Guest guest Posted June 21, 2003 Report Share Posted June 21, 2003 > Here We Go Again - > 'Monkeypox-Like' Illness > From Patricia Doyle, PhD > dr_p_doyle > http://www.rense.com/general38/monk.htm > 6-9-3 > > I notice that the post refers to a monkeypox-LIKE illness. We have had West > Nile-LIKE virus, SARS-LIKE virus, and even Lyme-like illness. Now we can add > to the list of first time ever emerging disease in the US, Monkeypox-LIKE > illness. > > As far as I can trace, the last Monkeypox outbreak was in Africa back in Oct. > 2002. I am wondering how the prariedogs became infected? > > Patricia > > 1] > Mon 9 Jun 2003 > ProMED-mail <promed > Source: Centers for Disease Control and Prevention, Preliminary report, > Mon 9 Jun 2003 [edited] > > http://www.cdc.gov/ncidod/monkeypox/report060903.htm > > Multistate Outbreak Of Monkeypox In Persons Exposed To Prairie Dogs > > An extensive multidisciplinary investigation in Wisconsin, Illinois, and > Indiana has identified cases of febrile rash illness in persons who had direct > or close contact with recently purchased ill prairie dogs. Scientists at the > Marshfield Clinic in Marshfield, Wisconsin, recovered viral isolates from a > patient and a prairie dog and demonstrated a virus morphologically consistent > with a poxvirus by electron microscopy (see > http://research.marshfieldclinic.org/crc/prairiedog.asp for electron > microscopy images). > > Preliminary results of serologic testing, polymerase-chain-reaction [PCR] > analysis, and gene sequencing performed at the Centers for Disease Control and > Prevention (CDC) on 6-7 Jun 2003 indicated that the causative agent is > monkeypox virus, a member of the orthopoxvirus group of viruses. Results of > additional evaluation at CDC by electron microscopy and immunohistochemical > studies are consistent with the finding of an orthopoxvirus. These findings > represent the first evidence of community-acquired monkeypox-like infection in > the United States. Further characterization of the virus is in progress. > > Human monkeypox is a rare zoonotic viral disease that occurs primarily in the > rain forest countries of central and west Africa. In humans, the illness > produces a vesicular and pustular rash similar to that of smallpox. Limited > person-to-person spread of infection has been reported in disease-endemic > areas in Africa; the incubation period is about 12 days. Case-fatality ratios > in Africa have ranged from 1% to 10% -- for additional information about > monkeypox, see <www.cdc.gov/ncidod/eid/vol7no3/hutin.htm> > > As of Sat 7Jun 2003, cases of suspected monkeypox had been reported among > residents of Wisconsin (17), northern Illinois (1), and northwestern Indiana > (1). Onset of illness among patients began in early May [2003]. Patients > typically experienced a prodrome consisting of fever, headaches, myalgias, > chills, and drenching sweats. Roughly one- third of patients had nonproductive > cough. This prodromal phase was followed 1-10 days later by the development of > a papular rash that typically progressed through stages of vesiculation, > pustulation, umbilication, and crusting. In some patients, early lesions have > become ulcerated. Rash distribution and lesions have occurred on head, trunk, > and extremities; many of the patients had initial and satellite lesions on > palms and soles and extremities. Rashes were generalized in some patients. > After onset of the rash, patients have generally manifested rash lesions in > different stages. > > All patients reported direct or close contact with prairie dogs, most of which > were sick. Illness in prairie dogs was frequently reported as beginning with a > blepharoconjunctivitis, progressing to presence of nodular lesions in some > cases. Some prairie dogs have died from the illness, while others reportedly > recovered. > > In May [2003] the prairie dogs were sold by a Milwaukee animal distributor to > 2 pet shops in the Milwaukee area and during a pet " swap meet " (pets for sale > or exchange) in northern Wisconsin. The Milwaukee animal distributor had > obtained prairie dogs and a Gambian giant rat that was ill at the time from a > northern Illinois animal distributor. It is unclear whether other retail > outlets are involved. Investigations are under way to trace back the source of > the prairie dogs and the Gambian giant rat and determine if distributors in > other states might be involved. Animal species susceptible to monkeypox virus > may include non-human primates, lagomorphs (rabbits), and some rodents. > > On the basis of preliminary findings from this investigation, it appears that > the primary route of transmission may be from infected prairie dogs to humans > as a result of close contact. However, the possibility of human- to-human > transmission cannot be excluded at this time. As a precaution until additional > information is available, the measures below should be followed. > > General Prevention > ------------------ > Avoid contact with any prairie dogs or Gambian giant rats that appear to > be ill (e.g., are missing patches of fur, have a visible rash on the skin, or > have a discharge from eyes or nose). Wash hands thoroughly after any > contact with prairie dogs, Gambian giant rats, or any ill animal. > > Diagnosis > ----------- > Physicians should consider monkeypox in persons with fever, cough, > headache, myalgias, rash, or lymph node enlargement within 3 weeks > after contact with prairie dogs or Gambian giant rats. Inform the treating > physician or other clinician of the animal exposure. > > Veterinarians > ------------- > Veterinarians examining sick exotic animal species, especially prairie > dogs