Despite panic, Bayelsa remains calm as government battles Monkeypox

Beyond the media frenzy, the misinformation and misconception about the Monkey Pox disease that broke in the sleepy community of Agbura, Yenagoa local council area of Bayelsa state, social interaction among residents in the state capital has remained cordial.

In spite of rumours that people avoid handshakes and other interactions, residents of the state go about their normal businesses, oblivious of the momentum the news of the Monkey Pox outbreak is having globally.

Some of those who spoke with The Guardian said they never heard of the virus disease until the government made announcements on radio and television stations in the state. Besides, they all go about their daily routine since the outbreak came to public consciousness.

Normal activities were going on at Agbura on Thursday, where the first index case was recorded, when The Guardian visited on Thursday. Children were playing freely, the adults mostly traders, okada riders, artisans and farmers go about their daily routine without any hindrance.

However, nothing betrayed the incident that had drawn so much global attention, except for the unusual traffic of visitors to the town. Although most of the people declined on the scourge, a resident Yenagoa directed us to the street where the first victim resided with his parents.

After much conviction, Jonathan Egba, told The Guardian that the disease was brought into town by a non-indigene who he identified as a male secondary school pupil. He said the teenager allegedly ate monkey meat at his village in Anambra State, Southeast Nigeria shortly before he started showing symptoms of the disease when he returned to the community.

The elderly man said the community had never experienced such disease, noting that when the boy was down with the disease, they initially thought he had chicken pox. He added that they later heard on the television and radio that the strange disease he contracted was called Monkey Pox virus and that health officials took him and his infected seven-year-old brother away.

At Unity Street, contrary to the rumours that the place was deserted, the place was bubbling with life but most of the residents and shop owners were suspicious of new comers to the community.

A female resident of the street confirmed that there was indeed a Monkey Pox victim in the area, but gave a different version on how the victims contacted the virus.

According to her, the victims always play with a neighbour’s monkey to the extent of fondling and kissing the monkey while playing with it. Meanwhile, the state government has intensified its efforts, especially in the area of public enlightenment ‎and civic engagement.

Rivers State Government Responds Proactively, Revives Isolation Centre
From Kelvin Ebri and Ann Godwin, Port Harcourt
Rivers State has vigorously responded to the outbreak of Monkey Pox plague by reviving its temporary isolation centre located in Oduoha in Emohua Local Council of the state.

Barely three years after the Ebola outbreak, residents of State were once again alarmed over the reported case that some persons infected by the Monkey Pox have been admitted at the University of Port Harcourt Teaching Hospital (UPTH).

The report had alarmed the people of the state particularly as the photographs of victims in neighbouring Bayelsa went viral. Presently, people have continued to wait with agitation and dread-filled suspense for the outcome of the medical investigation of reportedly suspected cases.

But generally speaking, the people have commended the state government for its speedy and sustained effort at fighting the ailment. Unlike the Ebola plague, social life in the state, especially in Port Harcourt and its environs, has remained precautionary normal.

People still throng public places like parks, malls, eateries, zoo and bars. However, people are still wary of getting too close to anyone with rashes, particularly in taxis and commercial vehicles.

Commissioner for Health, Princewill Chike, told The Guardian that two persons were recently quarantined at the UPTH on suspicion of a possible infection. He said one of the patients who was admitted, has HIV and a weakened immune system that resulted in noticeable rashes in his body. But after a thorough examination, both patients were discharged.

He explained that although Monkey Pox was not as fatal as Ebola or Lassa fever, the state government has put in place the same preventive and protective measures adopted during the last Ebola outbreak.

As part of precautionary measures to contain the spread of the plague, Chike said disease surveillance team has been deployed to all the entry points of the state to scale up operational efforts in assessing persons coming into the State.

“It is a related virus like chicken pox, cow pox and camel pox. They are not as deadly as Ebola. Most viral ailments are self-limiting. There is no treatment for them. That is why we appeal that people should not panic. It is not Lassa fever. It is not Ebola.

We have not had real confirmed cases. Our rapid response team has been activated though. Our contract tracers are on the field. Our field men are at direct entry points to Rivers State. Our infection disease centre has been activated and they are ready to receive patients,” Chike said.

Speaking on the issue, the Chief Medical Director of UPTH, Professor Aaron Ojule, said the institution has prepared its facilities to receive and manage any case of the Monkey Pox outbreak.

He said, although there were no confirmed cases yet in the state, results from samples collected from two patients with rashes in the hospital isolation ward were still being awaited.

“Once we know that there is an emerging epidemic, our Emergency Response Mechanism (ERM) will use the Infection Prevention Control Team. Now we have activated our ERM because we have to stand in the gap for this local area.”

