Earlier warnings of monkeypox outbreaks were ignored five years ago. A patient whose illness would ultimately be related to the greatest monkeypox outbreak in history was seen by Dr. Dimie Ogoina five years ago. On September 22, 2017, a young kid with a weird rash on his skin and lesions inside his mouth visited Ogoina’s clinic. The youngster was 11 years old.
“He had really enormous lesions affecting his face and all over his body.” This is according to Ogoina, a specialist in infectious illness at the Niger Delta University in Nigeria. The rash has some characteristics of chickenpox. Ogoina counters by saying, “But the kid already had chickenpox.” Therefore, he was aware that this was not the issue.
Ogoina was concerned that the youngster could have monkeypox, which at the time was an exceptionally uncommon illness. He suspected that this might be the case based on the size of the lesions and their placement. “The possibility of monkeypox has now arisen,” he adds.
In those days, Nigeria lacked the diagnostic tools necessary to check for the presence of the illness. “So in order to establish a diagnosis, we were required to send our samples to Senegal and even to the United States.” “We were required to wait.”
After waiting a few days, the findings came back and they confirmed that Ogoina was right: the kid did have monkeypox.
According to Ogoina, this boy was the first instance of monkeypox to be diagnosed in Nigeria in 38 years. Over the course of the subsequent several months, he and his colleagues uncovered over twenty other cases at their clinic.
Earlier warnings of monkeypox outbreaks were ignored five years ago
Experts, including Ogoina, are only now realizing that this little child was a first not only for Nigeria, but for the entire world. This kid was born with a condition that had never been seen before. He was the first person to be diagnosed with the worldwide pandemic of monkeypox. This is presently spreading across 78 different nations.
Since May, health officials throughout the globe have recorded over 20,000 cases of monkeypox. This includes over 4,000 cases in the United States alone. This pandemic has been deemed a public health emergency by the World Health Organization. This made the announcement over the weekend.
Researchers are getting closer to understanding when and where this catastrophic pandemic first started. They were able to track it back to instances that took place in Nigeria in 2017. This includes the ones that Ogoina found in his clinic. According to the collected evidence, the virus has been continually spreading from person to person in Nigeria. This is for at least five years and most likely for much longer. In the end, that pandemic was able to spread over the rest of the globe.
When Ogoina initially diagnosed the little kid with monkeypox, Ogoina believed that the virus would behave in the same way that it has for more than 50 years in other regions of Africa, the way that experts explain in textbooks. However, Ogoina was wrong. In other words, epidemics almost always start when a human has contact with an infected animal. Ogoina said that there was widespread conjecture that the little child had been seen in the neighborhood interacting with monkeys.
Sporadic cases of monkeypox
However, under these conditions, the virus did not transmit very quickly between people since it was not extremely infectious, particularly amongst adults. This was especially true for adult-to-adult transmission. Ogoina notes that in the past, the majority of those who had monkeypox were children.
As a direct consequence of this, there have only been sporadic cases of monkeypox in the past. They often included fewer than a few dozen instances total. They eventually lost their momentum on their own.
Ogoina and the other physicians speculated that 2017’s epidemic would be similar to the previous one. “At first, we thought, ‘OK, this is the typical monkeypox that we are familiar with.'”
But a few weeks after making the diagnosis, Ogoina began to grow anxious – very concerned. He was worried about the small kid. The number of those infected in Nigeria has started to dramatically increase. Cases emerged in jurisdictions not only in the vicinity of this one youngster, but all throughout the country. Ogoina claims that all of a sudden, cases started popping up in different parts of the nation.
It seemed that the virus was moving further and more quickly than anybody had anticipated. And adults in their 20s and 30s were the ones who were being infected, not children. Ogoina reports that young, physically active guys were becoming ill with monkeypox. “At that time, that was somewhat out of the ordinary.”
The monkeypox Inspection
In addition, these males did not meet the characteristics of a typical patient diagnosed with monkeypox. They did not engage in hunting or animal husbandry; rather, they were men of the middle class who lived in bustling, contemporary cities. Ogoina wondered, “Why aren’t children affected by it? Or females? Or what about the elderly? Why are we only seeing young guys between the ages of 20 and 40?” (In point of fact, Ogoina and his coworker finally came to the conclusion that the little child did not receive the virus from an animal but rather from a male relative living in the same home as him.)
In addition, the rashes that appeared on these individuals did not appear in the normal locations where monkeypox manifests itself. The blisters did not appear on their faces or extremities; rather, they were located around their genital areas. “They had really severe genital lesions all throughout their bodies. Extensive to an extreme degree, “Ogoina states.
