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This report describes the first reported outbreak of human monkeypox in the Republic of Congo. Eleven confirmed and probable monkeypox cases were observed during this outbreak, all were less than 18 years old, and most resided on the grounds of the Government Hospital in Impfondo. Molecular, virologic, and serologic, and diagnostic assays were used to detect evidence of monkeypox (or orthopox) virus infection in individuals with striking dermatologic and other clinical manifestations. The majority of cases in this outbreak experienced significant, symptomatic illnesses; there was one death, possibly involving secondary complications, and one instance of profound sequelae. Up to six sequential transmissions of monkeypox virus from person to person are hypothesized to have occurred, making this the longest uninterrupted chain of human monkeypox fully documented to date. The pattern of sustained human-to-human transmission observed during this outbreak may influence our current perception of the capacity for this zoonotic virus to adapt to humans.
Received December 30, 2004. Accepted for publication February 22, 2005.
We thank the World Health Organization Regional Office for Africa in Brazzaville, the U.S. Department of State, and the Ministry of Health and Populations of the Republic of Congo for their assistance during this outbreak. For more information on monkeypox, please visit www.cdc.gov/ncidod/monkeypox.
These authors contributed equally to this work.
* Address correspondence to Dr. Mary G. Reynolds, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333. E-mail: nzr6{at}cdc.gov
Note: The case definition for human monkeypox in the Republic of Congo appears online at www.ajtmh.org.
Authors’ addresses: Lynne A. Learned, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14214-3013. Mary G. Reynolds, Yu Li, Victoria A. Olson, Kevin Karem, Linda L. Stempora, Zach H. Braden, Richard Kline, Anna Likos, and Inger K. Damon, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G-18, Atlanta, GA 30333, Telephone: 404-639-2878, Fax: 404-639-3111, E-mail: nzr6{at}cdc.gov. Demole Wassa Wassa, Ministry of Health and Populations, Impfondo, Republic of Congo. François Libama, Henri Moudzeo, Jean Daniel Bolanda, Paul Tarangonia, and Paul Boumandoki, Ministry of Health and Populations, Brazzaville, Republic of Congo. Pierre Formenty, Alert and Response Operations Office, World Health Organization, Geneva, Switzerland. Joseph M. Harvey, Global Outreach Mission, Pioneer Christian Hospital, Imp-fondo, Republic of Congo.
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