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Monkeypox Kills 40-Year-Old As Nigeria Confirms 21 Cases In Nine States

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Monkeypox Kills 40-Year-Old As Nigeria Confirms 21 Cases In Nine States

Nigeria has recorded its first death from monkeypox disease since the beginning of the year 2022, the nation’s disease outbreak management agency has said.

In the last five months, Nigeria Centre for Disease Control (NCDC) revealed that it has 21 cases from nine states and the Federal Capital Territory (FCT).

These include Adamawa – five, Lagos – four, Bayelsa – two, Delta – two, Cross River – two, FCT – two, Kano – two, Imo – one, and Rivers – one.

“The death was reported in a 40-year-old patient who had underlying co-morbidity and was on immunosuppressive medications,” NCDC Director-General, Dr Ifedayo Adetifa, said in a statement on Sunday.

“Genomic surveillance is ongoing at NCDC’s National Reference Laboratory in Abuja and so far, all of the cases have been confirmed to be caused by West Africa clade Monkeypox virus.

“Among the 21 cases reported in 2022 so far, there has been no evidence of any new or unusual transmission of the virus, nor changes in its clinical manifestation documented (including symptoms, profile and virulence).”

Adetifa stated that the NCDC activated a national multisectoral Emergency Operations Centre for Monkeypox (MPX-EOC) at level two last Thursday, to strengthen and coordinate ongoing response activities in-country while contributing to the global response.

This, he explained, was based on the report of a preliminary risk assessment done by a group of Subject Matter Experts from the NCDC, as well as relevant government Ministries, Departments and Agencies, and partner agencies.

What To Know

Prior to the activation of the MPX-EOC, a multi-agency Technical Working Group (TWG) coordinated at the NCDC led Nigeria’s efforts to improve the detection, prevention, and control of monkeypox, the NCDC chief said.

According to him, Nigeria’s national surveillance system – the Surveillance Outbreak Response Management and Analysis System (SORMAS) – was first deployed in response to the 2017 monkeypox outbreak to improve the timeliness and completeness of case reporting, as well as facilitate the overall response.

“In addition, this pilot project informed the nationwide scale-up of SORMAS to enable real-time reporting of surveillance data for prompt public health response to infectious disease outbreaks including COVID-19,” said Adetifa.

“Following the detection of the index case on September 22, 2017, and the effective containment of the 2017 outbreak in Nigeria, the NCDC through the Monkeypox TWG worked on various interventions to gain a better understanding of the epidemiology of the virus to inform preparedness and response in-country.”

The NCDC said Nigeria’s risk of exposure to the monkeypox virus was high based on the recent risk assessment conducted.

It, however, noted that the current situation in-country and globally has shown no significant threat to life or the community that can result in severe disease or high case fatality rate., while the EOC would continue to monitor the evolving situation to inform public health action accordingly.

Symptoms of monkeypox include sudden fever, headache, body pain, weakness, sore throat, enlargement of glands (lymph nodes) in the neck and under the jaw, followed by the appearance of a rash (often solid or fluid-filled at the onset) on the face, palms, soles of the feet, genitals, and other parts of the body.

The NCDC emphasised that members of the public should remain aware of the risk of monkeypox and adhere to public health safety measures and report to the nearest health facility if they notice the known signs and symptoms of the disease.

Healthcare workers were also advised to maintain a high index of suspicion for monkeypox and report any suspected case to the relevant state Epidemiology Team for prompt public health intervention, including sampling for confirmatory testing.

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Lagos Govt Unveils New Guidelines On Safe, Lawful Abortions

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Lagos Govt Unveils New Guidelines On Safe, Lawful Abortions

The Lagos State government says its Ministry of Health has developed a set of policies on safe termination of pregnancy.

Tagged “Lagos State Guidelines on Safe Termination of Pregnancy for Legal Indications,” the 40-page policy document sets out guidelines for safe termination of pregnancy within the ambit of the criminal law of the state.

Dr Olusegun Ogboye, who is the Permanent Secretary of the ministry, presented and launched the document at a stakeholders’ engagement held on Tuesday in Lagos.

He explained that the policy document was produced following the need to provide evidence-based data and information for health workers in public and private sectors who have the requisite skills and training necessary to provide safe terminations to reduce preventable deaths.

