🦠 Men's Health

Monkeypox (Mpox) in Nigeria

Understanding mpox — endemic in Nigeria since 1971

Monkeypox (now officially renamed mpox) is a viral zoonotic disease caused by monkeypox virus, endemic in Nigeria since it was first identified in humans in 1970. Nigeria reported a major outbreak in 2017-2018 and has had ongoing transmission since. During the 2022 global mpox outbreak, Nigeria reported significant cases. Unlike the 2022 global outbreak driven by sexual transmission, the Nigerian endemic strain is primarily transmitted through animal contact and close household contact. Mpox causes a distinctive rash and is rarely fatal in healthy adults.

Signs and Symptoms

✓ Fever, headache, muscle aches, and swollen lymph nodes (often before the rash)

✓ Distinctive rash: starts on the face, spreads to palms and soles (unlike chickenpox which spares palms/soles), then body

✓ Rash evolves through stages: flat spots (macules) → raised bumps (papules) → fluid-filled blisters (vesicles) → pustules → scabs; all lesions are at the same stage at the same time

✓ Lesions are deep-seated and well-circumscribed — different from chickenpox

✓ Duration: 2-4 weeks total illness

✓ Lymphadenopathy (swollen lymph nodes): a distinguishing feature from smallpox and chickenpox

Risk Factors

Contact with infected wild animals (rodents — rope squirrels, tree squirrels, Gambian pouched rats) in forest-edge communities: Bayelsa, Rivers, Akwa Ibom, Cross River states
Consumption of bushmeat from infected animals
Close household contact with an infected person
Caring for an mpox patient without personal protective equipment
Sexual contact (the transmission route driving the 2022 global outbreak — relevant to men who have sex with men)
Healthcare workers: exposure through needlestick or unprotected patient care

When to Seek Help

Report to health authoritiesAny patient with fever, swollen lymph nodes, and the characteristic rash — report to the nearest hospital or call the NCDC Emergency Operations Centre (0800-9700-0010)

Isolate at homeMild cases without complications — self-isolate until all scabs have fallen off (typically 3-4 weeks); avoid skin-to-skin contact with others

Hospital admissionSevere disease: extensive rash, respiratory distress, encephalitis, or secondary bacterial infection of lesions

Tests & Diagnosis

🧪 PCR testing of lesion swabs

Definitive diagnosis — swab from a lesion (roof of vesicle or pustule, exudate) sent to NCDC reference laboratory or WHO-accredited labs; the only reliable confirmation method

🧪 Blood PCR

Used in early illness before rash appears, or in immunocompromised patients

🧪 Electron microscopy

Shows brick-shaped poxvirus particles — available at reference labs

🧪 Exclude chickenpox and herpes zoster

Clinical differentiation is important — chickenpox vesicles appear in crops at different stages; mpox lesions all at the same stage

Treatment Options

Supportive care

Most mpox cases are self-limiting; treat fever with paracetamol; keep lesions clean and dry; oral antihistamines for itch; adequate hydration; calamine lotion for comfort

Antibiotics for secondary infection

Bacterial superinfection of mpox lesions is common in Nigeria — flucloxacillin or amoxicillin-clavulanate for clinically infected lesions

Antiviral (tecovirimat)

Specific mpox antiviral; compassionate use for severe disease; limited availability in Nigeria; available through NCDC/WHO emergency access programme

Vaccination

Smallpox vaccines (ACAM2000, MVA-BN/Imvamune) provide 85% protection against mpox; not routinely available in Nigeria; being evaluated for healthcare workers and high-risk contacts

Isolation

Full isolation until all scabs have fallen and skin underneath is healed — typically 21 days; separate bathroom and bedding; N95 mask for caregivers; no sharing of personal items

Frequently Asked Questions

Is mpox the same as smallpox?

No — mpox is caused by a different but related virus in the same Orthopoxvirus genus as smallpox. Mpox is far less severe, rarely fatal in healthy adults, and much less transmissible. Smallpox was eradicated in 1980; mpox was not.

Can mpox be transmitted by shaking hands?

Brief skin contact without lesion exposure carries low risk. Transmission requires prolonged close contact with lesions, bodily fluids, or respiratory secretions, or contact with contaminated materials (bedding, clothing). Normal social contact (handshaking) without lesion exposure is low risk.

Is mpox a sexually transmitted infection?

In the 2022 global outbreak, mpox spread primarily through close sexual skin-to-skin contact among men who have sex with men. In Nigeria's endemic form, household and bushmeat contact are the main routes. Both modes of transmission occur.

How long am I infectious with mpox?

A person with mpox is infectious from the onset of the rash until all scabs have completely fallen off and healthy skin is underneath — typically 3-4 weeks. Isolation should be maintained for this entire period.

Where do I report a suspected mpox case in Nigeria?

Call NCDC on 0800-9700-0010 (toll-free) or report to the nearest LGA health officer, primary health centre, or any government hospital. Do not travel by public transport if you suspect mpox — arrange private transport to a health facility.