been trained to enhance their surveillance activities.
In the laboratory where the disease is actually ascertained, the Commissioner points out that they have trained Health Community Workers from Health facilities in Mkpat Enin on sample collection, packaging and transportation even as they have trained them on the appropriate use of Personal Protective equipments, PPES.
Regardless of the meetings and training, after ascertaining the positivity of the disease, how prepared are they to manage cases before them? The Commissioner says they have sensitized Health Workers at all the Health Facilities on identification, management and reporting of cases. He notes that emphasis is also placed against stigmatization even as they have created isolated areas in the facility. Ukpong adds that the Ministry has also distributed Personal Protective equipments to all the Health facilities in Mkpat Enin.
For Risk assessment, Ukpong notes that they have begun sensitization about the disease in churches and markets in Mkpat Enin LGA through the use of Nigeria Centers for Disease Control
(NCDC) risk Communication tool.
Yet, in spite of how plausible the effort of government may be, everyone has a role to play in the fight against monkey pox. Watch out for symptoms, adhere to preventive measures and do not hesitate to report all suspected cases to the nearest Health Facility or call 08037934966, 08028442194 and 09023330092 as emergency numbers. If we neglect our little role in contributing towards the fight, we may wake one day and find ourselves aesthetically embellished with excruciating rashes. We certainly do not want to be reminded this way on the imperative to join the war against monkey pox.
