title: Monkeypox transmission and pathogenesis in prairie dogs.
abstract: During May and June 2003, the first cluster of human monkeypox cases in the United States was reported. Most patients with this febrile vesicular rash illness presumably acquired the infection from prairie dogs. Monkeypox virus was demonstrated by using polymerase chain reaction in two prairie dogs in which pathologic studies showed necrotizing bronchopneumonia, conjunctivitis, and tongue ulceration. Immunohistochemical assays for orthopoxviruses demonstrated abundant viral antigens in surface epithelial cells of lesions in conjunctiva and tongue, with less amounts in adjacent macrophages, fibroblasts, and connective tissues. Viral antigens in the lung were abundant in bronchial epithelial cells, macrophages, and fibroblasts. Virus isolation and electron microscopy demonstrated active viral replication in lungs and tongue. These findings indicate that both respiratory and direct mucocutaneous exposures are potentially important routes of transmission of monkeypox virus between rodents and to humans. Prairie dogs offer insights into transmission, pathogenesis, and new vaccine and treatment trials because they are susceptible to severe monkeypox infection.
authors.affiliation: Infectious Disease Pathology Activity, Centers for Disease Control and Prevention, Mailstop G32, 1600 Clifton Road NE, Atlanta, GA 30333, USA. jguarner@cdc.gov
authors.forename: Jeannette
authors.initials: J
authors.lastname: Guarner
authors.forename: Bill J
authors.initials: BJ
authors.lastname: Johnson
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Paddock
authors.forename: Wun-Ju
authors.initials: WJ
authors.lastname: Shieh
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Goldsmith
authors.forename: Mary G
authors.initials: MG
authors.lastname: Reynolds
authors.forename: Inger K
authors.initials: IK
authors.lastname: Damon
authors.forename: Russell L
authors.initials: RL
authors.lastname: Regnery
authors.forename: Sherif R
authors.initials: SR
authors.lastname: Zaki
mesh_terms: D000818:Animals; D004196:Disease Outbreaks / Q000662:veterinary*; D006801:Humans; D008168:Lung / Q000473:pathology; D045908:Mpox, Monkeypox / Q000503:physiopathology / Q000635:transmission / Q000662:veterinary*; D008993:Monkeypox virus / Q000235:genetics / Q000302:isolation & purification*; D012150:Polymorphism, Restriction Fragment Length; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012589:Sciuridae