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COVID-19: WHO Suspends Trial Of Hydroxychloroquine Over Safety Concerns

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Coronavirus patients treated with Hydroxychloroquine stand high risk of death – Study
Some drugs have shown promise in treating coronavirus — WHO
Doctors warn of dangers of using chloroquine to treat COVID-19

Trump says he’s been taking hydroxychloroquine ‘to prevent coronavirus’
A clinical trial of hydroxychloroquine as a potential treatment for COVID-19 has been ’temporarily’ suspended by the World Health Organisation (WHO).

The Director-General of the UN health agency, Tedros Ghebreyesus, in a virtual press conference on Monday said the decision follows a study in the Lancet indicating that use of the drug on COVID-19 patients could increase their likelihood of dying.

The cited study, titled “Chloroquine or hydroxychloroquine for COVID-19: Why might they be hazardous?” published on Friday, highlighted that patients who took chloroquine, which hydroxychloroquine is derived from, were also more likely to develop irregular heart rhythms.

Mr Ghebreyesus also said the executive group of the Solidarity Trial, in which hundreds of hospitals across several countries have enrolled patients to test several possible treatments for the virus, had as a precaution, suspended trials using that drug.

“The executive group has implemented a temporary pause of the hydroxychloroquine arm within the Solidarity Trial while the data is reviewed by the Data Safety Monitoring Board.

“The other arms of the trial are continuing,” he said.

He also said this decision only applies to the use of the hydroxychloroquine and chloroquine in COVID-19 patients.

“I wish to reiterate that these drugs are accepted as generally safe for use in patients with autoimmune diseases or malaria, ” he said.

Chloroquine for COVID-19?
Chloroquine is a synthetic drug introduced in the 1940s. It is a member of an important series of chemically related agents known as quinoline derivatives. Hydroxychloroquine is a related compound that was introduced in 1955.

Both drugs are used in the treatment of tropical diseases such as malaria and amebiasis, a parasitic disease also known as amebic dysentery.

They are also useful in the treatment of various skin conditions and diseases of the joints such as rheumatoid arthritis and lupus.

U.S. President Donald Trump had at a press briefing in the White House said he had been using hydroxychloroquine to protect himself against COVID-19.

However, Nigeria’s Presidential Task Force (PTF) on coronavirus at a daily briefing warned Nigerians against using the drug.

It said the drug has not been declared a cure for the disease and further warned of the possibility of chloroquine poisoning if one indulges in self-medication with the drug.

But Bauchi State governor, Bala Mohammed, who was the index case of COVID-19 in his state, had told journalists early this month that he was administered with chloroquine, zithromax, and Vitamin C during his successful treatment for the disease.

The governor said COVID-19 patients in the state would, henceforth, be treated with the drugs.

He also said he would rather ask medics managing the state’s COVID-19 patients to treat them with chloroquine and zithromax “than watch them die of the disease.”

Meanwhile, the National Agency for Food Administration and Control (NAFDAC), in an apparent reaction to the governor’s statement, warned Nigerians “not to use any drug for the treatment of COVID-19 that is not approved by the NCDC”.

“The agency is concerned about reports on social and other media of drugs or vaccines to cure COVID 19,” NAFDAC’s Director-General, Mojisola Adeyeye, had said in a statement.

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Mpox: What You Need to know

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WHO image

 

Mpox

Mpox, formerly called monkeypox, is a rare disease similar to smallpox caused by a virus. It’s found mostly in areas of Africa, but has been seen in other regions of the world. It causes flu-like symptoms such as fever and chills, and a rash that can take weeks to clear. There’s no proven treatment for mpox, but it usually goes away on its own.

What is Mpox?

Mpox (previously known as monkeypox) is a rare disease caused by a virus. It leads to rashes and flu-like symptoms. Like the better-known virus that causes smallpox, it’s a member of the genus Orthopoxvirus.

Mpox spreads through close contact with someone who’s infected. You can also get it from an infected animal.

There are two known types (clades) of mpox virus — one that originated in Central Africa (Clade I) and one that originated in West Africa (Clade II). The current world outbreak (2022 to 2023) is caused by Clade IIb, a subtype of the less severe West African clade.

How common is mpox?

Mpox is rare. But the number of cases is increasing in Africa, as well as in regions that haven’t seen these infections before.

Where else is mpox found?

For decades, mpox was mostly seen in Africa. But it’s occasionally found in other countries, including the United States.

