# Mpox outbreak in Abia State, Nigeria, 2024: implications for varicella zoster virus coinfection among children

## TL;DR

This study analyzed a 2024 Mpox outbreak in Nigeria, finding that children were most affected and many had a coinfection with varicella zoster virus.

## Contribution

The study highlights the high prevalence of varicella zoster virus coinfection among Mpox cases in children in Nigeria.

## Key findings

- 10 out of 61 suspected Mpox cases were confirmed, with 60% having varicella zoster virus coinfection.
- Most confirmed Mpox cases were in children under 15 years old, with males predominantly affected.
- Ukwa East LGA had the highest attack rate of 3 per 100,000 population.

## Abstract

Mpox remains a significant public health concern in Africa with a notable increase in cases and outbreaks in several countries. Despite the efforts of surveillance and other specific interventions, Nigeria has been reporting ongoing cases since its re-emergence in 2017. We conducted an epidemiologic description of the 2024 Mpox outbreak in Abia State to understand the drivers and inform its control strategies.

we investigated the cases and conducted a descriptive study of suspected cases of Mpox line listed in 2024. Data were collected with a standardized case investigation form. An active case search was conducted in affected communities, and a review of hospital records was done. Samples were collected and tested at the National Reference Laboratory for confirmation. The data was downloaded from SORMAS, cleaned, and analysed using SPSS. Frequencies, proportions, and attack rates were generated.

sixty-one suspected Mpox cases were line listed and 10 (16.4%) were laboratory-confirmed, with 6(60%) out of the confirmed cases having varicella zoster virus (VZV) coinfection. Among the confirmed cases, males constituted 60% (6/10), and the median age was 9.5 years (IQR: 3 - 27 years). The predominant age group was 0 - 15 years, 7 (70%). Out of the 12 reporting LGAs, confirmed cases were dominant in 5 LGAs. The commonest symptoms were fever (90%) and itchy vesiculopustular rash (90%). The most common symptom was fever (30%). Among all confirmed cases with rashes (90%), skin lesions were mostly on the face, legs, arms, and genitals. Ukwa East LGA had the highest attack rate (3/100,000 population).

the confirmed cases were mostly children with a high prevalence of VZV coinfection, and males were mostly affected. We recommended targeted public health awareness campaigns to the demographic groups mostly affected and emphasized enhanced surveillance and early diagnosis to minimize complications from Mpox/VZV coinfection.