title: Extended interhuman transmission of monkeypox in a hospital community in the Republic of the Congo, 2003.
abstract: This report describes the first reported outbreak of human monkeypox in the Republic of Congo. Eleven confirmed and probable monkeypox cases were observed during this outbreak, all were less than 18 years old, and most resided on the grounds of the Government Hospital in Impfondo. Molecular, virologic, and serologic, and diagnostic assays were used to detect evidence of monkeypox (or orthopox) virus infection in individuals with striking dermatologic and other clinical manifestations. The majority of cases in this outbreak experienced significant, symptomatic illnesses; there was one death, possibly involving secondary complications, and one instance of profound sequelae. Up to six sequential transmissions of monkeypox virus from person to person are hypothesized to have occurred, making this the longest uninterrupted chain of human monkeypox fully documented to date. The pattern of sustained human-to-human transmission observed during this outbreak may influence our current perception of the capacity for this zoonotic virus to adapt to humans.
authors.affiliation: School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York, USA.
authors.forename: Lynne A
authors.initials: LA
authors.lastname: Learned
authors.forename: Mary G
authors.initials: MG
authors.lastname: Reynolds
authors.forename: Demole Wassa
authors.initials: DW
authors.lastname: Wassa
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Olson
authors.forename: Kevin
authors.initials: K
authors.lastname: Karem
authors.forename: Linda L
authors.initials: LL
authors.lastname: Stempora
authors.forename: Zach H
authors.initials: ZH
authors.lastname: Braden
authors.forename: Richard
authors.initials: R
authors.lastname: Kline
authors.forename: Anna
authors.initials: A
authors.lastname: Likos
authors.forename: François
authors.initials: F
authors.lastname: Libama
authors.forename: Henri
authors.initials: H
authors.lastname: Moudzeo
authors.forename: Jean Daniel
authors.initials: JD
authors.lastname: Bolanda
authors.forename: Paul
authors.initials: P
authors.lastname: Tarangonia
authors.forename: Paul
authors.initials: P
authors.lastname: Boumandoki
authors.forename: Pierre
authors.initials: P
authors.lastname: Formenty
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Harvey
authors.forename: Inger K
authors.initials: IK
authors.lastname: Damon
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003223:Congo; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D008297:Male; D045908:Mpox, Monkeypox / Q000175:diagnosis / Q000473:pathology / Q000635:transmission* / Q000821:virology; D008993:Monkeypox virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification* / Q000502:physiology