HomeHEALTHRED ALERT! Fears Over Deadly Monkey Diseases at Nigerian Ports as WHO...

RED ALERT! Fears Over Deadly Monkey Diseases at Nigerian Ports as WHO Renames ‘Monkeypox’, ‘Mpox’

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The twin menaces of zoonotic ailments, both reportedly traceable to primates – monkeypox and Marburg diseases – are messing up the minds of the health authorities at the Nigerian Ports Authority (NPA) big-time, The News Room can authoritatively report.

The NPA Management, according to exclusive findings by The News Room, is sorely concerned about erecting effective bulwarks against potential outbreaks of these diseases, and promptly and efficiently corralling them should these occur in the organisation’s workspaces.

While monkeypox is a mild viral disease, Marburg is a highly infectious viral haemorrhagic fever, and the possibility of either any one of them, or worst-case scenario, both zoonotic diseases breaking out simultaneously in Nigeria, one of the world’s most populous nations, potentially delivered via her seaports, major entry points into the country, has the authorities of the NPA clanging the alarm bells, according to our exclusive findings.

At the NPA HOUSE, the Corporate Headquarters of the Federal Government-owned blue-chip agency, on the Marina, Lagos State, South-West Nigeria, as well as the various other offices and other operational locations of the NPA and its subsidiaries in Lagos and in Delta, Rivers, Cross River states, Abuja, and the United Kingdom (UK), the public protocols for the so-called “novel” corona virus disease (COVID-19) have, with the retreat of the publicity blitzkrieg on the affliction that rocked the world to its very foundations particularly in 2019, been mostly deactivated to virtual nonexistence.

The wearing of face masks by staff and visitors at these locations have become rarity. The very few persons still sticking to the culture of wearing face masks actuated by the COVID-19 scourge now viewed by the majority at those places as curiosities, as enforcement of wearing a face mask as let to access and be in those have ceased.

Similarly, the hand-washing facilities installed at the entry points of those places and strategic locations therein in the heat of COVID-19.

There are, however, indications that the NPA, “the Landlord of the Nation’s Ports” might just be mulling reintroducing a strict regime of face masking and handwashing for both staff and visitors at its premises.

The rethink, it was gathered, follows the recent outbreak of the highly contagious and fatal Marburg disease in the West African subregion.

The subject of the Internal Memorandum from the NPA Occupational Health Department compels some palpitations in even the strongest of hearts. The circular from the General Manager, Medical Services blared: HEALTH ALERT – MARBURG DISEASE ON THE MOVE!

In its introduction, the document stated: “This is to bring to employees’ notice the ongoing spread of Marburg Disease in West Africa, no has been detected in Nigeria but it is necessary to be cautious considering Ghana currently has cases and shares a border with Nigeria. In particular, the World Health Organisation has reached out to neighbouring high-risk countries including Nigeria to remain alert.”

Perhaps the great danger any outbreak of the disease posed must have triggered so much angst in the NPA Occupational Health Department that allowed the fallacy of Ghana purportedly sharing a border with Nigeria to slide? Apart from that geographic error, there was certainly no dearth of useful medical information in the copy of the memo sighted by The News Room, which was dated 1st August, 2022, and bore reference number: HQ/GMMS/AD/M.21/329.

Offering a “situation report”, the circular stated: “Marburg virus (MARV) is rare but one of the deadliest viruses known to man. Ghana announced the country’s first outbreak of Marburg virus disease on the 26th June, 2022, involving a 26-year-old male farm worker in Adansi North District, Ashanti Region with a travel history to the Western Region. Prior to symptom onset on 24 June, he arrived from the Western Region to Ashanti Region. He sought care at a hospital on 26 June and died on 27 June, 2022. The second case was a 51-year-old male who reported to the hospital on 28 June and died on the same day. Both cases sought treatment at the same hospital within days of each other.

“Earlier, Guinea confirmed a single case on the 16th September, 2021. The current outbreak in Ghana is the second time the virus will be detected in West Africa, after the 2021 experience in Guinea. Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Africa, the Democratic Republic of the Congo, Kenya, South Africa and Uganda. It is useful to note that this is the second time the zoonotic disease has been detected in West Africa.”