The permanent secretary added that while therapeutic termination of pregnancy was permissible under the law, the absence of clear guidelines has stalled the effective implementation at appropriate levels of care, resulting in preventable deaths.

“In 2011, the Lagos State House of Assembly updated the criminal code, providing for abortion to save the life and protect the physical health of the woman,” he said. “While physical health is covered under the Lagos legal framework, services conforming to the law have not been available in Lagos State health sector.

“This document provides information on relevant laws applicable in Lagos State while providing standards and best practices with regards to legal indications, pre and post-procedure care, methods, and monitoring. I must state here that this document has undergone wide consultation with relevant technical stakeholders within the legal and health service context in the state.”

Ogboye explained that the process to develop the guidelines commenced in 2018 with the Safe Engage project led by the ministry and hosted by the Society for Obstetricians and Gynaecologists of Nigeria (SOGON), with support from the Population Reference Bureau (PRB).

He added that stakeholders in the health sector worked with key opinion leaders in Lagos and the south-west region to develop a tailored advocacy tool for terminations within the legal context.

The permanent secretary pointed out that the advocacy messages on the Safe Engage project focused on two immediate outcomes, including ensuring that safe abortion services were available within legal indications in Lagos and domesticating the Violence Against Persons Prohibition Act, supporting women to terminate a pregnancy caused by rape or incest.

“To guide the implementation, one of the follow-up recommendations of the project was the adaptation of the National Standards and Guidelines for Safe Termination of Pregnancy within Legal Indications within the Lagos State context,” he said.

“The Federal Ministry of Health had developed and disseminated the national guidelines on safe termination of pregnancy which highlights the compendium of conditions and circumstances under which termination of pregnancy could be instituted.

“The guideline was intended to build the capacity of health professionals to identify pregnancies for which legal termination could be instituted.”

Others who spoke at the event include the Country Director of Marie Stopes International Organisation Nigeria (MSION), Emmanuel Ajah; the Vice-Chancellor of the University of Medical Sciences, Otukpo, Professor Innocent Ujah; and a Professor of Law at the University of Lagos, Ayodele Atsenuwa.

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Covid Vaccines Saved 20 Million Lives In First Year – Study

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Covid Vaccines Saved 20 Million Lives In First Year – Study

Covid vaccines prevented nearly 20 million deaths in the first year after they were introduced, according to the first large modelling study on the topic released Friday.

The study, published in The Lancet Infectious Diseases, is based on data from 185 countries and territories collected from December 8, 2020 to December 8, 2021.

It is the first attempt to estimate the number of deaths prevented directly and indirectly as a result of Covid-19 vaccinations.

It found that 19.8 million deaths were prevented out of a potential 31.4 million deaths that would have occurred if no vaccines were available.

It was a 63 percent reduction, the study found.

The study used official figures — or estimates when official data was not available — for deaths from Covid, as well as total excess deaths from each country.

Excess mortality is the difference between the total number of people who died from all causes and the number of deaths expected based on past data.

These analyses were compared with a hypothetical alternative scenario in which no vaccine was administered.

The model accounted for variation in vaccination rates across countries, as well as differences in vaccine effectiveness based on the types of vaccines known to have been primarily used in each country.

China was not included in the study because of its large population and strict containment measures, which would have skewed the results, it said.

The study found that high- and middle-income countries accounted for the largest number of deaths averted, 12.2 million out of 19.8 million, reflecting inequalities in access to vaccines worldwide.

Nearly 600,000 additional deaths could have been prevented if the World Health Organization’s (WHO) goal of vaccinating 40 percent of each country’s population by the end of 2021 had been met, it concluded.

“Millions of lives have probably been saved by making vaccines available to people around the world,” said lead study author Oliver Watson of Imperial College London.

“We could have done more,” he said.

Covid has officially killed more than 6.3 million people globally, according to the WHO.

But the organisation said last month the real number could be as high as 15 million when all direct and indirect causes are accounted for.

The figures are extremely sensitive due to how they reflect on the handling of the crisis by authorities around the world.

The virus is on the rise again in some places, including in Europe, which is seeing a warm-weather resurgence blamed in part on Omicron subvariants.

