The monkeypox crisis is secretly spreading in the virus epicenter of Nigeria

AKAMKPA, Nigeria – The two sons of Destiny, a 48-year-old Nigerian businessman whose nephew recently contracted the monkeypox virus, are already showing similar symptoms.

You have swollen lymph nodes that started a few days after the onset of a fever. Though the rash on their bodies turns into pus-filled pimples that have become crusted, Destiny believes his sons are only feeling the effects of the heatwave sweeping Nigeria’s southeastern Cross River State, where they live. He has prevented his sons – both in their early 20s – from attending the hospital because he believes the rash “will go away after a while”.

“In less than a week it will all be gone,” Destiny told The Daily Beast right outside his home in the town of Akamkpa in Cross River’s southern region. “We started applying calamine lotion [a medication commonly used to treat mild itchiness] on it and we will see the first results soon.”

Monkeypox, a viral zoonosis caused by a virus transmitted from animals to humans, was first detected in monkeys kept for research in the Democratic Republic of the Congo (DRC) in 1958 and later in humans in the same country in 1970 . The disease is currently endemic in rodent and monkey populations in West and Central Africa, including Nigeria, where cases are increasing, causing flu-like symptoms and skin rashes in infected humans. Recently, the virus has emerged in Europe and the US, raising alarms that the disease could soon become a pandemic.

Few on the Destiny grounds seem to believe the disease really exists. As with some COVID-19 conspiracy theorists, many believe it is another “so-called” disease invented by the West for the purpose of rolling out vaccines that will reduce Africa’s population. It’s the kind of belief that’s already hampering coronavirus vaccination in Nigeria, with just nearly 17 million fully vaccinated in a country of 200 million people.

“America has started yet another infectious disease outbreak talk,” muttered one of Destiny’s neighbors over hearing Destiny speaking to The Daily Beast. “She [Americans] saw that the Africans weren’t buying their COVID scam and introduced this one [monkeypox] scaring people.”

But since many who are very close to fate live in denial, the signs that the disease lives very close to them are glaring. A woman who developed a rash and swollen lymph nodes on her body, blaming a “spiritual attack” by her enemies, according to her younger sister, had to run about 200 km (120 miles) to the home of a traditional medicine practitioner. away for treatment. No one, her sister said, had seen or heard from her since. Another 80-year-old man who died a week ago reportedly had symptoms of monkeypox but failed to see a doctor.

“Many people are afraid that if they get into hospitals and are diagnosed with the disease, they could be separated from their families and quarantined for long periods of time,” said Dr. Collins Anyachi of the Department of Family Medicine at the University Teaching Hospital (UCTH). ) in Calabar, the state capital of Cross River, opposite The Daily Beast. “They prefer to patronize patent drug dealers or traditional medicine practitioners who just prescribe them drugs or herbs and tell them they’ll be fine in a few days.”

Cases like that in Akamkpa show that Nigeria almost certainly does not document many cases of monkeypox, particularly in rural areas where surveillance has been very poor.

Unlike in the West, the outbreak in Nigeria, where the disease is endemic, did not start this year. It started in 2017. Between then and nowthere were more than 650 suspected cases with over 260 confirmed cases, a seventh of which were registered in the first half of this year.

But government records in Nigeria, where monkeypox cases are on the rise, don’t tell the true story of the disease, which has been on the rise in Europe and the United States.

Officially, Nigeria has announced 141 suspected cases and 36 confirmed cases from 12 states between January 1 and June 12. But as seen in Cross River state, where official records show only two cases have been confirmed, many who are likely to have the disease are refusing medical evaluations.

“There’s also the fear of stigma,” Anyachi said. “When people are officially diagnosed with monkeypox, there is a tendency for society to treat them with contempt. We have seen this often in people suffering from leprosy.”

But aside from people’s reluctance to visit hospitals, authorities have had trouble monitoring the monkeypox outbreak. First of all, disease surveillance in Nigeria in general has been hampered by the outbreak of COVID-19. For example, Lassa fever had almost 1,200 confirmed cases in 2020 when the novel coronavirus emerged. That number dropped to 510 in 2021 as overwhelmed health officials paid more attention to the more contagious COVID-19. However, as COVID is no longer as dominant, the number of confirmed Lassa fever infections rose to 751 in the first quarter of 2022 alone. As with Lassa fever, monkeypox received insufficient attention in 2021, meaning many infections went unnoticed.

To make matters worse, with countries like the US and UK offering a vaccine made by Bavarian Nordic – one approved by the US Food and Drug Administration for monkeypox in 2019 – for high-risk contacts, Nigeria has been unable to obtain vaccines or medicines to help Prevention and treatment of monkeypox, a virus that according to the World Health Organization (WHO) “is transmitted from one person to another through close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding”.

In a country where there are only 40,000 doctors for 200 million people, there is real concern that Nigeria’s health sector will not be able to deal with cases of monkeypox emerging in poor rural areas with overcrowding and poor sanitation.

“The greatest fear is the possibility of misdiagnosis in primary health care facilities available to people in rural communities,” said Dr. Elijah Akpe Orim, who worked in Cross River state community health for many years, told The Daily Tier. “The people you often find in these health centers are local health workers who are not professionally trained in how to deal with such cases.”

Because of similar symptoms, according to Dr. Orim, who now works at UCTH’s pharmacology department, “patients who may have monkeypox can be wrongly told they’re infected with a disease like measles, and that doesn’t help anyway.”

As for Destiny, he says he will only seek treatment at a hospital if his son’s ailments get “out of control.”

“At this point we can’t start spending that kind of money [in a hospital] unless it’s life-threatening,” Destiny said. “It’s too early to waste money.”