and Gambian giant rats, should consider monkeypox. Veterinarians > should also be alert to the development of illness in other animal species > that may have been housed with ill prairie dogs or Gambian giant rats. > > Treatment > -------- > No specific treatment recommendations are being made at this time. > Smallpox vaccine has been reported to reduce the risk of monkeypox > among previously vaccinated persons in Africa. CDC is assessing the > potential role of postexposure use of smallpox vaccine as well as > therapeutic use of the antiviral drug cidofovir. [A newswire report states > that one of the victims had been vaccinated against smallpox back in > 1972. - Mod.JW] > > Reporting > --------- > Health care providers, veterinarians, and public health personnel should > report cases of these illnesses in humans and animals to their state or > local health departments as soon as they are suspected. > > Submission of Specimens from Patients with Suspected Monkeypox > ----------------------------- > Procedures recommended for collection of samples for diagnosis of > potential monkeypox disease are essentially the same as those for > diagnosis of the related orthopoxvirus diseases, vaccinia and smallpox. > For information regarding collection of serum specimens and lesions, > please refer to the smallpox laboratory testing guidelines at > > www.bt.cdc.gov/agent/smallpox/lab-testing. > > Consultation with the state epidemiologist > > www.cste.org/members/state_and_territorial_epi.asp > > and state health laboratory > > www.aphl.org/public_health_labs/index.cfm > > is necessary for submission instructions before sending specimens to > CDC. > > Additional Information > ---------------------- > For more information contact your state or local health department. > Additional information and recommendations will be released as they > become available. Updated information will be posted on CDC's > monkeypox Web site > <http://www.cdc.gov/ncidod/monkeypox/index.htm> > > -- > ProMED-mail > <promed > > [At present there still seems to be some ambiguity regarding the identity > of the etiologic agent responsible for this outbreak. Monkeypox virus has > not been observed outside West/Central Africa and its name is something > of a misnomer. Monkeypox virus causes mild illness in primates but its > principal reservoir hosts may be squirrels and rodents. Monkeypox virus > is a member of the same poxvirus genus as smallpox virus (i.e. the genus > _Orthopoxvirus_) and smallpox virus vaccine (i.e. vaccinia virus) > provides protective immunity. However, in its natural range outbreaks of > monkeypox are infrequent and it has often been confused with outbreaks > of chickenpox (caused by an unrelated herpesvirus): see a previous > cautionary comment posted by Dr. D.A. Henderson in " Monkeypox - > Congo DR (Equateur) (06) 20020410.3926 " - Mod.CP] > > ****** > [2] > Mon 9 Jun 2003 > " Robin Nypaver " <RobinNypaver > > The Associated Press article on monkeypox quoted on ProMED-mail > states that: [ " One of the cases] said she got 2 female prairie dogs from > SK Exotics on 5 May 2003. Neither looked sick at first, she said, but > one eventually began to look tired. [she] said she got sick in mid-May > with blisters, coughing and a 101-degree fever. Hospital staff gave her > aspirin, told her it was a viral infection and she went home, she said. " > > Monkeypox presents very much like smallpox. If the article is accurate > and the case did go to a hospital, why did the hospital not recognize the > similarities and become fretful? > > -- > Robin Nypaver, R.N., B.S.N. > Communicable Disease Specialist > El Paso County Department of Health and Environment > 301 South Union Blvd. > Colorado Springs, Colorado 80910 > <robinnypaver > > [i would suggest that there is significant reason for concern about the > efficacy of the BT preparedness training that has gone on, if the patient > presented with a febrile " blister " illness to an Emergency Department. > > Who were the targets of the training? Did they include all ED staff > including nursing (triage nurses are usually rotated among all ED nurses) > and all ED docs? > > And if the patient was a young adult, giving ASA [aspirin] with a possible > varicella infection is still questionable because of the association with > Reye's syndrome. - Mod.MPP] > > [see also: > Monkeypox, human, prairie dogs - USA (WI, IL, IN) 20030608.1412 > 2002 > ----- > Monkeypox - Congo DR (Equateur) (07) 20021025.5638 > Monkeypox - Congo DR (Equateur) 20020228.3654 > Monkeypox - Congo DR (Equateur) (06) 20020410.3926 > 2001 > ---- > Monkeypox, suspected - Congo DR (Equateur) (02) 20010927.2353 > Monkeypox, suspected - Congo DR (Equateur): RFI 20010315.0523 > 2000 > ---- > Monkeypox - Congo, Dem. Rep. (Mbuji-Mayi): 1999 20000428.0645 > Monkeypox - Congo, Dem. Rep. (Mbuji-Mayi): comment > 20000506.0691 > 1998 > ---- > Monkeypox, new therapeutic agent 19980311.0470 > 1997 > ---- > Monkeypox, threat to humans? 19970728.1585 > Monkeypox - Congo, Dem.Rep. 19970928.2049 > Monkeypox - Congo, Democratic Republic (09) 19971214.2481 > Monkeypox - Zaire 19970321.0599 > Monkeypox - Zaire (09) 19970426.0847 > 1996 > ---- > Monkeypox - Zaire 19960903.1505 > Monkeypox - Zaire (02) 19961030.1834] > ....................................................mpp/cp/jw > > Patricia A. Doyle, PhD > Please visit my " Emerging Diseases " message board at: > http://www.clickitnews.com/ubbthreads/postlist.php?Cat= & Board=emergingdiseases > Zhan le Devlesa tai sastimasa > Go with God and in Good Health Quote Link to comment Share on other sites More sharing options...
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