Monkey pox B04.x0

Sporadic infection with monkeypox virus occurring in rural areas of the tropical rainforest (Cameroon, Liberia, Nigeria, Sierra Leone, Gabon, Democratic Republic of Congo, Ivory Coast, Central African Republic).

Transmission is by direct contact or aerosol. 28% human-to-human transmission (the chain of infection breaks off quickly), otherwise through contact with sick animals. Approximately 65 infections reported annually. 30% of infections are subclinical. Lethal outcome possible. Presumably protected by smallpox vaccination.

The clinical picture is similar to variola infection. Incubation period is about 12 days. The clinical picture begins with fever, a patchy exanthema, severe headache and back pain, and severe feeling of illness. Almost simultaneously, there is an outbreak of typical smallpox exanthema. Papules become pustules with typical central indentation. A high percentage of patients also develop mucosal involvement. The disease lasts 2-4 weeks. The efflorescences heal with scarring.

Pustule contents with electron microscopic detection of 300x200nm monkeypox virus.

1. Mukinda VB et al (1997) Re-emergence of human monkeypox in Zaire in 1996 Monkeypox Epidemiologic Working Group. Lancet 349: 1449-50
2. Mukinda VB et al (1997) Re-emerge of human monkeypox in Zaire in 1996. dermatologist 48:598
3. Meyer H et al (2002) Outbreaks of disease suspected of being due to human monkeypox virus infection in the democratic republic of congo in 2001 J Clin Microbiol 40: 2919-2921