To cite: Oyebanji O, Ofonagoro U, Akande O, et al. Lay media reporting of monkeypox in Nigeria. BMJ Global Health 2019; 4: e002019. doi:10.1136/ bmjgh-2019-002019
In October 2017, the first confirmed case of a monkeypox outbreak was reported in Bayelsa State, Nigeria, although suspected cases started to be reported in September 2017. It continues to this day, with exported cases reaching the UK, Israel and Singapore. Prior to this outbreak, the disease was last reported in Nigeria in 1978.
Monkeypox is an orthopox virus, closely related to smallpox, that produces vesicopapular lesions on the skin. Symptoms are usually self-limiting and most people recover within weeks. Severe illness and death usually only occurs among immunosuppressed individuals.
When the first cases were announced in Nigeria, media reports exaggerated the symptoms and impact of the outbreak. The outbreak generated front page headlines, with one title describing it as a ‘new airborne Ebola’. A European headline (from the Voice of Europe) was ‘Horrible Nigerian disease called monkeypox spreads in the United Kingdom for the first time’. The media used unverified pictures of people with skin rashes, to amplify their messages.
There may be substantial discrepancies between what the National Public Health Institute responsible for outbreak response coordination aims to communicate during epidemics, and what the media actually disseminates. This can exacerbate public uncertainty and distrust. Globally, the response to outbreaks of severe acute respiratory syndrome and avian influenza, releases of anthrax and sarin, and natural disasters such as the South-East Asian tsunami, demonstrated the importance of communication during public health emergencies.
Subsequently, particular focus has been placed on strengthening the capacity for risk communication within relevant government institutions. However, such capacity is still evolving in many low/middle-income countries, including Nigeria where event-based surveillance is enhancing the existing indicator-based surveillance system. It uses information from the internet and other channels including phone calls, text messages, Whatsapp messages and others.
The Nigeria Centre for Disease Control (NCDC) — Nigeria's National Public Health Institute — uses a proprietary internet crawling system called ‘Tatafo’, which generates unstructured event-based reports from 350 media sites (webs, newspapers, television, blogs/online media and social media). The system uses keywords including the 41 notifiable diseases as outlined in the Integrated Disease Surveillance and Response guidelines. Searches on this system are automated, but can also be moderated for key conditions.
During the peak of the monkeypox outbreak (September to December 2017), 3475 entries generated by the event-based surveillance system mentioned monkeypox. The majority of Tatafo entries came from newspapers, television and blogs. We extracted, reviewed and summarised these lay media reports.