Under the subheading “about the Marburg viral disease”, the NPA memo had described the affliction as “a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease.” The document noted: “This disease is a zoonotic infection transmitted to people from fruit bats and is spread among humans through direct contact with the bodily fluids of infected people, surfaces and materials. Marburg virus was first discovered at the Philipps University of Marburg in Germany in 1967. Researchers and laboratory technicians showed symptoms of a haemorrhagic fever after handling samples from African green monkeys that had been imported from Uganda to Germany and the former Yugoslavia for research purposes. Case fatality rates have varied from 24 percent to 88 percent.”

On the “signs and symptoms” of the Marburg disease, the nemo explained that the illness usually begins abruptly with high fever, severe headache and malaise. The other symptoms of the disease, according to the document, include diarrhoea, nausea and vomiting, with many patients developing haemorrhagic signs within seven days. The disease incubation period was given as 21 days.

Explaining the “mode of spread”, the circular stated: “Originally transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.

“Essentially, the virus spreads through direct contact such as through broken skin or mucous membranes in the eyes, nose, or mouth with blood or body fluids including urine, saliva, sweat, faeces, vomit, breast milk, amniotic fluid, and semen of a person who is sick with or has died from Marburg virus disease.
“Relatives and health workers remain most vulnerable, and bodies can remain contagious at burial.”

On a general level, the memo, which was signed by the NPA General Manager, Occupational Health, Dr. Chuma Ezenweinyinya, counseled adherence to precautions, including avoiding direct contact with infected persons and animals; adequate cooking of animal products; regular hand washing with soap and water; and isolation of infected persons and animals.

Specifically, “for health care providers”, the document recommended the universal precautions of wearing protective gowns, gloves, and masks; implementation of strict isolation techniques among infected patients; and sterilisation, proper disposal of needles, equipment, and patient excretions.

Employees of the NPA were “advised to please report at the Occuational Health Department and/Clinic of any suspected case in the Authority.”

In a related development on 21st June, 2022, the NPA Occupational Health Department had issued 2022 MONKEYPOX OUTBREAK ALERT! via the Internal Memorandum bearing reference number: HQ/AGM/OH/OP/148.

Declaring its intent as being “to sensitise the workforce on the ongoing spread of Monkeypox disease in Nigeria,” the document went on: “On the 26th May 2022, the Nigeria Centre for Disease Control and Prevention (NCDC) activated a national Multisector Emergency Operations Centre for Monkeypox (MPX-EOC) in order to strengthen and coordinate ongoing response activities in-country while contributing to the global response. The global alarm was activated after more than 200 suspected and confirmed cases of the virus were detected in at least 19 countries since early May, mostly in Europe.”

The memo quoted WHO as reporting “there are about 1,900 confirmed cases as at 15th June, 2022, in 39 countries across the world including eight countries in Africa.”

According to the NPA circular: “In Nigeria, the NCDC report, as at 29th May, 2022, a total of 21 confirmed cases with one death have been reported from nine states and the FCT (Federal Capital Territory) – Adamawa, five; Lagos, four; Bayelsa, two; Delta, two; Cross River, two; FCT, two; Kano, two; Imo, one; Rivers, one. The death was reported in a 40-year-old patient who had underlying co-morbidity and was on immunosuppressive medications.”

Describing monkeypox as “a mild viral zoonotic disease with ability to spread from animals to humans and not just between people,” the circular stated: “The disease is called Monkey pox because it was first identified in colonies of monkeys kept for research in 1958. It was only later detected in humans in 1970. It is endemic in the African countries of Cameroon, Central African Republic, Democratic Republic of Congo, Benin, Republic of Congo and Nigeria. In this recent outbreak, it has been reported for the first time in Ghana and Morocco.”

With the incubation period of monkeypox reportedly ranging from five to 21 days, the signs and symptoms of the disease, according to the memo, “typically” include fever, intense headache, muscle aches, back pain, low energy, swollen lymph nodes and a skin rash or lesions.