Ogoina and his colleagues began doing more research on these patients. He states that they came to the conclusion that they needed to investigate the sexual histories of some of the victims. According to the findings of that evaluation, a significant number of the patients engaged in sexual practices that posed a high level of danger to themselves, such as having several sexual partners or having sex with prostitutes.
The repercussions in the change in transmission
The conclusion that can be drawn from all of this is that the virus has evolved. It was discovered that sexual interaction was the primary means of transmission. Even Ogoina and his colleagues highlighted the concept in their 2019 paper, which was published as follows: “Although the role of sexual transmission in human monkeypox has not been established, sexual transmission is plausible in some of these patients, Ogoina and his colleagues wrote in the journal PLOS One. Sexual transmission is plausible in some of these patients through close, skin-to-skin contact during sexual intercourse or by transmission via genital secretions,” they added.
Ogoina was aware that this change in transmission would have significant repercussions. It meant that the monkeypox virus could be transmitted more readily from person to person and that it was no longer necessary for the virus to move from animals to humans. That it is now possible for it to survive transmission from human to human, when before it was unable to do so.
That made it much more difficult to put a halt to the pandemic that was occurring in Nigeria. It is possible that it may continue for many years and that it will ultimately spread to other nations. The results indicated that monkeypox was not just a possible concern for communities in West and Central Africa but also a potential hazard to the rest of the globe. In many respects, this meant that monkeypox was no longer merely a threat to populations in West and Central Africa.
Public health and scientists
Ogoina claims that he has made several attempts over the course of the previous few years to alert authorities in charge of public health and scientists to the fact that monkeypox has mutated and was likely spreading via sexual contact. He attempted to bring up the idea of sexual transmission at one of the international meetings that he attended. Someone admonished him to keep his mouth shut.
An epidemic that has never been contained.
“Yes, someone cautioned me that it was inappropriate for me to say that. Okoina thinks back to that time and says, “I shouldn’t have made it sound like sexual transmission was possible because.” He assured me that we had nothing to be concerned about in terms of sexual transmission.
Approximately 200 cases of monkeypox were recorded in Nigeria in 2017. And then suddenly, at the beginning of 2018, there was a significant drop in the number of instances. On the surface, it seemed as if the government had effectively managed the virus and that the epidemic had come to a stop, just as all other instances of monkeypox had in the past.
Ogoina, however, asserts that this was not the case. According to him, health authorities have instead slowed down their hunt for new instances of the disease. “Over the course of time, interest in and focus on monkeypox just faded away. “Surveillance diminished,” he explains.
“The number of instances we’ve had in Nigeria is not a genuine depiction of real cases because we are not undertaking appropriate monitoring,” which translates to “the number of cases we’ve had in Nigeria does not accurately reflect actual cases.”
Monkeypox in Nigeria
Ogoina’s notion is supported by recent genomic evidence that has been gathered by academics all around the globe. Michael Worobey, an evolutionary biologist at the University of Arizona, has been doing research and analysis on this data.
According to Worobey, the data demonstrates that monkeypox in Nigeria did not come to an end at any point. Instead, the spread of the virus in Nigeria remained hidden for many years. And soon, the infection there spread to other nations, finally becoming the expanding worldwide disease that the world is now combating.
Even though Worobey has not yet published his research, he maintains that the evidence cannot be disputed. “Since at least 2017, it is abundantly obvious that Nigeria has been experiencing endemic transmission, sometimes known as a continual occurrence of instances of the disease. “After that, anything from there was sent out [to the rest of the globe],” says Worobey.
According to these results, the global community had about five years to eradicate monkeypox and stop the spread of the virus, which would have prevented it from becoming endemic not only in Nigeria but also in Europe and North America.
Effort to halt the pandemic of monkeypox
However, Ogoina and Worobey also point out that the worldwide effort to halt the pandemic of monkeypox abroad has been far more successful than the international effort to stop the outbreak of monkeypox in Nigeria.
For instance, when the first instances of monkeypox were identified in the United Kingdom and Spain in the month of May, health authorities moved swiftly to begin immunizing those who were considered to be at risk or who had been exposed to the virus with the monkeypox vaccine.
Read: Monkeypox forces governor Newsom to declare state of emergency
Healthcare professionals in the United States have vaccinated tens of thousands of individuals, and the federal government has obtained more than 300,000 doses of the vaccine. However, this is not the case for Nigeria, as they have received no vaccine of any sort.