Spectrum of infection and risk factors for human monkeypox, United States, 2003.
For the 2003 monkeypox virus (MPXV) outbreak in the United States, interhuman transmission was not documented and all case-patients were near or handled MPXV-infected prairie dogs. We initiated a case-control study to evaluate risk factors for animal-to-human MPXV transmission. Participants completed a questionnaire requesting exposure, clinical, and demographic information. Serum samples were obtained for analysis of immunoglobulin G (IgG) and IgM to orthopoxvirus. When data were adjusted for smallpox vaccination, case-patients were more likely than controls to have had daily exposure to a sick animal (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.2-13.4), cleaned cages and bedding of a sick animal (OR 5.3, 95% CI 1.4-20.7), or touched a sick animal (OR 4.0, 95% CI 1.2-13.4). These findings demonstrate that human MPXV infection is associated with handling of MPXV-infected animals and suggest that exposure to excretions and secretions of infected animals can result in infection.
Reynolds
Mary G
MG
Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. nzr6@cdc.gov
Davidson
Whitni B
WB
Curns
Aaron T
AT
Conover
Craig S
CS
Huhn
Gregory
G
Davis
Jeffrey P
JP
Wegner
Mark
M
Croft
Donita R
DR
Newman
Alexandra
A
Obiesie
Nkolika N
NN
Hansen
Gail R
GR
Hays
Patrick L
PL
Pontones
Pamela
P
Beard
Brad
B
Teclaw
Robert
R
Howell
James F
JF
Braden
Zachary
Z
Holman
Robert C
RC
Karem
Kevin L
KL
Damon
Inger K
IK
D000293:Adolescent; D000328:Adult; D000818:Animals; D016022:Case-Control Studies; D006801:Humans; D045908:Mpox, Monkeypox / Q000453:epidemiology*; D016017:Odds Ratio; D012307:Risk Factors; D012589:Sciuridae / Q000821:virology; D014481:United States / Q000453:epidemiology