He, however, advised members of the public to avoid overcrowded places, sleep in well-ventilated apartments, avoid close contact with people and keep their environments clean to keep away rodents.

“We are working in collaboration with the state Ministry of Health in our catchment areas. We have intensified enlightenments and urge the public to stick to health hygiene, even though there is no confirmation that the cases here are Monkey Pox,” he added.

Ojule described the disease as very infectious, noting that it was not as deadly as Ebola, but stressed the need for people to wash their hands frequently. According to him, people with rashes related illnesses should report to any health facility closest to them for prompt action.

A veterinary doctor, Susan Abba, has advised health authorities in the state to cultivate the habit of monitoring for virus outbreaks in animals before they spread to human beings, owing to the fact that people in the rural areas often come in contact with animals from the wild.

Similarly, a public health expert, Rowland Nwafor, expressed concern that due to deteriorating hygiene and sanitation conditions across the state, the government should intensify the campaign that one of the most important strategies to contain the spread of the plague was by avoiding physical contact with animals in the wild and even pets such as monkeys at home.

Akwa Ibom Govt Has Sent Suspected Cases To Senegal For Diagnosis, Says Health Commissioner
From Inemesin Akpan Usoh, Uyo
Acting on the spur of the moment, the Akwa Ibom State Government is not leaving any stones unturned to nip the spread of the Monkey Pox virus in the bud.

Speaking on the outbreak of the disease, the state Commissioner for Health, Dr. Dominic Ukpong said the scourge was a rare disease transmitted to humans by animals, caused by a virus, which was first isolated from monkey serum, by the State Serum Institute in Copenhagen, Demark in 1958.

He pointed out that Akwa Ibom State became one of the states to have a suspected case of the disease. He explained that the suspected person cannot be said to have Monkey Pox since no laboratory test has proven so, stressing that the state has sent the serum to Senegal for definitive confirmation.

“On October 5, 2017, we got information of a suspected case in a General Hospital and immediately visited the patient, who was already in proper isolation. On the same date, we also received information about a female petty trader who had rashes and reached out to her and found her and her two children with similar rashes.

“We quarantined her with her kids in her home, while we continue to monitor and trace her contacts. No definitive diagnosis of the virus in the state and therefore, there is no confirmation of the spread of the disease. We only have suspected cases. It is only Senegal that has the equipment to confirm the disease. So, samples of all suspected cases have been sent for confirmation,” he said.

Unlike the Ebola saga, the news of the outbreak has not really affected the social life or activities in the state. When The Guardian visited some public places around Itam Junction, Wellington Bassey Way and Ikot Ekpene road popularly known as ‘Lagos,’ businesses were going on as those interviewed said they were not aware of the outbreak.

“That was what they told us when Ebola came. That we should not eat bush meat and that we should wash our hands. But at the end of the scare, nobody was affected.

Meanwhile, government officials have refused to disclose the hospital where the suspected victims in the state are being kept. Ukpong said such was strictly based on ethical reasons and explained that doing so could create problems for the facility, where those persons are kept as people may stop patronising them.

When The Guardian visited a community in the state, which has age-long tradition against monkeys to find out, whether the fear of the disease was the reason they do not eat monkeys, their responses was in the affirmative.

“This is why it is always said that the words of our elders are words of wisdom. Our forefathers might not have known this, but traditionally in our community it is an abomination to eat or have anything to do with monkeys. So, our people here will not have it except through any other means of contacting the disease,” he said.

The Commissioner said the state government has put precautionary measures to check any outbreak, adding that government has reactivated the Infectious Disease Emergency Rapid Response Team to monitor health facilities across the state.

According to him, Emergency Operations Centre (EOC) in Ikot
Ekpene and Infectious Disease Hospital (IDH) have been reactivated to take care of any suspected cases.

He said the state government has trained about 25 doctors and 75 nurses to respond to any emergency situation in the state. “All health facilities and workers therein have been notified to be on alert and exercise high index of suspicion.”

He, therefore, urged residents of the state be calm and not panic, advising that they should report any symptom of fever to the nearest heath facility for medical attention, instead of self medication.

In Edo, It’s More Questions, No Answers Yet
From Alemma-Ozioruva Aliu, Benin City
In Edo State, it has been caution and calculated acceptance of the recent outbreak of the Monkey Pox disease, which has put residents on the edge. Just like when the dreaded Ebola virus broke out in 2014, bush meat sellers were the worst hit as they lost all patronage.

Investigations showed that there was considerable drop in patronage even as the Association of Animal Hunters in Nigeria (AAHON) said they were the worst hit.
 President of the Association, Comrade Ray Macaulay, in a telephone chat with The Guardian, also complained of inadequate information on the epidemic.

