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Diasporia News of Friday, 13 June 2003

Source: Houston Chronicle

Wisconsin health worker suspected of monkeypox

..."Akrantie" Might Have Caused It...
A health care worker in Wisconsin, USA, may have contracted monkeypox from a human patient, which would be the nation's first such incidence.

Wisconsin officials said Thursday the virus hasn't been confirmed in the worker, but tissue specimens have been sent to the Centers for Disease Control and Prevention in Atlanta. The worker has been isolated.

"The worker had no contact with an animal and became ill after caring for a person with a suspected case of monkeypox," said Dr. Herb Bostrom, director of Wisconsin's bureau of communicable diseases. "She had respiratory symptoms and a short-lived smallpox on the back of her hand consistent with monkeypox."

Monkeypox, the exotic African disease that has spread from pet prairie dogs to humans, is typically and most effectively transmitted from animal to animal. But it can pass from human to human, as it has in Africa.

The U.S. government Wednesday recommended smallpox shots for people exposed to monkeypox, including pregnant women and children; banned the sale and distribution of prairie dogs; and prohibited importation of all rodents. A Gambian rat is believed to have spread the virus to prairie dogs.

The CDC also issued a list of signs and symptoms to determine which patients have monkeypox and to help in its investigation of the potentially fatal viral disease.

Lab tests have confirmed 12 of the 62 suspected cases of monkeypox under investigation in four states. These include Indiana, with 28 cases; Wisconsin with 21; Illinois with 12; and New Jersey with one. Fourteen of the patients have been hospitalized, but none has died.

The smallpox vaccine, 85 percent effective against monkeypox, can prevent the disease up to two weeks after exposure to the virus. It's most effective in the first four days.

But Bostrom was skeptical of CDC's recommendation that exposed people get the shot, saying the Wisconsin health department will continue to identify those who've been exposed, monitor those providing care for ill victims and act promptly to limit spread of the disease.

"Although known to provide some immunity against monkeypox, the smallpox vaccine has the potential for serious side effects such as encephalitis and heart problems," said Bostrom. "In addition, the CDC has not provided final guidance on this experimental use of smallpox vaccine."

Texas has had no suspected cases of monkeypox, though its source went through the state. Federal, state and local authorities have linked the disease to Gambian rats imported from Ghana, West Africa, in early April by a Texas pet distributor. The prairie dogs also came from Texas, one of 15 states where infected prairie dogs are being sought.

The signs and symptoms of monkeypox are considered similar to those if smallpox -- a rash consisting of raised bumps and pus-filled blisters, a fever of 99.3 degrees or higher, headache or backache, sore throat, cough, and shortness of breath -- except it causes swollen lymph nodes. The illness typically lasts two to four weeks.

Monkeypox is a rare disease that occurs mainly in the rain forest countries of central and west Africa.

In Africa, monkeypox is fatal in as many as 10 percent of those who contract it. Before smallpox was eradicated, the equivalent figure for that disease was 30 percent.

"This monkeypox outbreak is another reminder that in today's world, infections we don't know anything about can be a threat," said Robert Couch, a professor of molecular virology at Baylor College of Medicine.

"The once-popular notion that the only things we have to worry about now are cancer and heart disease is wrong. We have to continue to be vigilant about newly emergent infectious diseases."