The document noted: “The rash usually begins within one to three days of the start of a fever. Lesions can be flat or slightly raised, filled with clear or yellowish fluid, and can then crust, dry up and fall off. The number of lesions on one person can range from a few to several thousand. The rash tends to be concentrated on the face, palms of the hands and soles of the feet. They can also be found on the mouth, genitals and eyes.”

Noting that “mode of spread” is through “close physical contact with someone who has symptoms”, the memo stated: “The rash, bodily fluids (such as fluid, pus or blood from skin lesions) and scabs are particularly infectious. Clothing, bedding, towels or objects like eating utensils/dishes that have been contaminated with the virus from contact with an infected person can also infect others. Ulcers, lesions or sores in the mouth can also be infectious, meaning the virus can spread through saliva. People who closely interact with someone who is infectious, including health workers, household members and sexual members are therefore at greater risk for infection.

“The virus can also spread from someone who is pregnant to the foetus from the placenta, or from an infected parent to child during or after birth through skin-to-skin contact. Animal hosts include rodents and primates, any foods containing animal meat.”

On the matter of prevention, it was stated: “A newer vaccine that was developed for smallpox (MVA-B, also known as Imvamune, Imvanex was approved in 2019 by WHO for use in preventing Monkeypox although not yet widely available. WHO is also not encouraging mass vaccination at this time.”

The circular listed precautions against being infected by monkeypox to include avoiding direct contacts with infected persons and animals; adequate cooking of animal products; good housekeeping by getting rid of rodents and ensuring good sanitation and environmental and environmental hygiene; regular hand washing with soap and water; and isolation of infected persons and animals. In conclusion, the document had advised NPA employees to “please report at the Occupational Health Department and/Clinic of any suspected case in the Authority”.

It was learnt that the NPA Occupational Health Services Annual Health Assessment For Year 2022 that ran from 16th August to 22nd September, 2022, had not recorded any case of either monkeypox or Marburg Disease. It could not be ascertained if any positive test result for COVID-19 had been recorded during the exercise held at the NPA Corporate Headquarters.

It is, however, a certainty that the organisation, having willfully converted its arsenal at the various offices against COVID-19 into relics, would be hard put efficiently mobilising resources in quick time for the expected battles against the backdrop of the very real possibilities of outbreaks of monkeypox or/and the Marburg Disease in the international transportation and related logistics arena it plays in.

Instructively, even as China, one of Nigeria’s top trading partners, has been experiencing alarming levels of resurgence in COVID-19 cases, deploying the strictest of protocols and other countermeasures to arrest the situation, the NPA has not made any visible moves to reinstall the COVID-19 protocols at its various locations.

Meanwhile, WHO announced Monday, November 28, 2022, that “mpox” is now the preferred name for monkeypox.

“Both names will be used simultaneously for one year while ‘monkeypox’ is phased out,” according to WHO.

It said that monkeypox was named in 1970, over a decade after the virus that causes the disease was discovered in captive monkeys.

There are opinions that monkeypox might not have originated in monkeys, because its origin is still unknown, and the virus can be found in several other kinds of animals.

The name was created before WHO published best practices for naming diseases in 2015.

Since the recent outbreak began, scientists and other experts have campaigned to change the name to avoid discrimination and stigma that could steer people away from testing and vaccination.

WHO had in August encouraged people to propose new names for monkeypox by submitting suggestions to its website.

On the day WHO announced mpox as the new name, it explained in a statement that the consultation process included experts from medical, scientific, classification and statistics advisory committees “which constituted of representatives from government authorities of 45 different countries.”

WHO stated: “The issue of the use of the new name in different languages was extensively discussed. The preferred term mpox can be used in other languages.

WHO further explained that “monkeypox” will remain searchable in the International Classification of Diseases in order to allow access to historic information, and the one-year period when both will be used allows time for publications and communications to be updated.

As at the day it announced the renaming of monkeypox as mpox, WHO claimed that over 81,000 monkeypox cases in 110 cases have been reported to the organisation in the recent outbreak.

WHO reportedly stated that the global risk remains moderate, and outside of countries in West and Central Africa, the outbreak continues to primarily affect men who have sex with men.

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