“We are having issues with this monkey pox of a thing. We are at the receiving end of this issue. It is the hunters that are bearing the brunt and how long is this going to be with us.

“We are not being told anything and we wonder why when these things happen, it is always the hunters that receive the worst blow and we wonder why is always so.

“The Ministry of Health should give us the details of this monkey pox. Tell us how did this come about because we just woke in the morning and then we started hearing monkey pox.

“Where did it start? How did it start, so that we can know where to lay the blame, is it the hunters, is it that doctors cannot detect it or that somebody came from where the thing originated from and brought it to Bayelsa state. We don’t know how it came to Nigeria. This is what the Minister of Health supposed to tell Nigerians.

“Is it all manner of animals that are affected or is it only monkey that are affected because even if the squirrel is part of it when the monkey eats some fruits, it drops some, which the squirrels pick. The hunters are virtually out of business now. Our politicians are in Abuja collecting and sharing our money while the hunters are in the bush trying to get something to feed the family. I call this oppression against the hunters.”

A medical expert and Medical Director, Central Hospital, Benin City, Dr. Philip Ugbodaga called for vigilance in the management of the epidemic.

Explaining the mode of contraction, Ugbodaga said: “Monkey Pox infection can be contracted from direct contact with bodily fluids, blood or cutaneous or mucosal lesions of infected animals like monkeys, some types of giant rats, squirrels, and rodents. Eating inadequately cooked meat of infected animals is also a possible risk factor.

“People are advised to note and immediately present themselves to the nearest hospital in case of any unexplained incidence of fever, headache, muscle aches, chills, exhaustion and the occurrence within the first three days after the appearance of fever, the development of a rash, often beginning on the face then spreading to other parts of the body.

“Granted that since the first human case of Monkey Pox was recorded in 1970 in the Democratic Republic of Congo (DRC) and there has been any proven treatment for the viral infection. There are ample preventive measures against the disease. Because Monkey Pox can be transmitted from human to human through physical touch, contact with stool and blood. But avoiding contact with sick and dead animals can be very helpful.”

He lamented that hand hygiene, which should be a habit of all was only observed during epidemics like this. “We remember it as the most effective way of preventing contagious diseases, only to be discarded as soon as the epidemic is over. People are, therefore, advised to always practice good hygiene by washing their hands regularly or using an alcohol-based hand sanitiser.

“I also advise all healthcare workers to use personal protective equipment and observe universal precautions when caring for patients. No case of Monkey Pox has been recorded in Central Hospital, Benin City and I am certain that with the various efforts of the State Commissioner of Health, Dr. David Osifo and the Directorate of Disease Control in the State Ministry of Health, no incidence of the disease will be reported in Edo State.”

The Commissioner for Communication and Orientation, Paul Ohonbamu, while briefing journalists on the outcome of the disease in its weekly Executive Council (EXCO) meeting held at Government House, in Benin said the state government was alert and ready to combat the scourge.

He assured Edo residents of government’s proactive plans to guard against the spread of the disease to the state, saying government has directed the Ministry of Health to set up a fully-equipped situation room, where it can track and monitor possible outbreak.

He advised residents, who observe any seeming symptoms of the disease to call Dr. Osamwonyi Irowa, a Director in the State Ministry of Health on O8023345987 and Dr. Osa Bruce on 08084096723.

“The State Ministry of Health has been asked to reactivate an old centre located at Ikpoba Slope area of the state, to serve as a dedicated situation room. This is so that the outbreak can be monitored. We are calling on citizens to be circumspect, but calm and adhere to good health practices that will prevent contacting and spreading of the disease,” he said.

Panic Grips Residents, Parents, School Children In Delta
From Owen Akenzua, Asaba
The outbreak of the Monkey Pox disease in Delta State on Tuesday unsettled pupils of various primary schools and some secondary schools students in Ibusa, Asaba, Okpanam and their environs.

Expectedly, many of the pupils, particularly in Ibusa near Asaba were reportedly confused when one of the pupils was seen with symptoms of Monkey Pox in his body; thus raising fear of the unknown in the teachers and his friends.

But the head teacher of the school who spoke to The Guardian on the condition of anonymity said: “We observed rashes all over the boy’s body like the symptoms of Monkey Pox, but on getting to the hospital, the doctors said it was ordinary rashes, but the boy was kept under examination.”

It had been widely reported on social media that Delta State has joined other seven states presently hit by the disease, thereby increasing apprehension among residents of the state.

One of the parents, Mary Obuse who operates a restaurant in Asaba said: “I have asked my grandchild not to go to school in Ibusa until the government of Delta State clears the air on the rumours of Monkey Pox outbreak”.

