The resurgence comes two years after the index case was reported in the country. While Lagos, in the current reappearance, recorded three cases, Rivers and Akwa Ibom have one each.

According to the latest situation report on monkeypox and Lassa fever published by NCDC , “In the reporting month (September 2019), 15 new suspected monkeypox cases were reported from five states – Lagos (five), Rivers (two), Akwa Ibom (three), Zamfara (one), Delta (one), Imo (two) and the Federal Capital Territory, FCT (one).

“Five of the 15 suspected cases were confirmed positive for monkeypox in three states. Five of the suspected cases tested positive for chickenpox, while others are for further evaluation. No death was recorded in the reporting month.”

The NCDC said a total of 81 suspected cases have been reported so far in 2019, of which 39 confirmed cases were recorded in nine states (Bayelsa, Lagos, Delta, Rivers, Akwa Ibom, Enugu, Anambra, Cross River, and Oyo), with one death.

The centre noted that of the confirmed cases, 59 per cent was from two states, Delta (28 per cent) and Lagos (26 per cent); the most affected age group was 21-40 years; and 84.6 per cent of confirmed cases had a male-to-female ratio of 2.6:1.

According to the NCDC, since the beginning of the outbreak in September 2017, 176 confirmed cases and nine deaths have been recorded in 18 states (Rivers, Bayelsa, Cross River, Imo, Akwa Ibom, Lagos, Delta, Bauchi, FCT, Abia, Oyo, Enugu, Ekiti, Nasarawa, Benue, Plateau, Edo, and Anambra).

To address the problem, the chief executive officer of NCDC, Dr. Chikwe Ihekweazu, said the centre, through the Monkeypox Technical Working Group, is coordinating the national response and control in collaboration with states and partners. He said outbreak response support is provided to states amid ongoing surveillance for Monkeypox in all states, especially high-risk ones.

Ihekweazu said the World Health Organisation African Region (WHO-Afro) regional office listed Monkeypox for immediate reporting in the 2018 Integrated Disease Surveillance and Response guidelines.

The epidemiologist said Nigeria also listed Monkeypox as a priority disease for routine reporting. This will be covered in the 2019 edition of the Nigeria Integrated Disease Surveillance and Response (IDSR) guidelines. He said surveillance and case management regional training in the southeast and southwest regions has been rescheduled to November 2019, and a response team has been deployed to support enhanced surveillance in Akwa Ibom.

Ihekweazu said animal surveillance is currently being conducted in Lagos, while the result of similar surveillance in four states (Cross River, Rivers, Bayelsa and Edo) is being awaited.

According to the NCDC, from January 1 to October 6, 2019, a total of 4019 suspected cases have been reported from 23 states. Of these, 721 were confirmed positive, 18 probable, and 3256 negatives. Also, since the onset of the 2019 outbreak, there have been 154 deaths in confirmed cases with a fatality ratio of 21.4 per cent.

The NCDC said 23 states (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Plateau, Taraba, Adamawa, Gombe, Kaduna, Kwara, Benue, Rivers, Kogi, Enugu, Imo, Delta, Oyo, Kebbi, Cross River, Zamfara, Lagos and Abia) have recorded at least one confirmed case across 86 local government areas.

The centre said 93 per cent of all confirmed cases are from Edo (38 per cent), Ondo (30 per cent), Ebonyi (7 per cent), Bauchi (7 per cent), Taraba (6 per cent), and Plateau (5 per cent).

According to the NCDC, in reporting week 40, no new healthcare worker was affected and a total of 19 healthcare personnel have been infected since the onset of the outbreak in 10 states – Edo (six), Ondo (four), Ebonyi (two), Enugu (one), Rivers (one), Bauchi (one), Benue (one), Delta (one), Plateau (one) and Kebbi (one), with two deaths in Enugu and Edo.

The NCDC said 12 patients are currently being managed at various treatment centres across the country: 11 at the Irrua Specialist Teaching Hospital (ISTH) treatment Centre, Edo State; and one patient at the Federal Medical Centre, Owo, Ondo State.