AFP

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WHO considers declaring monkeypox a global health emergency

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WHO considers declaring monkeypox a global health emergency

As the World Health Organization convenes its emergency committee Thursday to consider if the spiraling outbreak of monkeypox warrants being declared a global emergency, some experts say WHO’s decision to act only after the disease spilled into the West could entrench the grotesque inequities that arose between rich and poor countries during the coronavirus pandemic.

Declaring monkeypox to be a global emergency would mean the U.N. health agency considers the outbreak to be an “extraordinary event” and that the disease is at risk of spreading across even more borders. It would also give monkeypox the same distinction as the COVID-19 pandemic and the ongoing effort to eradicate polio.

Many scientists doubt any such declaration would help to curb the epidemic, since the developed countries recording the most recent cases are already moving quickly to shut it down.

Last week, WHO Director-General Tedros Adhanom Ghebreyesus described the recent monkeypox epidemic identified in more than 40 countries, mostly in Europe, as “unusual and concerning.” Monkeypox has sickened people for decades in central and west Africa, where one version of the disease kills up to 10% of people. In the epidemic beyond Africa so far, no deaths have been reported.

“If WHO was really worried about monkeypox spread, they could have convened their emergency committee years ago when it reemerged in Nigeria in 2017 and no one knew why we suddenly had hundreds of cases,” said Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups. “It is a bit curious that WHO only called their experts when the disease showed up in white countries,” he said.

Until last month, monkeypox had not caused sizeable outbreaks beyond Africa. Scientists haven’t found any major genetic changes in the virus and a leading adviser to WHO said last month the surge of cases in Europe was likely tied to sexual activity among gay and bisexual men at two raves in Spain and Belgium.

To date, the U.S. Centers for Disease Control and Prevention has confirmed more than 3,300 cases of monkeypox in 42 countries where the virus hasn’t been typically seen. More than 80% of cases are in Europe. Meanwhile, Africa has already seen more than 1,400 cases this year, including 62 deaths.

David Fidler, a senior fellow in global health at the Council on Foreign Relations, said WHO’s newfound attention to monkeypox amid its spread beyond Africa could inadvertently worsen the divide between rich and poor countries seen during COVID-19.

“There may be legitimate reasons why WHO only raised the alarm when monkeypox spread to rich countries, but to poor countries, that looks like a double standard,” Fidler said. He said the global community was still struggling to ensure the world’s poor were vaccinated against the coronavirus and that it was unclear if Africans even wanted monkeypox vaccines, given competing priorities like malaria and HIV.

“Unless African governments specifically ask for vaccines, it might be a bit patronizing to send them because it’s in the West’s interest to stop monkeypox from being exported,” Fidler said.

WHO has also proposed creating a vaccine-sharing mechanism to help affected countries, which could see doses go to rich countries like Britain, which has the biggest monkeypox outbreak beyond Africa — and recently widened its use of vaccines.

To date, the vast majority of cases in Europe have been in men who are gay or bisexual, or other men who have sex with men, but scientists warn anyone in close contact with an infected person or their clothing or bedsheets is at risk of infection, regardless of their sexual orientation. People with monkeypox often experience symptoms like fever, body aches and a rash; most recover within weeks without needing medical care.

Even if WHO announces monkeypox is a global emergency, it’s unclear what impact that might have.

In January 2020, WHO declared that COVID-19 was an international emergency. But few countries took notice until March, when the organization described it as a pandemic, weeks after many other authorities did so. WHO was later slammed for its multiple missteps throughout the pandemic, which some experts said might be prompting a quicker monkeypox response.

“After COVID, WHO does not want to be the last to declare monkeypox an emergency,” said Amanda Glassman, executive vice president at the Center for Global Development. “This may not rise to the level of a COVID-like emergency, but it is still a public health emergency that needs to be addressed.”

Salim Abdool Karim, an epidemiologist and vice chancellor at the University of KwaZulu-Natal in South Africa, said WHO and others should be doing more to stop monkeypox in Africa and elsewhere, but wasn’t convinced that a global emergency declaration would help.

“There is this misplaced idea that Africa is this poor, helpless continent, when in fact, we do know how to deal with epidemics,” said Abdool Karim. He said that stopping the outbreak ultimately depends on things like surveillance, isolating patients and public education.

“Maybe they need vaccines in Europe to stop monkeypox, but here, we have been able to control it with very simple measures,” he said.

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