But the State Health Commissioner, Dr. Nicholas Azinge, in a swift reaction said in view of the outbreak in other states, the state government was prepared to wage effective war against the disease, adding that they have placed rapid response team on red alerts to respond to emergencies whenever and wherever they may occur.

He urged members of the public not to panic as adequate arrangements were being made to prevent and curtail the outbreak of the disease in the state.

His words: “Disease outbreak prevention and case management materials have been pre-positioned in the council areas that have common borders with Bayelsa State to forestall a possible spread of the disease.

Azinge explained that Monkey Pox was a rare disease that occurs primarily in remote parts of central West Africa, near tropical rain forests adding that it was a rural zoonosis (a virus transmitted to humans from animals) with symptoms in humans similar to those seen in the past in small pox patients, through less severe.

Calm, Doubts, Apprehension In Cross River Over Reported Case Of Monkey Pox
From Tina Todo, Calabar
Mixed reactions have continued to trail the alleged reported case of Monkeypox in Okuni Community of Ikom Local Council of Cross River State. Calabar, the state capital has experienced calm as residents go about their normal businesses, while some said that the reported case was a mere speculation.

Some residents said they were afraid of exchanging handshakes with friends and loved ones for fear of contacting the disease, while some other residents of the affected community said they were not aware of any case of the disease.

But the State Government said there was a reported case of Monkey Pox in the community, which was yet to be confirmed. A teacher at Government Secondary School, Ikom, who lives in Okuni Community, Njah Akwa, said there has been calm as everyone in the community was going about their normal businesses, insisting though that the reported Monkey Pox case was a mere rumor.

“I am still surprised at the rate of rumours in this state. I am not aware of any case of Monkey Pox. The news is a surprise to most of us,” she said.

A businessman Mai Koli, who sells bush meat and palm wine in Ikom, lamented the lack of sales since the reported case of the ailment broke, saying most of his customers have not visited his shop for the past three days.

“My bush meat pepper soup is one of the best in Ikom, but sales have dropped since the spread of the fake news. There is no such thing here.”  Speaking to The Guardian, the state Epidemiologist, Patience Uka, disclosed that the suspected person was ignorantly sent out of the community for fear of spreading the disease to other members.

Uka said the two health personnel who attended to the suspected case were under surveillance as their samples have been taken for further investigation.

“We didn’t get the real contact, because by the time we got to the community, the resident had already sent him away out of ignorance. So, we only have two people that were in contact with him and they are the healthcare workers that took care of the suspect at Okuni Healthcare Centre.

“As at the time we visited, the two of them have started developing rashes and on Tuesday when we looked at the second one, the rashes were obvious than the other one. We only took history of the disease and also collected their samples and we are yet to take them to Lagos for screening. We are still on surveillance for other cases.

“I have sent his contact to my colleague in Akwa Ibom. If they get him, they will tell me. As I speak, we are trying to get him on telephone, but his line is switched off. We will continue to follow him up until we get in touch with him.

“It is unfortunate. I don’t know whether they picked the virus because we have not been able to confirm it yet. It is just that they came down with few rashes on their body and face. It is not very obvious. It is not yet confirmed,” she stated.

She said the easiest way to contract the disease was through handshake and physical contact with other persons, noting that the state government through the Office of the Commissioner for Health has alerted communities in the state to be cautious of handshake for now.

Earlier, the State Ministry of Health in a statement said that the symptoms to look out for include fever, intense headache, swelling of the lymph node and back pains. She also mentioned muscle ache and an intense lack of energy, then, finally, the skin erupts with rashes mostly on the face, palms and soles of the feet.

The State Commissioner for Health, Dr. Iyang Asibong, said the Health ministry’s attention has been drawn to reports of Monkey Pox in Okuni, Ikom Council just days after the suspect returned from Akwa Ibom State with symptoms that were suggestive of the disease.

He called on members of the public, especially those living in the area to be careful and avoid close contacts with each other as the incubation period of Monkey Pox disease is usually from six to 16 days but could vary from five to 21 days.

“Along with the activation of the disease surveillance and response team for the outbreak across the state, the state Epidemiology team has also collected samples from the suspect and sent to Abuja for proper investigation while they continue to contact tracing and isolation of the suspect.

“We urge the public to be on red alert and not hesitate to report any suspected cases to the State Epidemiology Department or appropriate authorities immediately.

“Avoiding close physical contacts with body fluids of suspects, regular hand washing especially after caring for or visiting sick people and thoroughly cooking all animal products before eating are the best preventive measures against human to human transmission,” she warned.