In the summer of 2021, a case of mpox was found in a U.S. resident who had traveled from Nigeria to the United States. Then, 2022 brought outbreaks to regions outside of Africa, including Europe, the Americas and Australia.

Who does mpox affect?

Anyone can get mpox. In Africa, most cases are among children under 15 years old. Outside of Africa, the disease appears to be more common in men who have sex with men (MSM), but there are numerous cases in people who don’t fall into that category.

Mpox (monkeypox) rash can be painful, with spots that change over time before scabbing and falling off.

What are the signs and symptoms of mpox?

After exposure, it may be several days to a few weeks before you develop symptoms. Signs of mpox include:

Fever.

Rash.

Swollen lymph nodes.

Chills.

Headache.

Muscle aches.

Fatigue.

The rash starts as flat, red bumps, which can be painful. Those bumps turn into blisters, which fill with pus. Eventually, the blisters crust over and fall off. The whole process can last two to four weeks. You can get sores on your mouth, face, hands, feet, penis, vagina or anus.

Not everyone with mpox develops all the symptoms. Different ways you might experience symptoms include:

* Only a rash (no other symptoms), or other symptoms developing later.

* Flu-like symptoms, then a rash. Some people don’t get a rash at all.

* A rash can be widespread, but some people only a have few bumps or blisters.

* You can have mpox and not know it. Even if you don’t show many signs of infection, it’s possible that you can spread still spread it to others through prolonged close contact.

How do you catch mpox?

Mpox spreads when you come into contact with an animal or a person infected with the virus.

Person-to-person spread (transmission) occurs when you come in contact with the sores, scabs, respiratory droplets or oral fluids of a person who’s infected, usually through close, intimate situations like cuddling, kissing or sex. Research is ongoing, but experts aren’t sure if the virus is transmitted through semen or vaginal fluids.

Animal-to-person transmission occurs through broken skin, like from bites or scratches, or through direct contact with an infected animal’s blood, bodily fluids or pox lesions (sores).

You can also get mpox by coming into contact with recently contaminated materials like clothing, bedding and other linens used by a person or animal who’s infected.iagnosis and Tests

How is mpox diagnosed?

Because mpox is rare, a healthcare provider may first suspect other rash illnesses, such as measles or chickenpox. But swollen lymph nodes usually distinguish mpox from other poxes.

To diagnose mpox, your healthcare provider takes a tissue sample from an open sore (lesion). Then, they send it to a lab for polymerase chain reaction (PCR) testing (genetic fingerprinting). You may also need to give a blood sample to check for the mpox virus or antibodies your immune system makes.

Management and Treatment: Is mpox curable?

Mpox is usually a self-limited disease (gets better without treatment) with symptoms lasting from two to four weeks. Following diagnosis, your healthcare provider will monitor your condition and try to relieve your symptoms, prevent dehydration and give you antibiotics to treat secondary bacterial infections if they develop.

How is mpox treated?

There aren’t any currently approved antiviral treatments for mpox. If you’re very sick, your provider might prescribe antiviral drugs like cidofovir or tecovirimat. These drugs are approved to treat other viral infections (like smallpox), but researchers need to learn more about how well they work for mpox.

Prevention: How do you prevent mpox?

If you’re at risk for mpox, getting vaccinated helps stop the spread. Other forms of prevention include decreasing human contact with infected animals and limiting person-to-person spread.

Mpox vaccines

Vaccines developed for smallpox also provide protection against mpox. Mpox vaccines are currently only recommended for people who’ve been exposed to, or are likely to be exposed to, mpox. You might be at higher risk of exposure if:

* You’ve been in close contact with someone with mpox.

* Someone you’ve had sex with in the past two weeks has been diagnosed with mpox.

* You’ve had sex at a sex club, bathhouse or other commercial sex venue in the past six months.

* You’ve had sex at an event or location where mpox was spreading.

* You have a sex partner who’s been in any of the above situations.

* You expect to be in one of the above situations.

* If you’re a man who has sex with men, a transgender person or a nonbinary person, you may also be at risk if you’ve:

Been diagnosed with one or more sexually transmitted infections (STIs) in the past six months. This includes acute HIV, gonorrhea, syphilis, chancroid or chlamydia.

Had sex with more than one person in the past six months.

It’s important to get vaccinated before or as soon as possible after exposure. Talk to a healthcare provider if you’re unsure if you should get vaccinated. If you’d like to get your shot in a more concealed location on your body, your provider can give it to you in your shoulder blade instead of your forearm.

Other ways to prevent mpox

In addition to vaccines, other ways to help prevent the spread of mpox include:

* Avoiding contact with infected animals (especially sick or dead animals).

