Following the outbreaks of Mpox (previously known as Monkeypox) coupled with measles (chikuku) and perennial cases of cholera, Ministry of Heath is enhancing the global 'One Health' approach that urges the public to seriously maintain personal hygiene as these diseases are preventable.
One Health is an approach that recognises that the health of people is closely connected to the health of animals and the shared environment and Mpox, a zoonotic disease, is transmitted to people through in animals.
Following the surge of Mpox cases in countries in the African region with trade and travel connections with Malawi, the Public Health Emergency Operations Centre is on ALERT and preparedness efforts underway.
The country has not reported any confirmed case of Mpox but there were 44 alert signals that were reported from several districts.
At an engagement with the media last week, the Ministry of Health, through Health Promotion Division, said the philosophy at the heart of One Health is far from new but it has acquired a fresh impetus as the fallout from the CoVID-19 pandemic continues to be picked over.
Critical questions that were drawn on CoVID-19 included: Was it triggered by an animal virus crossing over to humans? Could better food safety have prevented its spread? Did environmental destruction make it more likely?
In his presentation, Health Promotion Division's Alvin Chidothi Phiri indicated that "as critical as these lines of inquiry are individually of greater significance, but when viewed from the perspective of One Health, is that they cannot be separated from one another".
"As a concept, One Health has its roots in the 1960s, when Calvin Schwabe, a veterinarian and public health expert, wrote about the close relationship between human and animal medicine.
"Leading on from this observation, the concept suggested that human medicine, particularly in relation to public health, doesn't occur in isolation, and that not only does the interaction between humans and animals need to be taken into account, but also the interaction between humans and animals and the environment."
He added that ways people can reduce their risk of infection with any zoonotic disease also applies to Mpox and these include:
* Staying up-to-date on vaccinations and if one is at risk for certain zoonotic illnesses, like Mpox, rabies or Ebola, they can get vaccinated to help protect you from infection.
Sadly many zoonotic illnesses don't have vaccines. The evolution of orthopoxvirus vaccines, particularly in Mpox, is a narrative of scientific advancement and public health adaptation. The historical eradication of smallpox is a significant triumph in medicine:
* Protect oneself from bug bites is to wear long sleeves and long pants, use bug spray; check oneself and their pets for ticks after being outside, and asking veterinarians how to prevent ticks and fleas on their pets.
Preventing animal to human transmission
* Wear gloves when handling animals (living or dead). Never pick up a wild animal with your bare hands. Wash your hands thoroughly after handling animals, even if you wear gloves
* Follow safe food preparation practices: cook meat to safe temperatures, don't drink unpasteurized milk or eat foods made with unpasteurized milk;
* Avoid contact with infected body fluids: For some serious illnesses (like Ebola), this means using protective equipment (such as a mask, goggles, apron and gloves) when caring for someone with an infection.
The One Health approach can help prevent outbreaks of zoonotic disease in animals and people; improve food safety and security; reduce antimicrobial-resistant infections and improve human and animal health.
It is also to protect global health security; protect biodiversity and conservation and by promoting collaboration across all sectors, a 'One Health' approach can achieve the best health.
Mpox is found in Africa, mostly around tropical rainforest regions but in recent years, several cases detected in Europe & USA. It is characterised by fever and rash and range of illness is from asymptomatic to death.
Mpox is clinically milder than Smallpox, although the presentations are similar. It also presents with less mortality and scarification and most important is to note the enlarged lymphnodes in Monkeypox.
Skin rash may look like chicken pox (katsabola). The lesions in chickenpox are more superficial and occur in clusters of the same stage, with denser manifestations on the trunk than on the face and extremities.
It can be transmitted by animals such as bites/scratches; preparation/consumption of undercooked bush meat (monkeys, rodents etc) and by humans through close physical contact (mouth, sex); sharing of linen & toiletries and droplets (speaking, coughing, sneezing).
A patient is infectious from onset of symptoms until lesions have healed and progression of the disease is that healing is usually in two to four weeks while death may occur in 1% to 10% of cases due to complications.
Common complications include major rash; bacterial superinfection; infection of the cornea or eye lids; dehydration; meningoencephalisis, pneumopathy and most vulnerable are children, immunocompromised & pregnant women.
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There is no specific treatment but only symptomatic management (fever, pain etc). Studies suggest benefits from some antiviral drugs that were initially developed for smallpox (Tecovirimat, Brincoovir) while antivirals may be needed in those with severe complications.
Prevention is isolation of patient for 3 weeks; contact tracing and reporting of suspected cases to health authorities; regular hand washing with soap/sanitizer; not sharing clothes, linen etc; avoiding physical contact and vaccination.
As of 13 September 2024 key strategic developments in Mpox epidemiology is that a total of 14 countries in the WHO African region have been affected and a total of 8,153 confirmed cases, including 54 deaths, have been reported to WHO.
The three countries with the majority of cases in 2024 are Democratic Republic of the Congo (5,160), Burundi (448) and Nigeria (55).
Newly active countries after several months of reporting zero cases include Cameroon reporting another Mpox case on September 1 2024; South Africa reporting a new case on September 6 after not reporting cases since July (Africa numbers are taken from official Member State reports).
