title: Extended Human-to-Human Transmission during a Monkeypox Outbreak in the Democratic Republic of the Congo.
abstract: A >600% increase in monkeypox cases occurred in the Bokungu Health Zone of the Democratic Republic of the Congo during the second half of 2013; this increase prompted an outbreak investigation. A total of 104 possible cases were reported from this health zone; among 60 suspected cases that were tested, 50 (48.1%) cases were confirmed by laboratory testing, and 10 (9.6%) tested negative for monkeypox virus (MPXV) infection. The household attack rate (i.e., rate of persons living with an infected person that develop symptoms of MPXV infection) was 50%. Nine families showed >1 transmission event, and >6 transmission events occurred within this health zone. Mean incubation period was 8 days (range 4-14 days). The high attack rate and transmission observed in this study reinforce the importance of surveillance and rapid identification of monkeypox cases. Community education and training are needed to prevent transmission of MPXV infection during outbreaks.
authors.forename: Leisha Diane
authors.initials: LD
authors.lastname: Nolen
authors.forename: Lynda
authors.initials: L
authors.lastname: Osadebe
authors.forename: Jacques
authors.initials: J
authors.lastname: Katomba
authors.forename: Jacques
authors.initials: J
authors.lastname: Likofata
authors.forename: Daniel
authors.initials: D
authors.lastname: Mukadi
authors.forename: Benjamin
authors.initials: B
authors.lastname: Monroe
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Doty
authors.forename: Christine Marie
authors.initials: CM
authors.lastname: Hughes
authors.forename: Joelle
authors.initials: J
authors.lastname: Kabamba
authors.forename: Jean
authors.initials: J
authors.lastname: Malekani
authors.forename: Pierre Lokwa
authors.initials: PL
authors.lastname: Bomponda
authors.forename: Jules Inonga
authors.initials: JI
authors.lastname: Lokota
authors.forename: Marcel Pie
authors.initials: MP
authors.lastname: Balilo
authors.forename: Toutou
authors.initials: T
authors.lastname: Likafi
authors.forename: Robert Shongo
authors.initials: RS
authors.lastname: Lushima
authors.forename: Benoit Kebela
authors.initials: BK
authors.lastname: Ilunga
authors.forename: Frida
authors.initials: F
authors.lastname: Nkawa
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pukuta
authors.forename: Stomy
authors.initials: S
authors.lastname: Karhemere
authors.forename: Jean-Jacques Muyembe
authors.initials: JJ
authors.lastname: Tamfum
authors.forename: Beatrice
authors.initials: B
authors.lastname: Nguete
authors.forename: Emile Okitolonda
authors.initials: EO
authors.lastname: Wemakoy
authors.forename: Andrea M
authors.initials: AM
authors.lastname: McCollum
authors.forename: Mary G
authors.initials: MG
authors.lastname: Reynolds
keywords: Africa; Democratic Republic of the Congo; animal diseases; incubation; monkeypox; monkeypox virus; orthopoxvirus; transmission; viruses; zoonosis