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Monkeypox

30 June, 2022

‘Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms very similar to those seen in the past in smallpox patients, although it is clinically less severe. It is caused by the monkeypox virus which belongs to the orthopoxvirus genus of the Poxviridae family. There are two clades of monkeypox virus: the West African clade and the Congo Basin (Central African) clade. The name monkeypox originates from the initial discovery of the virus in monkeys in a Danish laboratory in 1958. The first human case was identified in a child in the Democratic Republic of the Congo in 1970.’

‘Monkeypox endemic countries are: Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ghana (identified in animals only), Côte d’Ivoire, Liberia, Nigeria, the Republic of the Congo, and Sierra Leone. Benin and South Sudan have documented importations in the past. Countries currently reporting cases of the West African clade are Cameroon and Nigeria.’

These countries are considered endemic for the disease, and have suffered the effects for years and years, but we cannot remember vaccination being considered for their populations, running into almost a billion people, as a public health intervention. What happened? Where were the Vaccines?

‘Since 13 May 2022, cases of monkeypox have been reported to WHO from 12 Member States that are not endemic for monkeypox virus, across three WHO regions. Epidemiological investigations are ongoing, however, reported cases thus far have no established travel links to endemic areas. Based on currently available information, cases have mainly but not exclusively been identified amongst men who have sex with men (MSM) seeking care in primary care and sexual health clinics.’

‘In non-endemic countries, one case is considered an outbreak. Because of the public health risks associated with a single case of monkeypox, clinicians should report suspected cases immediately to national or local public health authorities regardless of whether they are also exploring other potential diagnoses. Cases should be reported immediately, according to the case definitions above or nationally tailored case definitions. Probable and confirmed cases should be reported immediately to WHO through IHR National Focal Points (NFPs) under the International Health Regulations (IHR 2005).’

Arms Up

‘US Pledges Nearly 300,000 Monkeypox Vaccines

In the weeks ahead American health care workers will have another 296,000 doses at their disposal, and around 56,000 of those are expected to be released immediately. The Department of Health and Human Services hopes a total 1.6 million doses of monkeypox vaccine will be available by the end of the year. Patients will be required to have two doses one month apart for immunity. For the time being, the vaccine will be available only to those who have been exposed to the disease. There have been no reported monkeypox deaths in the U.S. to date. (Source: NPR)’

The World must have one standard for public health response to infectious disease control, for LIMCs and HICs, alike. The reaction to Monkey Pox appearing in nonendemic countries, remembering the Small Pox vaccines stockpile should be a good reason to re-examine extant behaviour in the WHO.

Prof Joseph Ana

Lead Senior Fellow/ medicalconsultant.

Center for Clinical Governance Research &

Patient Safety (ACCGR&PS), Calabar, Nigeria.

P: +234 (0) 8063600642

E: info@hri-global.org

8 Amaku Street, State Housing, Calabar,Nigeria.

www.hri-global.org

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria, established by HRI Global (former HRIWA). In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: www.hri-global.org. Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Website: www.hri-global.com Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

http://www.hifa.org/support/members/joseph-0

http://www.hifa.org/people/steering-group

Email: info@hri-global.org and jneana@yahoo.co.uk