EXTENDED INTERHUMAN TRANSMISSION OF MONKEYPOX IN A HOSPITAL COMMUNITY IN THE REPUBLIC OF THE CONGO, 2003

LYNNE A. LEARNED School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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MARY G. REYNOLDS School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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DEMOLE WASSA WASSA School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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YU LI School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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VICTORIA A. OLSON School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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KEVIN KAREM School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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LINDA L. STEMPORA School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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ZACH H. BRADEN School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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RICHARD KLINE School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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ANNA LIKOS School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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FRANÇOIS LIBAMA School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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HENRI MOUDZEO School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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JEAN DANIEL BOLANDA School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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PAUL TARANGONIA School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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PAUL BOUMANDOKI School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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PIERRE FORMENTY School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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JOSEPH M. HARVEY School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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INGER K. DAMON School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York; Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health and Populations, Impfondo, Republic of Congo; Ministry of Health and Populations, Brazzaville, Republic of Congo; Alert and Response Operations Office, World Health Organization, Geneva, Switzerland; Global Outreach Mission, Pioneer Christian Hospital, Impfondo, Republic of Congo

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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.

Author Notes

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