BACKGROUND: In September, 2017, human monkeypox re-emerged in Nigeria, 39 years after the last reported case. We aimed to describe the clinical and epidemiological features of the 2017-18 human monkeypox outbreak in Nigeria. METHODS: We reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept 22, 2017, and Sept 16, 2018. Data were collected with a standardised case investigation form, with a case definition of human monkeypox that was based on previously established guidelines. Diagnosis was confirmed by viral identification with real-time PCR and by detection of positive anti-orthopoxvirus IgM antibodies. Whole-genome sequencing was done for seven cases. Haplotype analysis results, genetic distance data, and epidemiological data were used to infer a likely series of events for potential human-to-human transmission of the west African clade of monkeypox virus. FINDINGS: 122 confirmed or probable cases of human monkeypox were recorded in 17 states, including seven deaths (case fatality rate 6%). People infected with monkeypox virus were aged between 2 days and 50 years (median 29 years [IQR 14]), and 84 (69%) were male. All 122 patients had vesiculopustular rash, and fever, pruritus, headache, and lymphadenopathy were also common. The rash affected all parts of the body, with the face being most affected. The distribution of cases and contacts suggested both primary zoonotic and secondary human-to-human transmission. Two cases of health-care-associated infection were recorded. Genomic analysis suggested multiple introductions of the virus and a single introduction along with human-to-human transmission in a prison facility. INTERPRETATION: This study describes the largest documented human outbreak of the west African clade of the monkeypox virus. Our results suggest endemicity of monkeypox virus in Nigeria, with some evidence of human-to-human transmission. Further studies are necessary to explore animal reservoirs and risk factors for transmission of the virus in Nigeria. FUNDING: None.
BACKGROUND: In September, 2017, human monkeypox re-emerged in Nigeria, 39 years after the last reported case. We aimed to describe the clinical and epidemiological features of the 2017-18 human monkeypox outbreak in Nigeria. METHODS: We reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept 22, 2017, and Sept 16, 2018. Data were collected with a standardised case investigation form, with a case definition of human monkeypox that was based on previously established guidelines. Diagnosis was confirmed by viral identification with real-time PCR and by detection of positive anti-orthopoxvirus IgM antibodies. Whole-genome sequencing was done for seven cases. Haplotype analysis results, genetic distance data, and epidemiological data were used to infer a likely series of events for potential human-to-human transmission of the west African clade of monkeypox virus. FINDINGS: 122 confirmed or probable cases of human monkeypox were recorded in 17 states, including seven deaths (case fatality rate 6%). People infected with monkeypox virus were aged between 2 days and 50 years (median 29 years [IQR 14]), and 84 (69%) were male. All 122 patients had vesiculopustular rash, and fever, pruritus, headache, and lymphadenopathy were also common. The rash affected all parts of the body, with the face being most affected. The distribution of cases and contacts suggested both primary zoonotic and secondary human-to-human transmission. Two cases of health-care-associated infection were recorded. Genomic analysis suggested multiple introductions of the virus and a single introduction along with human-to-human transmission in a prison facility. INTERPRETATION: This study describes the largest documented human outbreak of the west African clade of the monkeypox virus. Our results suggest endemicity of monkeypox virus in Nigeria, with some evidence of human-to-human transmission. Further studies are necessary to explore animal reservoirs and risk factors for transmission of the virus in Nigeria. FUNDING: None.
Authors: Ramadan Abdelmoez Farahat; Ranjit Sah; Amro A El-Sakka; Amira Yasmine Benmelouka; Mrinmoy Kundu; Fatma Labieb; Rahma Sameh Shaheen; Abdelaziz Abdelaal; Basel Abdelazeem; D Katterine Bonilla-Aldana; Carlos Franco-Paredes; Andres F Henao-Martinez; Mohammed A Garout; Darwin A León-Figueroa; Monica Pachar; José Antonio Suárez; Juan David Ramirez; Alberto Paniz-Mondolfi; Ali A Rabaan; Jaffar A Al-Tawfiq; Hiroshi Nishiura; Yeimer Ortiz-Martínez; Juan Esteban Garcia-Robledo; Sergio Cimerman; Alexandre Naime Barbosa; Pasquale Pagliano; Gabriela Zambrano-Sanchez; Jaime A Cardona-Ospina; Beatrice Bížová; Alfonso J Rodriguez-Morales Journal: Infez Med Date: 2022-09-01
Authors: Fatma A Amer; Noha M Hammad; Ahmed Ashraf Wegdan; Nissreen E ElBadawy; Pasquale Pagliano; Alfonso J Rodríguez-Morales Journal: Infez Med Date: 2022-09-01
Authors: Jesús Iñigo Martínez; Elisa Gil Montalbán; Susana Jiménez Bueno; Fernando Martín Martínez; Alba Nieto Juliá; Jesús Sánchez Díaz; Natividad García Marín; Esther Córdoba Deorador; Antonio Nunziata Forte; Marcos Alonso García; Ana María Humanes Navarro; Laura Montero Morales; María José Domínguez Rodríguez; Manuel Carbajo Ariza; Luis Miguel Díaz García; Nelva Mata Pariente; Mercedes Rumayor Zarzuelo; Manuel José Velasco Rodríguez; Andrés Aragón Peña; Elena Rodríguez Baena; Ángel Miguel Benito; Ana Pérez Meixeira; María Ordobás Gavín; María Ángeles Lopaz Pérez; Araceli Arce Arnáez Journal: Euro Surveill Date: 2022-07