Dr. Sylvester Ikhisemojie
When the World Health Organisation announced that it was changing the name of Monkeypox disease to Mpox, it seemed like a curious step in the nomenclature for a disease. The current and ongoing outbreak of the disease condition was first confirmed in the United Kingdom in May 2022. It was to become the nucleus of a cluster of cases to emerge in the British capital.
That index case was detected in a patient who had recently travelled to Nigeria where the disease is quite common. Subsequent cases among people who had not travelled to Nigeria seemed to confirm that they were infected following contact with the visitor from Nigeria. In the following month, the disease was detected in other European countries and in North America as well. It has also spread to Asia and Australia. This would mark the first time the disease condition would spread beyond West and Central Africa since it was first diagnosed.
By July 2022, the Director General of WHO, Dr. Tedros Adhanom Ghebreyesus, announced that it had become a public health emergency of international concern. Once more, the world was faced with an international health situation of public dimensions, and there were those who quickly attributed its emergence to the dark African continent.
The WHO announced very unusually in November 2022 that it would change the name of this disease from Monkeypox to Mpox because of a letter communicated to the organisation by a team of about 24 African scientists who criticised the name being linked to the monkey as the virus had no relationship with that primate. In their thinking, the name fitted the stereotype of the general view of those of us from this continent as nothing much different from apes. It, therefore, was a name that was likely to complicate the attempts to fight the disease. It was unlikely to attract the necessary attention and mobilsation of the world’s resources that could be directed to combat the condition, they reasoned. It is commendable that the WHO listened to them. It is a huge service done to Africa. It is a testament to the state of affairs for the majority of the African population that it took such an extraordinary step to change course from validating what others have come to perceive about Africa being the origin of ignorance and infectious diseases.
The world had not yet recovered from the COVID-19 pandemic especially as new infections continued to manifest in the United States, Europe and China. It was evident from the crisis brought upon mankind by that pandemic that the fissures of race and economic inequality occurred everywhere.
From the United States through Latin America to Africa and Asia, it was evident that the poorest of the populations were also likely to suffer the most from a disease condition that had killed many. Blacks and Latinos in North America suffered disproportionately and died in huge numbers.
In the United Kingdom, France, Italy and Spain, all of which were hit hard, ethnic minorities and low-income earners bore the brunt of the disease. While Africans largely got off the worst aspects of the devastation it caused elsewhere, what was clear was that black immigrants in those hard-hit countries were more likely to be frontline workers who had direct contact with patients while their Caucasian supervisors were likely to be managerial staff with zero physical contact with patients. They were also likely to come from or live in less affluent neighbourhoods where sanitation is poorer and clean water may be scarce or non-existent as the world saw in Brazil and India. The likelihood is that poverty has a strong bearing on education, the level of knowledge and the affordability of decent housing and other amenities. These inequalities have a huge bearing on the outcome of disease outbreaks.
And so, the rich whites were spared far more than the poorer blacks and coloured races. The world refused to name the disease the Wuhan virus but did not fail to name Ebola after a Congolese river or Lassa fever after a village in Bauchi State. Not to mention the fact that many people in the northern hemisphere have long thought of people from sub-Saharan Africa as mere mammals quite similar to monkeys.
After all is said and done, Mpox is a viral infection that affects human beings and some other animals. It is related to the smallpox virus and is caused by the monkeypox virus. It is said to spread from infected animals through the handling of infected meat or via animal scratches. Many of the initial victims who eventually spread it to the human population lives on the fringes of the forests that dot the region. There are two broad species found in both Central Africa and West Africa and they behave differently. The key thing to note, however, is that the disease condition is characterised by fever, muscle aches, fatigue and swollen lymph nodes in various parts of the body. It is not usual to have all these features appear at once in the same person but that stage of the infection is followed by the appearance of eruptions in various parts of the body that look like blisters. However, some people may have a single such blister on their lip or their genitals.
The severity of the illness depends on the person’s immunity level. Young children, pregnant women and people suffering from other conditions that reduce their immune status have a severe form of the infection. Only a small percentage of people who ever caught Mpox have died from it. Most of the time, the blisters, which are properly called vesicles, appear between five and 21 days after the infection has occurred. They appear first on the face before going on to affect the torse, the palms of the hands and the soles of the feet. They begin as small, flat bumps but later fill up with clear fluid which later becomes yellow before bursting and forming scabs. These scabs could persist for up to 10 days.
The blisters may be only a handful but could also be several thousand around the body. When they dry up, they form pale lesions like those left by chicken pox and then they become dark over time. Certain complications are related to the disease, and these include pneumonia, sepsis, and severe eye infection which could be followed by blindness and the spread of the infection into the brain causing encephalitis, a viral infection. Stillbirths or birth defects may occur if the infection afflicts a pregnant woman. However, people who received vaccination against smallpox may be protected from this ugly infection.
The lesions produced by this infection may be small in size or in number as we said earlier. Sometimes, many of these could join together to form larger lesions. For good measure, this infection is believed to be under-reported in Nigeria and other African countries because it gained prominence at about the same time that many countries were focused on controlling COVID-19. It is believed therefore that many patients avoided going to the hospital for fear of contracting COVID-19. Sadly, it follows a certain string of disease conditions already associated with much of the continent and our native Nigeria is no exception.
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