Journal Article

Evaluation of Human-to-Human Transmission of Monkeypox from Infected Patients to Health Care Workers

Aaron T. Fleischauer, James C. Kile, Molly Davidson, Marc Fischer, Kevin L. Karem, Robert Teclaw, Hans Messersmith, Pamela Pontones, Bradley A. Beard, Zachary H. Braden, Joanne Cono, James J. Sejvar, Ali S. Khan, Inger Damon and Matthew J. Kuehnert

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 40, issue 5, pages 689-694
Published in print March 2005 | ISSN: 1058-4838
Published online March 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/427805
Evaluation of Human-to-Human Transmission of Monkeypox from Infected Patients to Health Care Workers

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Background. In 2003, human monkeypox was first identified in the United States. The outbreak was associated with exposure to infected prairie dogs, but the potential for person-to-person transmission was a concern. This study examines health care worker (HCW) exposure to 3 patients with confirmed monkeypox.

Methods. Exposed HCWs, defined as HCWs who entered a 2-m radius surrounding case patients with confirmed monkeypox, were identified by infection-control practitioners. A self-administered questionnaire and analysis of paired serum specimens determined exposure status, immune response, and postexposure signs and symptoms of monkeypox.

Results. Of 81 exposed HCWs, 57 (70%) participated in the study. Among 57 participants, 40 (70%) had ⩾1 unprotected exposure; none reported signs or symptoms consistent with monkeypox illness. One exposed HCW (2%), who had been vaccinated for smallpox within the past year, had serological evidence of recent orthopoxvirus infection; acute- and convalescent-phase serum specimens tested positive for anti-orthopoxvirus IgM. No exposed HCWs had signs and symptoms consistent with monkeypox.

Conclusion. More than three-quarters of exposed HCWs reported at least 1 unprotected encounter with a patient who had monkeypox. One asymptomatic HCW showed laboratory evidence of recent orthopoxvirus infection, which was possibly attributable to either recent infection or smallpox vaccination. Transmission of monkeypox likely is a rare event in the health care setting.

Journal Article.  2844 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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