* Avoiding contact with bedding and other materials contaminated with the virus.

* Thoroughly cooking all foods that contain animal meat or parts.

* Washing your hands frequently with soap and water.

* Avoiding contact with people who may be infected with the virus.

* Practicing safe sex, including the use of condoms and dental dams.

* Wearing a mask that covers your mouth and nose when around others.

* Cleaning and disinfecting frequently touched surfaces.

* Using personal protective equipment (PPE) when caring for people infected with the virus.

Outlook / Prognosi: How long does mpox last?

Mpox normally takes about two to four weeks to run its course. If you’re exposed to mpox, your provider will monitor you until the rash resolves.

Is mpox fatal?

It’s rare, but mpox is sometimes fatal. Mpox can also lead to problems (complications) like pneumonia and infections in your brain (encephalitis) or eyes, which can be life-threatening.

 

Living With: How do I take care of myself?

If you have mpox symptoms, there are over-the-counter (OTC) medications that can help you feel better, including:

Pain relievers and fever reducers. Medicines like ibuprofen (Advil®, Motrin®) and acetaminophen (Tylenol®) can help relieve your symptoms.

Oatmeal baths. Soaking in a warm bath with colloidal oatmeal can relieve the dry, itchy feeling that comes with skin rashes.

Isolate yourself if you’re infected. Avoid contact with others until all of your lesions have scabbed.

Cover single or local ulcers or sores. Use gauze or bandages to limit the spread to others and the environment.

Take good care. It’s important to stay home and rest when you’re sick, wear a mask around others and drink plenty of fluids.

Avoid contact with pets (especially rodents).

When should I see my healthcare provider?

Call your healthcare provider if you:

Feel sick with fever, aches or swollen lymph nodes.

Have a new rash or sores.

Have been in close contact with a person who’s infected.

When should I go to the ER?

Seek medical care if you develop the following symptoms:

Trouble breathing.

New or worsening chest pain.

Stiff neck.

Confusion or difficulty thinking clearly.

Difficulty speaking or moving.

Loss of consciousness.

Seizures.

Additional Common Questions

Why don’t we call it monkeypox anymore? Who changed the name?

The name monkeypox carries stigmas with it, including those about race. The World Health Organization (WHO) changed the name to mpox in November of 2022.

 

What is the difference: Mpox vs. chickenpox

Although they both cause skin rashes, different viruses cause mpox and chickenpox. Mpox is an orthopoxvirus, while chickenpox is a herpes virus. Both viruses can spread through skin-to-skin or prolonged face-to-face contact, but chickenpox is very contagious and spreads more easily than mpox. People with mpox are more likely to have swollen lymph nodes than people with chickenpox.

The rashes act differently, too. While the chickenpox rash can appear in waves, mpox sores develop at the same time. Chickenpox symptoms — including the rash — tend to get better within two weeks, while it takes two to four weeks for mpox to resolve.

Mpox vs. smallpox

Smallpox and mpox are both part of the Orthopoxvirus genus, so they’re caused by similar but distinct viruses. Thanks to effective vaccines, smallpox was eradicated (is no longer a circulating disease) by 1980. Smallpox was very contagious and spread more easily than mpox. Mpox symptoms are similar to smallpox, but milder.

 

A note from Cleveland Clinic

 

The last few years have been incredibly challenging — the COVID-19 pandemic changed so much about the way we lived and worked. Now, just as we’re starting to ease back into regular life, we’re hearing media stories about mpox as an emerging threat. But mpox is a rare disease. It’s spread through close contact, like kissing and sex, but we’re still learning about how mpox spreads in human

The best way to protect yourself is to get vaccinated if you’re at high risk, avoid contact with people who are infected, wash your hands frequently and wear a face mask in crowded, indoor spaces. Early symptoms of mpox are flu-like and include fever, chills and body aches. After a few days, a rash will begin to develop. See a healthcare provider if you develop symptoms.

(Source: Cleveland Clinic)

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Nigeria Records Mpox Cases Amid Global Health Emergency

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An undated colorized electron micrograph of mpox virus particles (red) found within an infected cell (brown) cultured in the laboratory, captured at the National Institute of Allergy and Infectious Diseases in Fort Detrick, Maryland. (NIAID via Reuters)

 

ABUJA, NIGERIA —

Barely 48 hours after the World Health Organization declared mpox a global health emergency, Nigeria went on high alert Friday, announcing new mpox cases and raising concerns about the country’s ability to contain the outbreak.

