EXTENDED INTERHUMAN TRANSMISSION OF MONKEYPOX IN A HOSPITAL COMMUNITY IN THE REPUBLIC OF THE CONGO, 2003

TLDR

This report describes the first reported outbreak of human monkeypox in the Republic of Congo. Molecular, virologic, serologic, and diagnostic assays were employed to detect monkeypox virus infection in patients with characteristic dermatologic and other clinical signs. Eleven under‑18 cases, mostly on the hospital grounds, exhibited severe symptoms—including one death and one case of profound sequelae—and up to six sequential person‑to‑person transmissions were documented, making this the longest uninterrupted human‑to‑human monkeypox chain and suggesting the virus’s capacity to adapt to humans.

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.