Clinical Course and Outcome of Human Monkeypox in Nigeria

Ogoina, Dimie; Iroezindu, Michael; James, Hendris Izibewule; Oladokun, Regina; Yinka-Ogunleye, Adesola; Wakama, Paul; Otike-Odibi, Bolaji; Usman, Liman Muhammed; Obazee, Emmanuel; Aruna, Olusola; Ihekweazu, Chikwe

doi:10.1093/cid/ciaa143

Cited by 358 publications

(447 citation statements)

References 9 publications

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“…Complicating the public health response, cases in Nigeria, although confirmed to be caused by the West African clade, have clinically been distinct: the West African Clade is historically believed to cause milder human disease, few deaths, and limited human-to-human transmission. However, some cases in Nigeria have been severe, even resulting in death, most commonly in persons with HIV infection ( 1 , 7 ). In addition, epidemiologic and genomic analyses have shown multiple human-to-human transmission events in Nigeria, including within households and a prison; secondary cases occurred in a health care provider and in family members of one patient whose illness was diagnosed in the United Kingdom ( 1 , 7 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, some cases in Nigeria have been severe, even resulting in death, most commonly in persons with HIV infection ( 1 , 7 ). In addition, epidemiologic and genomic analyses have shown multiple human-to-human transmission events in Nigeria, including within households and a prison; secondary cases occurred in a health care provider and in family members of one patient whose illness was diagnosed in the United Kingdom ( 1 , 7 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Monkeypox in a Traveler Returning from Nigeria — Dallas, Texas, July 2021

Rao¹,

Schulte²,

Chen³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

208

139

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Monkeypox in a Traveler Returning from Nigeria — Dallas, Texas, July 2021

Rao¹,

Schulte²,

Chen³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

208

139

View full text Add to dashboard Cite

“…These studies are essential to our understanding of the host and viral factors that modulate MPXV pathogenesis and its possible emergence as a VARV-like pathogen. There are reports of co-infection of MPXV and VZV (Varicella-Zoster virus) [72,93,136,[204][205][206] and co-infection of MPXV and HIV [206][207][208]. Ogoina et al hypothesized that the alteration (in co-infected patients) in MPXV natural history and course of infection could be related to HIV immunosuppression.…”

Section: Co-infection and Recombinationmentioning

confidence: 99%

“…Ogoina et al hypothesized that the alteration (in co-infected patients) in MPXV natural history and course of infection could be related to HIV immunosuppression. Thus, more studies are warranted to test this claim especially in Nigeria where MPXV and HIV co-infection has been reported [207].…”

Section: Co-infection and Recombinationmentioning

confidence: 99%

Monkeypox Virus in Nigeria: Infection Biology, Epidemiology, and Evolution

Alakunle

Moens

Nchinda

et al. 2020

Viruses

575

685

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Monkeypox is a zoonotic disease caused by monkeypox virus (MPXV), which is a member of orthopoxvirus genus. The reemergence of MPXV in 2017 (at Bayelsa state) after 39 years of no reported case in Nigeria, and the export of travelers’ monkeypox (MPX) from Nigeria to other parts of the world, in 2018 and 2019, respectively, have raised concern that MPXV may have emerged to occupy the ecological and immunological niche vacated by smallpox virus. This review X-rays the current state of knowledge pertaining the infection biology, epidemiology, and evolution of MPXV in Nigeria and worldwide, especially with regard to the human, cellular, and viral factors that modulate the virus transmission dynamics, infection, and its maintenance in nature. This paper also elucidates the role of recombination, gene loss and gene gain in MPXV evolution, chronicles the role of signaling in MPXV infection, and reviews the current therapeutic options available for the treatment and prevention of MPX. Additionally, genome-wide phylogenetic analysis was undertaken, and we show that MPXV isolates from recent 2017 outbreak in Nigeria were monophyletic with the isolate exported to Israel from Nigeria but do not share the most recent common ancestor with isolates obtained from earlier outbreaks, in 1971 and 1978, respectively. Finally, the review highlighted gaps in knowledge particularly the non-identification of a definitive reservoir host animal for MPXV and proposed future research endeavors to address the unresolved questions.

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“…Monkeypox data from the DRC accounted for approximately one-third of the eligible articles [5,13,14,[16][17][18][19][20][21][22][23][24][25][26][27][28]. The remaining articles had monkeypox data from the CAR [29][30][31][32][33][34][35], United States (US) [36][37][38][39][40][41], Nigeria [5,[42][43][44], Republic of the Congo [15,[45][46][47], Sierra Leone [42,48,49],…”

Section: Number Of Reports By Countrymentioning

confidence: 99%

The changing epidemiology of human monkeypox – a potential threat? A systematic review

Bunge¹,

Hoet²,

Chen

et al. 2021

Preprint

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Monkeypox, a zoonotic disease caused by an orthopoxvirus, results in a smallpox-like disease in humans. Since monkeypox in humans was initially diagnosed in 1970 in the Democratic Republic of the Congo (DRC), it has spread to other regions of Africa (primarily West and Central), and cases outside Africa have emerged in recent years. We conducted a systematic review of peer-reviewed and grey literature on how monkeypox epidemiology has evolved, with particular emphasis on the number of confirmed, probable, and/or possible cases, age at presentation, mortality, and geographical spread. The review is registered with PROSPERO (CRD42020208269). We identified 48 peer-reviewed articles and 18 grey literature sources for data extraction. The number of human monkeypox cases has been on the rise since the 1970s, with the most dramatic increases occurring in the DRC. The median age at presentation has increased from 4 (1970s) to 21 years (2010-2019). There was an overall case fatality rate of 8.7%, with a significant difference between clades - Central African 10.6% (95% CI: 8.4% - 13.3%) vs. West African 3.6% (95% CI: 1.7% - 6.8%). Since 2003, import- and travel-related spread outside of Africa has occasionally resulted in outbreaks. Interactions/activities with infected animals or individuals are risk behaviors associated with acquiring monkeypox. Our review shows an escalation of monkeypox cases, especially in the highly endemic DRC, a spread to other countries, and a growing median age from young children to young adults. These findings may be related to the cessation of smallpox vaccination, which provided some cross-protection against monkeypox, leading to increased human-to-human transmission. The appearance of outbreaks beyond Africa highlights the global relevance of the disease. Increased surveillance and detection of monkeypox cases are essential tools for understanding the continuously changing epidemiology of this resurging disease.

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Clinical Course and Outcome of Human Monkeypox in Nigeria

Cited by 358 publications

References 9 publications

Monkeypox in a Traveler Returning from Nigeria — Dallas, Texas, July 2021

Monkeypox in a Traveler Returning from Nigeria — Dallas, Texas, July 2021

Monkeypox Virus in Nigeria: Infection Biology, Epidemiology, and Evolution

The changing epidemiology of human monkeypox – a potential threat? A systematic review

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