ISID 2022: Monkeypox

The session discusses the issue of monkeypox in Nigeria and in the United Kingdom (UK).

The latest public health emergency of international concern is the epidemic of monkeypox. In Nigeria, the disease was discovered in 1971, 1 year after the first human cases in the Democratic Republic of Congo. With respect to diagnosis, the country has faced challenges due to limited testing and no sequencing capacity. In addition, at that time, the global and national guidelines for case management and response were all very limited and did not focus on research on monkeypox. The re-emergence of monkeypox in Nigeria in 2017 has led to the exportation of some cases to a number of countries. But now, with guidelines in practice, there are appropriate notifications and some efforts to prevent the spread of the disease. The current issues with monkeypox involve the stigma of reporting, unreliable images of the disease and the lack of vaccination. The establishment of diagnostics in 2017 improved the testing capacity and sequencing capacity. Surveillance of the disease has improved with digitized surveillance management. In 2022, Nigeria had to activate monkeypox emergency operations centre to respond to the outbreak and the WHO has declared it a public health emergency of international concern. Another challenge with monkeypox is co-infection with herpes zoster.

In the UK, there is a standardised public health response which is part of the high consequence infectious diseases approach. The UK has recently seen clusters of cases among gay, bisexual and other men who have sex with men. As of 14th November, 2022, the UK has 3710 cases of monkeypox and most cases are in young and middle-aged men. By targeting public health measures, the strategic aim is to suppress the transmission of the disease in the community. The principles of control also include protection against spread of infection in hospitals and healthcare and maintaining the safe functioning of health services. This is possible through good community engagement where people with compatible symptoms presenting to relevant services, developing the services within sexual health and enabling the laboratory capacity to diagnose people. However, contact tracing and stigmatization were the challenges in identifying cases and reducing transmission.  The vaccine administered in the UK is Imvanex which was given as a post-exposure vaccine. Selective pre-exposure vaccine was given to those individuals who were at a high risk of exposure. The drug tecovirimat is currently used for monkeypox patients. It targets VP37 protein and is given to confirmed hospitalized cases with symptoms

P03 International Society for Infectious Diseases (ISID) Congress 2022, 17^th-20^th  Nov. 2022, Malaysia