Clinico-epidemiological Study of Mpox in a Tertiary Hospital in Benin City, Nigeria.

• ¹, University of Benin Teaching Hospital,

Background: Mpox, a re-emerging outbreak-prone viral zoonosis has been reported from healthcare facilities in Nigeria. This study aims to describe a series of mpox cases seen at a tertiary hospital in Nigeria and surveillance activities undertaken in response to an outbreak in 2022. 
Methods: Epidemiologic and clinical data of patients suspected to have mpox were collated using a standardised case investigation form. Appropriate specimens were taken and transported for real-time PCR diagnosis at the National reference laboratory. Data were analysed and summarized using descriptive statistics. 
Results: Sixteen suspected cases reported from April 1 to December 31, had a mean age of 34.1 ± 11.5 years. Mean turn-around time for laboratory results was 10.6 ± 4.9 days. Mpox was confirmed in 7 (43.5%) cases, amongst whom the mean age was 42.3 ± 10.2 and 5/7 (71.4%) were males. Travel and animal contact history were non- contributory. Only one (14.3%) had epidemiological links with someone with rash. One (14.3%) had concurrent human immunodeficiency virus infection while three others were co-infected with varicella zoster virus. All cases presented with rash distributed variously on the face, scalp, limbs, trunk and genitals. Three (42.9%) patients had mild lesions, one (14.3%) was moderate, one (14.3%) severe and two (28.6%) serious. Three patients were hospitalised including two patients who had serious rash and one who also had neurological manifestation of headache and seizures. No deaths or secondary transmissions occurred within the hospital. 
Conclusion: This study describing self-limiting disease in predominantly male urban dwellers with undetermined exposure sources contributes to the literature on mpox in Nigeria.  Facility  response  was  hampered  by  laboratory  diagnostic  delays. Decentralised testing and further research to understand transmission mechanisms of mpox are recommended.