Monkeypox Rash Severity and Animal Exposures in the Democratic Republic of the Congo

• Published in: EcoHealth Vol. 17; no. 1; pp. 64 - 73
• Main Authors: Doshi, Reena H., Alfonso, Vivian H., Morier, Douglas, Hoff, Nicole A., Sinai, Cyrus, Mulembakani, Prime, Kisalu, Neville, Cheng, Alvan, Ashbaugh, Hayley, Gadoth, Adva, Cowell, Brian, Okitolonda, Emile W., Muyembe-Tamfum, Jean-Jacques, Rimoin, Anne W.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2020; Springer Nature B.V
• Subjects: Animal Ecology; Animals; Cross-Sectional Studies; Democratic Republic of the Congo - epidemiology; Ecosystems; Environmental Health; Exanthema; Exposure; Female; Humans; Hunting; Inoculum; Lesions; Male; Medicine; Medicine & Public Health; Microbiology; Monkeypox virus; Mpox; Mpox (monkeypox) - epidemiology; Original Contribution; Orthopoxvirus; Polymerase Chain Reaction; Primates; Public Health; Rodents; Surveillance; Viral infections; Viral Zoonoses - epidemiology; Viruses; Water and Health; Democratic Republic of the Congo; Congo-Democratic Republic of Congo; Rash illness; Animal exposure; Monkeypox; Rash severity
• ISSN: 1612-9202; 1612-9210
• DOI: 10.1007/s10393-019-01459-7

Experimental studies have suggested a larger inoculum of monkeypox virus may be associated with increased rash severity; however, little data are available on the relationship between specific animal exposures and rash severity in endemic regions. Using cross-sectional data from an active surveillance program conducted between 2005 and 2007 in the Sankuru Province of the Democratic Republic of the Congo, we explored the possible relationship between rash severity and exposures to rodents and non-human primates among confirmed MPX cases. Among the 223 PCR-confirmed MPX cases identified during active surveillance, the majority of cases ( n  = 149) presented with mild rash (5–100 lesions) and 33% had a more serious presentation (> 100 lesions). No association between exposure to rodents and rash severity was found in the multivariable analysis. Those that self-reported hunting NHP 3 weeks prior to onset of MPX symptoms had 2.78 times the odds of severe rash than those that did not report such exposure (95% CI: 1.18, 6.58). This study provides a preliminary step in understanding the association between animal exposure and rash severity and demonstrates correlation with exposure to NHPs and human MPX presentation. Additional research exploring the relationship between rash severity and NHPs is warranted.