The monkeypox crisis is secretly spiraling into this viral hotspot

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.

They have swollen lymph nodes, which started a few days after developing a fever. Despite the rash on their bodies turning into pus-filled pimples that have scabbed over, Destiny thinks her sons are only feeling the effect of the heat wave sweeping across Cross River State in the southeast Nigeria, where they live. He stopped his sons – both in their early 20s – from going to hospital, believing the rash “will go away after a while”.

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

Monkeypox, a viral zoonotic disease caused by a virus transmitted from animals to humans, was first discovered in monkeys held for research in the Democratic Republic of Congo (DRC) in 1958, and then 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 and causing flu-like symptoms and rashes in those infected. Recently, the virus has emerged in Europe and the United States, raising alarm that the disease could soon escalate into a pandemic.

Few people within the Destiny compound seem to believe that the disease really exists. As was the case with some COVID-19 conspiracy theorists, many believe it to be another “so-called” disease engineered by the West to introduce vaccines that will reduce the population by Africa. It’s the kind of belief that is already hampering coronavirus vaccination in Nigeria, with only nearly 17 million in a country of 200 million people fully vaccinated.

“America has started again with another talk about the infectious disease epidemic,” whispered one of Destiny’s neighbors when hearing Destiny speak to The Daily Beast. “They [Americans] saw that Africans didn’t buy into their COVID scam and so came up with this one [monkeypox] scare people. »

But as many people very close to Destiny live in denial, the signs that the disease lives very close to them are stark. A woman who developed a rash and swollen lymph nodes on her body blamed the event on a ‘spiritual attack’ by her enemies, according to her younger sister, and had to run to the home of a health practitioner. traditional medicine about 200 km (120 miles) away for treatment. No one, her brother said, has seen or heard from her since. Another 80-year-old man who died a week ago reportedly had symptoms of monkeypox, but did not see a doctor.

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

Cases like Akamkpa’s show that Nigeria almost certainly fails to document many cases of monkeypox, especially in rural areas, where surveillance has been very poor.

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

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

Officially, Nigeria announced 141 suspected cases and 36 confirmed cases in 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 of those likely to have the disease are refusing to be seen by a doctor.

“There’s also the fear of stigma,” Anyachi said. “When people are officially diagnosed with monkeypox, society tends to treat them with disdain. We have seen this happen often with people who had leprosy.

But beyond people’s reluctance to go to hospitals, authorities have struggled to monitor the monkeypox outbreak. To begin with, disease surveillance in Nigeria has been generally hampered by the COVID-19 outbreak. In the case of Lassa fever for example, nearly 1,200 confirmed cases were recorded in 2020 when the novel coronavirus emerged. That number fell to 510 in 2021 as overstretched health authorities paid more attention to the more contagious COVID-19. But with COVID no longer so dominant, the number of Lassa fever infections confirmed in the first quarter of 2022 alone rose to 751. Like Lassa fever, insufficient attention was paid to monkeypox in 2021 , which means that many infections have gone undetected.

To make matters worse, countries like the US and UK are offering a vaccine produced by Bavarian Nordic – a vaccine that was approved for monkeypox by the US Food and Drug Administration in 2019 – to contacts at high risk, Nigeria has been unable to obtain vaccines or drugs to prevent and treat monkeypox, a virus which the World Health Organization (WHO) says is “transmitted from person to person through close contact with lesions, bodily fluids, respiratory droplets, and contaminated materials such as bedding.”

At this point we can’t start spending so much money [in a hospital] when there is no danger of death.

In a country where there are only 40,000 doctors for 200 million people, there is a genuine fear that if cases of monkeypox develop in poor rural neighborhoods, where there is overcrowding and poor sanitation, the healthcare sector Nigeria’s health will not be able to handle it.

“The main fear is the possibility of misdiagnosis in primary health care facilities, which is available to people in rural communities,” Dr. Elijah Akpe Orim, who has worked in the field of health, told the daily. community health for many years in Cross River State. The beast. “The people you often find in these health centers are community health extension workers who are not professionally trained on how to deal with such cases.”

Due to similarities in symptoms, according to Dr. Orim, who now works in UCTH’s Department of Pharmacology, “Patients who may be suffering from monkeypox may be mistakenly told that they have been infected with a disease such as measles and it doesn’t help anyway.”

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

“At this point we can’t start spending so much money [in a hospital] when it’s not life threatening,” Destiny said. “It’s too early to waste money.”

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