Evidence map›Paper›PMID 31285143›Full record

ArticleThe Lancet. Infectious diseases2019

Outbreak of human monkeypox in Nigeria in 2017-18: a clinical and epidemiological report.

Adesola Yinka-Ogunleye, Olusola Aruna, Mahmood Dalhat, Dimie Ogoina, Andrea McCollum, Yahyah Disu, Ibrahim Mamadu, Afolabi Akinpelu, Adama Ahmad, Joel Burga and 27 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 454 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
454citing papers in PubMed, 13 pooled it
38.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

454 citing papers in PubMed, 13 syntheses or guidelines pooled it, 929 citations in OpenAlex.

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  20. A comprehensive overview of monkeypox virus disease.Tropical medicine and health · 2026
    Review

394 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

37 authors at 11 institutions in 4 countries.

Adesola Yinka-OgunleyeNigeria Centre for Disease Control, Abuja, Nigeria. Electronic address: adesola.ogunleye@ncdc.gov.ng.
Olusola ArunaNigeria Centre for Disease Control, Abuja, Nigeria; International Health Regulations Strengthening Programme in Nigeria, Public Health England, Abuja, Nigeria.
Mahmood DalhatAfrican Field Epidemiology Network, Abuja, Nigeria.
Dimie OgoinaNiger Delta University Teaching Hospital, Niger Delta University, Yenagoa, Nigeria.
Andrea McCollumPoxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Yahyah DisuNigeria Centre for Disease Control, Abuja, Nigeria.
Ibrahim MamaduWHO Country Office, Abuja, Nigeria.
Afolabi AkinpeluNigeria Centre for Disease Control, Abuja, Nigeria.
Adama AhmadNigeria Centre for Disease Control, Abuja, Nigeria.
Joel BurgaNigeria Centre for Disease Control, Abuja, Nigeria.
Adolphe NdorerahoNigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Edouard NkunzimanaNigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Lamin MannehNigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Amina MohammedNigeria Centre for Disease Control, Abuja, Nigeria.
Olawunmi AdeoyeNigeria Centre for Disease Control, Abuja, Nigeria.
Daniel Tom-AbaHelmholtz Centre for Infection Research, Braunschweig, Germany; German Centre for Infection Research, Braunschweig, Germany.
Bernard SilenouHelmholtz Centre for Infection Research, Braunschweig, Germany; German Centre for Infection Research, Braunschweig, Germany.
Oladipupo IpadeolaPoxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Muhammad SalehPoxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Ayodele Adeyemoe-Health Africa, Abuja, Nigeria.
Ifeoma NwadiutorRivers State Ministry of Health, Port Harcourt, Nigeria.
Neni AworabhiBayelsa State Ministry of Health, Yenagoa, Nigeria.
Patience UkeCross State Ministry of Health, Calabar, Nigeria.
Doris JohnDepartment of Health, Federal Capital Territory, Abuja, Nigeria.
Paul WakamaNigeria Prison Services, Port Harcourt, Rivers State, Nigeria.
Mary ReynoldsPoxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Matthew R MauldinPoxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jeffrey DotyPoxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Kimberly WilkinsPoxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Joy MusaUniversity Of Maryland, Abuja, Nigeria.
Asheena KhalakdinaWHO, Geneva, Switzerland.
Adebayo AdedejiNigeria Centre for Disease Control, Abuja, Nigeria.
Nwando MbaNigeria Centre for Disease Control, Abuja, Nigeria.
Olubunmi OjoNigeria Centre for Disease Control, Abuja, Nigeria.
Gerard KrauseHelmholtz Centre for Infection Research, Braunschweig, Germany; German Centre for Infection Research, Braunschweig, Germany.
Chikwe IhekweazuNigeria Centre for Disease Control, Abuja, Nigeria.
CDC Monkeypox Outbreak Team
Nigeria Centre for Disease Control · NGCenters for Disease Control and Prevention · USAfrican Field Epidemiology Network · NGHelmholtz Centre for Infection Research · DEFederal Ministry of Health · NGGerman Center for Infection Research · DENiger Delta University · NGRivers State University · NGUniversity of Abuja · NGWorld Health Organization · CHWorld Health Organization - Nigeria · NG

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundIn September, 2017, human monkeypox re-emerged in Nigeria, 39 years after the last reported case. We aimed to describe the clinical and epidemiological features of the 2017-18 human monkeypox outbreak in Nigeria.

methodsWe reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept 22, 2017, and Sept 16, 2018. Data were collected with a standardised case investigation form, with a case definition of human monkeypox that was based on previously established guidelines. Diagnosis was confirmed by viral identification with real-time PCR and by detection of positive anti-orthopoxvirus IgM antibodies. Whole-genome sequencing was done for seven cases. Haplotype analysis results, genetic distance data, and epidemiological data were used to infer a likely series of events for potential human-to-human transmission of the west African clade of monkeypox virus.

findings122 confirmed or probable cases of human monkeypox were recorded in 17 states, including seven deaths (case fatality rate 6%). People infected with monkeypox virus were aged between 2 days and 50 years (median 29 years [IQR 14]), and 84 (69%) were male. All 122 patients had vesiculopustular rash, and fever, pruritus, headache, and lymphadenopathy were also common. The rash affected all parts of the body, with the face being most affected. The distribution of cases and contacts suggested both primary zoonotic and secondary human-to-human transmission. Two cases of health-care-associated infection were recorded. Genomic analysis suggested multiple introductions of the virus and a single introduction along with human-to-human transmission in a prison facility.

interpretationThis study describes the largest documented human outbreak of the west African clade of the monkeypox virus. Our results suggest endemicity of monkeypox virus in Nigeria, with some evidence of human-to-human transmission. Further studies are necessary to explore animal reservoirs and risk factors for transmission of the virus in Nigeria.

fundingNone.

Indexed as

Disease OutbreaksAdultAnimalsExanthemaFemaleFeverHumansMaleMonkeypox virusMpox, MonkeypoxNigeriaWhole Genome Sequencing

Identifiers

PMID31285143
PMCPMC9628943
OpenAlexW2955071890

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.