Health Officials Face New Monkeypox Worry

In what would be the first known transmission of the monkeypox virus from one human to another in the United States, St. Francis Hospital in Milwaukee is investigating a possible case of monkeypox in a nurse who cared for a patient with the suspected of having the virus.

In another case, officials suspect a medical assistant might have contracted the disease from a young girl later diagnosed with monkeypox.

Monkeypox is a rare viral disease that occurs mostly in central and western Africa. It is called "monkeypox" because it was first found in 1958 in laboratory monkeys. Blood tests of animals in Africa later found that other types of animals probably had monkeypox. Scientists also recovered the virus that causes monkeypox from an African squirrel. These types of squirrels might be the common host for the disease. Rats, mice and rabbits can get monkeypox, too. Monkeypox was reported in humans for the first time in 1970.

The disease belongs to a group of viruses that includes the smallpox virus (variola), the virus used in the smallpox vaccine (vaccinia), and the cowpox virus.

The virus was originally spread to humans in the United States via pet prairie dogs that came into contact with an infected African rat at a pet importer. Although there are reports of human-to-human infection in Africa, none had been reported in the United States until today.

Dr. John Melski, a dermatologist at Marshfield Clinic in Marshfield, Wisc., told the Associated Press, "If I were a family member of somebody who had monkeypox, I would want to know you really need to practice precautions within the home."

Patrice M. Skonieczny, infection control coordinator at St. Francis Hospital in Milwaukee, said the infected nurse at St. Francis was wearing a mask, gloves and a gown when she treated the patient suspected of having monkeypox. She is under quarantine at her home, as is the medical assistant, who's boyfriend is also showing symptoms of monkeypox.

In humans, symptoms of monkeypox are like those of smallpox, but usually they are milder. About 12 days after people are infected with the virus, they get a fever, headache, muscle aches and backache; their lymph nodes will swell; and they will feel tired. One to 3 days (or longer) after the fever starts, patients get a rash. This rash develops into raised bumps filled with fluid and often starts on the face and spreads, but it can start on other parts of the body too. The bumps go through several stages before they get crusty, scab over and fall off. The illness usually lasts for 2 to 4 weeks.

In Africa, monkeypox has killed between 1 percent and 10 percent of people who get it. However, this risk would probably be lower in the United States, where nutrition and access to medical care are better.

Dr. David Fleming, deputy director for the Centers for Disease Control and Prevention (CDC), reported that as of 2 p.m. on Wednesday, the United States has had 54 cases of monkeypox infection in humans reported from four states Wisconsin with 20 cases, Indiana with 23 cases, Illinois with 10 cases, and one case from New Jersey. Approximately 10 of those people have been hospitalized.

"In response, CDC has been working with affected states, their public health systems at both the state and local level to do the investigation. Currently, we have at CDC activated our Emergency Operations Center, to help us deal logistically with this outbreak investigation, and in addition, CDC has deployed 11 epidemiologists to the affected states, in particular, nine in Indiana and two to Texas," said Fleming.

The government has implemented two interventions to help control the spread of this outbreak in the U.S. and to decrease the likelihood that this will become a chronic problem in the United States and the Western Hemisphere. The first step, taken by Secretary Tommy Thompson of Health and Human Services, was to place an immediate embargo on the importation of all rodents from Africa. The government also implemented a ban on the sale or movement of prairie dogs between states and also within state boundaries.

Secondly, said Fleming, the government is making the smallpox vaccination available to people in the affected areas, particularly healthcare workers, family members of those with monkeypox, and people who have had contact with a sick prairie dog. Studies have shown the smallpox vaccination is about 85 percent effective in preventing the monkeypox virus.

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