# P-2176. Descriptive Epidemiology of Mpox and Varicella-Zoster Virus (VZV) Co-Infection, January 2022 to March 2025 in Imo State, Southeastern Nigeria

## TL;DR

The study examines the co-infection of Mpox and VZV in Imo State, Nigeria, from 2022 to 2025, identifying risk factors and calling for vaccination.

## Contribution

The study provides descriptive epidemiology of Mpox-VZV co-infection in Nigeria, highlighting the need for vaccination and awareness.

## Key findings

- 56 laboratory-confirmed Mpox-VZV co-infection cases were identified with a case fatality rate of 3.6%.
- Owerri Municipal LGA had the highest proportion of cases at 23.8%, with most cases in males aged 0-5 years.
- Fever, rashes, and pustules were common symptoms in all confirmed co-infection cases.

## Abstract

Mpox is a zoonotic disease that is endemic to Nigeria and is caused by the Mpox virus, a member of the orthopoxvirus family. In humans, this virus can produce a severe illness that may resemble chickenpox or smallpox, and it frequently results in co-infections with varicella-zoster viruses (VZV). The first occurrence in Imo State was reported in 2018 and resulted in death. Beginning on January 6, 2022, a rising number of instances signaled the beginning of the outbreak. We looked into the severity of the co-infections of Mpox and varicella-zoster (VZV) outbreaks in the state.

Using the accepted standard case definition for Mpox, which is defined as a person with an acute illness who has a fever >38.3 °C, a severe headache, lymphadenopathy, back pain, and rashes that spread to every part of the body, including the soles of the feet and palms of the hands. In order to create a line list, we gathered sociodemographic and clinical information. For laboratory validation utilizing reverse transcription polymerase chain reaction (RT-PCR), we collected swabs and blood samples. We computed ratios and rates.

357 suspected cases were found and investigated from January 2022 to March 2025, there were 56 laboratory-confirmed cases of Mpox-VZV coinfection with 2 deaths and the highest proportion of cases being reported from Owerri Municipal LGA (23.8%), males (69.0%), aged 0-5 years (21.4%), and family members as contacts (50.3%). With a case fatality rate of 3.6% and a positivity rate of 15.7%. Fever, palm, foot, and cheek rashes, as well as pustules, were present in all 56 patients.

During the response, we enhanced surveillance for active case search, which helped to identify more cases. In order to encourage early diagnosis and case treatment, there is a need to increase awareness of the condition and its risk factors for high levels of index suspicion. In Nigeria, the introduction of the Mpox and varicella-zoster viruses (VZV) infection vaccines is needed, especially for children under 5 years children because they are mostly infected.

All Authors: No reported disclosures