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Year : 2018  |  Volume : 12  |  Issue : 1  |  Page : 1-9

Reminiscing the recent incidence of monkeypox in Nigeria: Its ecologic-epidemiology and literature review

1 Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Ilorin, Ilorin; Department of Medical Laboratory Services, University of Abuja Teaching Hospital, Gwagwalada, FCT Abuja, Nigeria
2 Department of Medical Laboratory Services, University of Abuja Teaching Hospital, Gwagwalada, FCT Abuja, Nigeria
3 Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
4 Department of Medical Laboratory Science, University of Calabar, Calabar, Nigeria

Correspondence Address:
Idris Abdullahi Nasir
Department of Medical Laboratory Services, University of Abuja Teaching Hospital, Gwagwalada, FCT Abuja
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/phmj.phmj_47_17

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Monkeypox (MKPX) is a rare viral zoonosis which was first discovered in a laboratory in Denmark in 1958. This critical review involved literature search of data on the history of MKPX virus (MKPXV), its emergence and re-emergence, molecular virology, global epidemiology and geographical distribution, the recent outbreak of MKPX in Nigeria, diagnostic and treatment considerations using Google Scholar, PubMed and Scopus. Findings from this review revealed that the first human cases of MKPX were diagnosed and differentiated from smallpox in the early 1970s. Since this period, several cases have been reported in rural, rainforest areas of West Africa and the Congo Basin, especially in the Democratic Republic of Congo, Cote d'Ivoire, Cameroon, Midwest of the United States of America, South-Sudan, Central African Republic, and recently in Nigeria. The outbreaks in the non-endemic areas of the US and Sudan occurred due to zoonotic transmission of the virus into these nonrain forested areas. The geographical spread of MKPXV until date has renewed research efforts in unravelling environmental factors that favour ecological niche of this pathogen. This study aimed to review both biotic and abiotic factors that are responsible for the expansion of the ecological niche and geographic distribution of human MKPX in Nigeria. It appears that environmental factors, conflict and globalisation are responsible for the increasing risk of animal-human transmission through direct contact between the cutaneous or mucosal lesions of the infected animal and the compromised skin barrier of a human, and the consumption of poorly cooked-infected flesh. Lymphadenopathy is a distinguishing clinical feature of MKPX from other pox-like illnesses. Laboratory diagnosis of anti-poxvirus antibodies in an unvaccinated person with a clinical history of severe illness and total body rash is suggestive of MKPX infection. The lack of sufficient data to guide the identification of potential reservoir hosts, and public health intervention strategies/surveillance, inadequate training for health workers, unavailability and inaccessibility of suitable diagnostic assays, vaccines and anti-viral treatment could be some of the reasons cases of MKPX re-emerge when not successfully contained, especially in endemic regions.

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