The Nigeria Center for Disease Control and Prevention, or NCDC, said it has recorded 39 cases of mpox so far this year amid a surge in infections across Africa. No deaths have been recorded in Nigeria.

Bayelsa, Cross River, Ogun and Lagos states are the most affected by the outbreak.

Speaking at a news conference, NCDC lead Dr. Olajide Idris said that the nation is ramping up its response to manage the spread of the virus and prevent the disease from being imported.

Mpox is a rare viral zoonotic disease, meaning it is primarily an animal disease that can be transmitted to humans. It is endemic in several African countries, with over 2,800 cases reported across 13 countries this year, claiming more than 500 lives.

Symptoms include fever, body aches, weakness, headaches and rashes.

With a more lethal strain emerging, Idris said that vaccination plans are being considered for high-risk populations.

“The Nigerian government is making effort to make vaccines available to the public, especially for the hotspot areas,” he said. “These vaccines have been shown to have a favorable safety profile. They are not yet in the country, but they are on their way.”

Olayinka Badmus, deputy project director for Global Health Security, Breakthrough Action Nigeria, said the new strain poses a higher risk.

“This particular strain is new, and anything new requires new learning. The things that we have seen related to this particular strain is the fact that it is spreading quite fast, the presenting symptoms — especially the rash — are widespread,” she said, meaning that the rash is all over the body.

“We are also seeing more children affected with mpox compared to the other strains,” Badmus said.

Another cause for concern, she said, is that this strain has “a higher human-to-human transmission at an accelerated rate.”

Idris stressed the need for public awareness in containing the spread and urged people to seek medical attention if they experience symptoms.

“We encourage everybody feeling feverish, muscle pain, sore throat to please visit the nearest health care facility,” he said.

Public health experts are also urging people to adhere to preventive measures such as avoiding contact with potentially infected animals and practicing good hygiene. (VOA)

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Pate Calls for Multi-Sectorial Approach to Combat Infectious Diseases in Nigeria

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The Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, has emphasized the need for a multi-sectorial approach to prevent outbreaks of infectious diseases such as Cholera, Typhoid Fever, and Tuberculosis in Nigeria.

Speaking on Channels Television’s “The Morning Brief” show on Wednesday, Prof. Pate highlighted the importance of addressing the social determinants of health through comprehensive public policies that provide social safety nets for vulnerable and impoverished populations.

“There are many diseases that are socially determined. They largely affect vulnerable and poor populations who live in inadequate housing, with low sanitation, insufficient food, malnutrition, or occupational hazards that expose them to certain disease conditions,” Prof. Pate explained.

He pointed out that tackling population health issues extends beyond biomedical solutions. “To address population health, there is the biomedical aspect, but many diseases go beyond that and are multi-sectorial in their determinants.

At the end of the day, we need to grow our economy and translate that growth into household incomes. We need to build infrastructure to support urbanization, ensuring people have good housing, nutrition, safe spaces, mental health support, and access to affordable health facilities.”

Prof. Pate underscored that health issues are intertwined with various public policies, including housing, transportation, agriculture, environment, youth, and gender. He called for a comprehensive effort from the entire government and society to improve the health and well-being of the population. “We need to address vulnerabilities through social protection mechanisms to ensure safety nets for those left behind.”

In response to the ongoing Cholera outbreak, Prof. Pate assured Nigerians that the Federal Government has mobilized resources to contain its spread. He noted that a technical working group, activated through the Nigeria Centre for Disease Control (NCDC), is supporting states to reduce transmission and treat infected individuals.

“We had anticipated the seasonal outbreak, and months ago, the President approved contingency financing for the NCDC, which has been utilized alongside technical financing. States also have a role to play in releasing their own funding,” Prof. Pate said. He revealed that 31 states and 107 local governments are currently affected, with approximately 1,500 Cholera cases recorded so far.

Addressing the root causes of the outbreak, Prof. Pate stressed the need to eliminate open defecation, which contributes to the contamination of food and water.

“Cholera is a public health crisis exacerbated by contaminated food and water, poor sanitation, developmental challenges, and infrastructure deficits. Open defecation prevalent in many parts of the country is fueling the outbreak,” he stated.

Prof. Pate called for a collective effort from all stakeholders, including citizens and federal, state, and local government administrations, to ensure proper waste management and hygiene sanitation. “It is not only Cholera; other infectious diseases like Typhoid Fever and Tuberculosis also need to be addressed. As we improve physical infrastructure, urbanization, and supporting utilities, we should see a healthier population.”

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