- I notice that the post refers to a monkeypox-LIKE illness.
We hae had West Nile-LIKE virus, SARS-LIKE virus, and even Lyme-like illness.
Now we can add to the list of first time ever emerging disease in the
US, Monkeypox-LIKE illness.
-
- As far as I can trace, the last Monkeypox outbreak was
in Africa back in Oct. 2002. I am wondering how the prariedogs became
infected?
-
- Patricia
-
- 1]
- Date: Mon 9 Jun 2003
- From: ProMED-mail <promed@promedmail.org>
- Source: Centers for Disease Control and Prevention, Preliminary
report,
- Mon 9 Jun 2003 [edited]
-
- http://www.cdc.gov/ncidod/monkeypox/report060903.htm
-
- Multistate Outbreak Of Monkeypox In Persons Exposed To
Prairie Dogs
-
- An extensive multidisciplinary investigation in Wisconsin,
Illinois, and Indiana has identified cases of febrile rash illness in persons
who had direct or close contact with recently purchased ill prairie dogs.
Scientists at the Marshfield Clinic in Marshfield, Wisconsin, recovered
viral isolates from a patient and a prairie dog and demonstrated a virus
morphologically consistent with a poxvirus by electron microscopy (see
http://research.marshfieldclinic.org/crc/prairiedog.asp for electron microscopy
images).
-
- Preliminary results of serologic testing, polymerase-chain-reaction
[PCR] analysis, and gene sequencing performed at the Centers for Disease
Control and Prevention (CDC) on 6-7 Jun 2003 indicated that the causative
agent is monkeypox virus, a member of the orthopoxvirus group of viruses.
Results of additional evaluation at CDC by electron microscopy and immunohistochemical
studies are consistent with the finding of an orthopoxvirus. These findings
represent the first evidence of community-acquired monkeypox-like infection
in the United States. Further characterization of the virus is in progress.
-
- Human monkeypox is a rare zoonotic viral disease that
occurs primarily in the rain forest countries of central and west Africa.
In humans, the illness produces a vesicular and pustular rash similar to
that of smallpox. Limited person-to-person spread of infection has been
reported in disease-endemic areas in Africa; the incubation period is about
12 days. Case-fatality ratios in Africa have ranged from 1% to 10% -- for
additional information about monkeypox, see <www.cdc.gov/ncidod/eid/vol7no3/hutin.htm>
-
- As of Sat 7Jun 2003, cases of suspected monkeypox had
been reported among residents of Wisconsin (17), northern Illinois (1),
and northwestern Indiana (1). Onset of illness among patients began in
early May [2003]. Patients typically experienced a prodrome consisting
of fever, headaches, myalgias, chills, and drenching sweats. Roughly one-
third of patients had nonproductive cough. This prodromal phase was followed
1-10 days later by the development of a papular rash that typically progressed
through stages of vesiculation, pustulation, umbilication, and crusting.
In some patients, early lesions have become ulcerated. Rash distribution
and lesions have occurred on head, trunk, and extremities; many of the
patients had initial and satellite lesions on palms and soles and extremities.
Rashes were generalized in some patients. After onset of the rash, patients
have generally manifested rash lesions in different stages.
-
- All patients reported direct or close contact with prairie
dogs, most of which were sick. Illness in prairie dogs was frequently reported
as beginning with a blepharoconjunctivitis, progressing to presence of
nodular lesions in some cases. Some prairie dogs have died from the illness,
while others reportedly recovered.
-
- In May [2003] the prairie dogs were sold by a Milwaukee
animal distributor to 2 pet shops in the Milwaukee area and during a pet
"swap meet" (pets for sale or exchange) in northern Wisconsin.
The Milwaukee animal distributor had obtained prairie dogs and a Gambian
giant rat that was ill at the time from a northern Illinois animal distributor.
It is unclear whether other retail outlets are involved. Investigations
are under way to trace back the source of the prairie dogs and the Gambian
giant rat and determine if distributors in other states might be involved.
Animal species susceptible to monkeypox virus may include non-human primates,
lagomorphs (rabbits), and some rodents.
-
- On the basis of preliminary findings from this investigation,
it appears that the primary route of transmission may be from infected
prairie dogs to humans as a result of close contact. However, the possibility
of human- to-human transmission cannot be excluded at this time. As a precaution
until additional information is available, the measures below should be
followed.
-
- General Prevention
- ------------------
- Avoid contact with any prairie dogs or Gambian giant
rats that appear to
- be ill (e.g., are missing patches of fur, have a visible
rash on the skin, or
- have a discharge from eyes or nose). Wash hands thoroughly
after any
- contact with prairie dogs, Gambian giant rats, or any
ill animal.
-
- Diagnosis
- -----------
- Physicians should consider monkeypox in persons with
fever, cough,
- headache, myalgias, rash, or lymph node enlargement within
3 weeks
- after contact with prairie dogs or Gambian giant rats.
Inform the treating
- physician or other clinician of the animal exposure.
-
- Veterinarians
- -------------
- Veterinarians examining sick exotic animal species, especially
prairie
- dogs and Gambian giant rats, should consider monkeypox.
Veterinarians
- should also be alert to the development of illness in
other animal species
- that may have been housed with ill prairie dogs or Gambian
giant rats.
-
- Treatment
- --------
- No specific treatment recommendations are being made
at this time.
