title: Transmission of monkeypox among persons exposed to infected prairie dogs in Indiana in 2003.
abstract: OBJECTIVE
  To describe a cluster of human monkeypox cases associated with exposure to ill prairie dogs in a home child care.
  
  
  METHODS
  We identified all persons exposed to 2 pet prairie dogs in County A, Indiana; performed active surveillance for symptomatic monkeypox infection; and evaluated the types of exposure that may have resulted in infection. For children who attended the child care where the animals were housed, we also measured the rate of seroconversion to monkeypox virus.
  
  
  METHODS
  Nine (13%) of 70 persons exposed to the prairie dogs reported signs and symptoms of monkeypox. Two (40%) of 5 symptomatic child care attendees reported direct contact with the prairie dogs. Two (13%) of 15 child care attendees evaluated tested positive for IgM antibodies against orthopoxvirus; both reported symptoms consistent with monkeypox.
  
  
  RESULTS
  The risk of symptomatic infection correlated with the time and intensity of animal exposure, which was 100% (4/4) among family members with extensive direct contact, 19% (5/26) among the veterinarian and nonfamily child care attendees with moderate exposure, and 0% (0/40) among school children with limited exposure (P<.01).
  
  
  CONCLUSIONS
  Monkeypox virus was transmitted from ill prairie dogs in a child care and veterinary facilities. The risk of symptomatic infection correlated with the amount of exposure to the prairie dogs. Although most cases of human monkeypox were associated with direct animal contact, other routes of transmission cannot be excluded.
authors.affiliation: Environmental Health Services Branch, Division of Emergency and Environmental Health Services, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. james.kile@fsis.usda.gov
authors.forename: James C
authors.initials: JC
authors.lastname: Kile
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Fleischauer
authors.forename: Bradley
authors.initials: B
authors.lastname: Beard
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kuehnert
authors.forename: Richard S
authors.initials: RS
authors.lastname: Kanwal
authors.forename: Pamela
authors.initials: P
authors.lastname: Pontones
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Messersmith
authors.forename: Robert
authors.initials: R
authors.lastname: Teclaw
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Karem
authors.forename: Zachary H
authors.initials: ZH
authors.lastname: Braden
authors.forename: Inger
authors.initials: I
authors.lastname: Damon
authors.forename: Ali S
authors.initials: AS
authors.lastname: Khan
authors.forename: Marc
authors.initials: M
authors.lastname: Fischer
mesh_terms: D000328:Adult; D000818:Animals; D000914:Antibodies, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D004196:Disease Outbreaks; D004283:Dog Diseases / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D004285:Dogs; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D045908:Mpox, Monkeypox / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D008993:Monkeypox virus / Q000235:genetics / Q000276:immunology; D012189:Retrospective Studies; D012307:Risk Factors; D012589:Sciuridae / Q000821:virology*; D015047:Zoonoses / Q000453:epidemiology / Q000635:transmission / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral