monkey pox

1. Overview of Monkeypox
(Cutar Kyandar Biri)

2. Background 1/3
• Monkey pox (MPX) is a zoonotic viral disease, endemic in western and central
Africa
• Discovered in 1958
• Two outbreaks of a pox-like disease in colonies of monkeys kept for
research.
• at Statens Seruminstitut in Copenhagen, Denmark,
• hosts range
• captive or wild non-human primates,
• small mammals, particularly rodents

3. Background
• First human case of monkey pox was in 1970.
• Prior to the 2022 outbreak, mainly reported in central and
western Africa.
• Previously, all monkey pox cases in people outside of
Africa were linked to international travel to countries where
the disease commonly occurs or through imported
animals.
• These cases occurred on multiple continents.

4. Etiology
• Monkey pox is a rare disease caused by infection with the
monkey pox virus.
• The virus is part of the same family of viruses as variola
virus, the virus that causes smallpox.
• Monkey pox symptoms are similar to smallpox symptoms, but
milder, and
• Disease is rarely fatal.
• Not related to chickenpox

5. Types of monkey Pox
• Two clades have been described :
• Congo Basin type
• More virulent,
• Human case fatality rates can reach 10%
• West African type
• Causes milder disease

6. Host range
• The full host range of MPX are still uncertain
• Species that have been affected include :
 Various rodents (rats, squirrels etc)
 Shrews and other small mammals
 Chimpanzees (Pan troglodytes)
 Sooty mangabey (Cercocebus atys)
 Captive gorillas (Gorilla gorilla)
 Asian Orangutans (Pongopygmaeus)
 Gibbons (Hylobates lar) etc

7. Host ranges for monkey pox

8. Factors responsible for human MPX re-
emergence in Nigeria
 human encroachment into wildlife habits due to urbanization
and hunting
 increased trade and demand for the consumption of barbequed
rodents/wildlife mammals (referred to as “bush meat”)
 heavy rainfall and flooding bringing humans and MPX-infected
animal hosts close together

9. Transmission
• Direct contact with monkey pox rash, scabs, or body fluids from
a person with monkey pox.
• Touching objects, fabrics (clothing, bedding, or towels), and
surfaces that have been used by someone with monkey pox.
• Contact with respiratory secretions.
• Contact with infected animals
• Bites
• Scratch
• Preparation/consumption/bush meat

10. Signs and symptoms
• Rash that may be located on or near the genitals
• penis, testicles, labia, and vagina or anus (butthole)
• Could be on other areas like the hands, feet, chest, face, or
mouth.
• The rash will go through several stages, including scabs,
before healing.
• The rash can initially look like pimples or blisters and may
be painful or itchy.

11. Other symptoms
• Fever
• Chills
• Swollen lymph nodes
• Exhaustion
• Muscle aches and backache
• Headache
• Respiratory symptoms (e.g. sore throat, nasal congestion, or
cough)

12. Monkey pox Rash

13. Monkeypox: An evolving rash
 The rash lesions evolve from
 macules (lesions with a flat base) to
 papules (raised firm lesions) to
 vesicles (filled with clear fluid) to
 pustules (filled with yellowish fluid)
 Crusting is the last stage
 The rash affects
 The face in 95% of cases
 The palms and soles of the feet (75%)
 Oral mucous membranes (70%)
 Genitalia (30%)
 The conjunctivae and cornea (20%)
 It may take three weeks for crusts to disappear

14. Epidemiology of Monkeypox 4

15. Distribution of Confirmed Monkeypox in
Nigeria, 2017-2021

16. Monkey pox outbreak in Katsina State
• Index case:
• 24 year old Male, Resident of Katsina LGA, Nurse at FMC Katsina who cared for a VZV case
• Kudu 3 wards, Tudun matawalle, Date of onset 17th June, 2022
• Specimen collected on 20th June, sent to lab on 21st
• Manifested symptoms. Lab result returned positive for Monkey pox and varicella zooster
• Case No 2
• 38 year old female, Resident of Dandagoro, a nurse with FMC Katsina. Was in contact with a
VZV case, DOS unknown
• Was in contact with VZV and index case,
• Specimen collected on 28 June, sent to lab 20th June
• Lab result positive for monkey pox and VZV

17. Confirmed Monkey pox cases in Katsina State,
May – Sept, 2022 (n 7)

18. Epi curve (Suspected & Confirmed Cases)
Monkey Pox, Katsina State, 2022 (n 39)
0
1
2
3
4
5
6
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39
Number
of
Cases
Week of onset

19. Month of onset suspected and confirmed
cases, Katsina State
0 0 0 0
2
4
3
13
6
11
January February March April May Jun e July August September NA

20. Age distribution of suspected and conformed
Cases of Monkey pox (n 39)
0
1
2
3
4
5
6
7
8
0-9 10-19 20-29 30-39 40-49 50-60
Number
of
Cases
Age

21. Sex distribution of monkey pox cases
(suspected and confirmed n= 39)
Male
54%
Female
46%

22. Lab results (Confirmed +suspected) cases

23. Manifestation and lesions of monkey pox

25. Treatment
 Isolation of affected person
 Treatment is symptomatic/ supportive

26. Infection Prevention and Control
for Monkeypox
• Standard contact barrier
• Avoid contact with infected animals
• Use of appropriate personal protective equipment (PPE) based on risk
assessment
• PPEs should include hand gloves, face shield, N95 mask, gown and other
empiric precautions
• Hand hygiene

27. Thank you