- Smallpox vaccine has been reported to reduce the risk
of monkeypox
- among previously vaccinated persons in Africa. CDC is
assessing the
- potential role of postexposure use of smallpox vaccine
as well as
- therapeutic use of the antiviral drug cidofovir. [A newswire
report states
- that one of the victims had been vaccinated against smallpox
back in
- 1972. - Mod.JW]
-
- Reporting
- ---------
- Health care providers, veterinarians, and public health
personnel should
- report cases of these illnesses in humans and animals
to their state or
- local health departments as soon as they are suspected.
-
- Submission of Specimens from Patients with Suspected
Monkeypox
- --------------------------------------------------------------
- Procedures recommended for collection of samples for
diagnosis of
- potential monkeypox disease are essentially the same
as those for
- diagnosis of the related orthopoxvirus diseases, vaccinia
and smallpox.
- For information regarding collection of serum specimens
and lesions,
- please refer to the smallpox laboratory testing guidelines
at
-
- www.bt.cdc.gov/agent/smallpox/lab-testing.
-
- Consultation with the state epidemiologist
-
- www.cste.org/members/state_and_territorial_epi.asp
-
- and state health laboratory
-
- www.aphl.org/public_health_labs/index.cfm
-
- is necessary for submission instructions before sending
specimens to
- CDC.
-
- Additional Information
- ----------------------
- For more information contact your state or local health
department.
- Additional information and recommendations will be released
as they
- become available. Updated information will be posted
on CDC's
- monkeypox Web site
- <http://www.cdc.gov/ncidod/monkeypox/index.htm>
-
- --
- ProMED-mail
- <promed@promedmail.org>
-
- [At present there still seems to be some ambiguity regarding
the identity
- of the etiologic agent responsible for this outbreak.
Monkeypox virus has
- not been observed outside West/Central Africa and its
name is something
- of a misnomer. Monkeypox virus causes mild illness in
primates but its
- principal reservoir hosts may be squirrels and rodents.
Monkeypox virus
- is a member of the same poxvirus genus as smallpox virus
(i.e. the genus
- _Orthopoxvirus_) and smallpox virus vaccine (i.e. vaccinia
virus)
- provides protective immunity. However, in its natural
range outbreaks of
- monkeypox are infrequent and it has often been confused
with outbreaks
- of chickenpox (caused by an unrelated herpesvirus): see
a previous
- cautionary comment posted by Dr. D.A. Henderson in "Monkeypox
-
- Congo DR (Equateur) (06) 20020410.3926" - Mod.CP]
-
- ******
- [2]
- Date: Mon 9 Jun 2003
- From: "Robin Nypaver" <RobinNypaver@epchealth.org>
-
- The Associated Press article on monkeypox quoted on
ProMED-mail
- states that: ["One of the cases] said she got 2
female prairie dogs from
- SK Exotics on 5 May 2003. Neither looked sick at first,
she said, but
- one eventually began to look tired. [She] said she got
sick in mid-May
- with blisters, coughing and a 101-degree fever. Hospital
staff gave her
- aspirin, told her it was a viral infection and she went
home, she said."
-
- Monkeypox presents very much like smallpox. If the article
is accurate
- and the case did go to a hospital, why did the hospital
not recognize the
- similarities and become fretful?
-
- --
- Robin Nypaver, R.N., B.S.N.
- Communicable Disease Specialist
- El Paso County Department of Health and Environment
- 301 South Union Blvd.
- Colorado Springs, Colorado 80910
- <robinnypaver@epchealth.org>
-
- [I would suggest that there is significant reason for
concern about the
- efficacy of the BT preparedness training that has gone
on, if the patient
- presented with a febrile "blister" illness
to an Emergency Department.
-
- Who were the targets of the training? Did they include
all ED staff
- including nursing (triage nurses are usually rotated
among all ED nurses)
- and all ED docs?
-
- And if the patient was a young adult, giving ASA [aspirin]
with a possible
- varicella infection is still questionable because of
the association with
- Reye's syndrome. - Mod.MPP]
-
- [see also:
- Monkeypox, human, prairie dogs - USA (WI, IL, IN) 20030608.1412
- 2002
- -----
- Monkeypox - Congo DR (Equateur) (07) 20021025.5638
- Monkeypox - Congo DR (Equateur) 20020228.3654
- Monkeypox - Congo DR (Equateur) (06) 20020410.3926
- 2001
- ----
- Monkeypox, suspected - Congo DR (Equateur) (02) 20010927.2353
- Monkeypox, suspected - Congo DR (Equateur): RFI 20010315.0523
- 2000
- ----
- Monkeypox - Congo, Dem. Rep. (Mbuji-Mayi): 1999 20000428.0645
- Monkeypox - Congo, Dem. Rep. (Mbuji-Mayi): comment
- 20000506.0691
- 1998
- ----
- Monkeypox, new therapeutic agent 19980311.0470
- 1997
- ----
- Monkeypox, threat to humans? 19970728.1585
- Monkeypox - Congo, Dem.Rep. 19970928.2049
- Monkeypox - Congo, Democratic Republic (09) 19971214.2481
- Monkeypox - Zaire 19970321.0599
- Monkeypox - Zaire (09) 19970426.0847
- 1996
- ----
- Monkeypox - Zaire 19960903.1505
- Monkeypox - Zaire (02) 19961030.1834]
- ....................................................mpp/cp/jw
-
- Patricia A. Doyle, PhD
- Please visit my "Emerging Diseases" message
board at: http://www.clickitnews.com/ubbthreads/postlist.php?Cat=&Board=emergingdiseases
- Zhan le Devlesa tai sastimasa
- Go with God and in Good Health
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