Managing Mpox Outbreak in a Congested Correctional Facility: Lessons from Rivers State, Nigeria

Review Article

Abstract

Mpox (formerly monkeypox) is a re-emerging zoonotic viral disease that poses significant public health challenges in congregate settings. Correctional facilities are particularly vulnerable due to chronic congestion, shared living spaces, limited infection prevention and control (IPC) capacity, and constrained access to healthcare services. During the 2017 Mpox outbreak in Nigeria, a cluster of cases was identified within a congested correctional facility in Rivers State, highlighting critical gaps in outbreak preparedness and response in custodial environments.

This chapter documents the management of the Mpox outbreak in this facility, with the aim of describing its epidemiological characteristics, emergency response actions, and system-level lessons for outbreak control in resource-limited settings.

A retrospective descriptive review of outbreak investigation and response activities was conducted using data from the Rivers State Ministry of Health, the Public Health Emergency Operations Centre, and collaborating partner agencies. It examined transmission dynamics, surveillance, infection prevention and control (IPC), risk communication, and coordination.

The response, coordinated through the Public Health Emergency Operations Centre, involved targeted surveillance, case isolation, adapted IPC measures, and collaboration between health and correctional authorities. Despite challenges of congestion, delayed detection, and limited healthcare, transmission was interrupted.

This experience underscores the need to integrate prisons into national disease surveillance frameworks, strengthen prison health services, and address structural overcrowding. These lessons are relevant for policymakers and public health practitioners working to improve epidemic preparedness and response in correctional and other high-risk congregate settings.