PATIENT MAY HAVE TRANSMITTED MONKEYPOX, OFFICIAL SAYS
13 Jun 2003
Source: New York Times, June 13, 2003
Patient May Have Transmitted Monkeypox, Official Says
By LAWRENCE K. ALTMAN
A health care worker in Wisconsin is suspected of having monkeypox in what would be the first known transmission of the viral disease between humans in this country, a Wisconsin state health official said yesterday.
The health worker cared for an adult with monkeypox before doctors and epidemiologists knew that the disease was occurring in the Americas for the first time, said the official, Dr. Jeffrey P. Davis, the Wisconsin state epidemiologist.
Federal officials have advised health workers to use standard infection control measures similar to those used to control SARS to prevent the spread of monkeypox.
As of yesterday, doctors in four states have reported 62 suspected cases. Fourteen of the patients have been hospitalized. There have been no deaths. But one child younger than 10 years suffered inflammation of the brain, or encephalitis, the federal Centers for Disease Control and Prevention reported yesterday. The child's condition was not disclosed.
Dr. Davis said he did not know exactly how the health care worker might have contracted the disease, though it could have resulted from direct contact with pox lesions on the patient's skin.
The health worker has experienced a milder illness than many other patients in the outbreak, Dr. Davis said. The worker had just one pock lesion and appears to be in the very end phase of the illness now, with a sore throat.
Tests are being conducted to confirm monkeypox in the health worker, who has been quarantined, Dr. Davis said. The worker's name, gender and residence were not released for reasons of confidentiality.
In issuing a definition of a case of monkeypox on Wednesday, the C.D.C. included these signs and symptoms: a rash consisting of raised bumps and pus-filled blisters spread over the body or confined to a small area, a fever of 99.3 degrees or higher, headache, backache, swollen lymph nodes, sore throat, cough and shortness of breath.
Monkeypox is endemic in West and Central Africa, where it is spread primarily by rodents and occasionally infects monkeys.
The outbreak in this country is thought to have resulted from the importation of small mammals from the West African nation of Ghana in April. The shipment, which went to a wildlife importer in Texas and was then sold to a distributor in Illinois, included about 800 small mammals of nine different species, the C.D.C. said yesterday in its Morbidity and Mortality Weekly Report.
The animals are believed to then have infected prairie dogs sold and traded in the upper Midwest.
Of the 62 suspected cases, 28 were from Indiana, 21 from Wisconsin, 12 from Illinois and 1 from New Jersey.
On Wednesday, federal officials banned the sale and distribution of prairie dogs in the nation and prohibited the importation of rodents from Africa. The Wisconsin health worker is not thought to have been exposed to an infected animal.
Monkeypox is much less communicable to other humans than are smallpox and other diseases like chickenpox and measles.
Monkeypox tends to die out as it is spread from person to person in successive waves of infection, according to studies conducted in Africa.
In an interview this week in his office at the Bloomberg School of Public Health at Johns Hopkins University, Dr. D. A. Henderson, who led the program to eradicate smallpox worldwide, cited a study in Africa in which 209 people with monkeypox transmitted the disease to 47 people in the second generation of cases. The 47 transmitted monkeypox to 11 people in the third generation. The 11 transmitted the disease to 3 people in the fourth generation. One person was infected in the fifth generation before the outbreak died out.