Monkeypox: An epidemiologic and clinical comparison of African and US disease

Department of Dermatology at Aspen Medical Group, Saint Paul, Minnesota, USA.
Journal of the American Academy of Dermatology (Impact Factor: 4.45). 10/2006; 55(3):478-81. DOI: 10.1016/j.jaad.2006.05.061
Source: PubMed

ABSTRACT Monkeypox is a double-stranded DNA virus and a member of the genus Orthopoxvirus. Human monkeypox was first identified in the Democratic Republic of the Congo (formerly Zaire) in 1970. The first outbreak in the western hemisphere occurred in the spring of 2003. Important epidemiologic and clinical differences exist between human monkeypox in the United States and in Africa, including sex distribution, case fatality, morphology of skin lesions, and associated lymphadenopathy. These divergent clinical presentations could be caused by mode of transmission (skin inoculation vs ingestion), the skin color of affected patients, the training backgrounds of those who saw and documented disease outbreaks, the virulence of monkeypox strains involved, nutritional status, access to advanced medical care, and the prevalence of prior smallpox vaccinations.

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    • "Non-classical presentation of disease during primary MPV infection, such as illness without exanthem, has also been reported ( Jezek et al. 1986; Lewis et al. 2007). Similar to smallpox, MPV infection is often mistaken for chickenpox (i.e., varicella zoster virus) ( Jezek et al. 1987b; Meyer et al. 2002; Rimoin et al. 2007), and this complicates diagnosis based on clinical symptoms alone (Sale et al. 2006; Rimoin et al. 2007). Bearing this in mind, it is important that simple, definitive assays for identification of virulent orthopoxvirus infections be developed for seroprevalence studies and potential use in outbreak situations. "
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