Evaluation of Human-to-Human Transmission of Monkeypox from Infected Patients to Health Care Workers

• Published in: Clinical infectious diseases Vol. 40; no. 5; pp. 689 - 694
• Main Authors: Fleischauer, Aaron T., Kile, James C., Davidson, Molly, Fischer, Marc, Karem, Kevin L., Teclaw, Robert, Messersmith, Hans, Pontones, Pamela, Beard, Bradley A., Braden, Zachary H., Cono, Joanne, Sejvar, James J., Khan, Ali S., Damon, Inger, Kuehnert, Matthew J.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.03.2005; University of Chicago Press; Oxford University Press
• Subjects: Adult; Antibodies, Viral - blood; Biological and medical sciences; Child; Data collection; Disease Outbreaks; Disease transmission; Diseases; Dresses; Exanthema; Female; Fever; Health care; Health Personnel; Hospitalization; Hospitals; Human viral diseases; Humans; Immunoglobulin G - blood; Immunoglobulin M - blood; Infections; Infectious Disease Transmission, Patient-to-Professional - statistics & numerical data; Infectious diseases; Major Articles; Male; Medical sciences; Middle Aged; Monkeypox; Mpox (monkeypox) - transmission; Orthopoxvirus; Patients; Preventive medicine; Public health; Smallpox; Smallpox Vaccine; Smallpox, monkey pox, tanapox; Stochastic models; Surveys and Questionnaires; Symptoms; Tropical viral diseases; Vaccination; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; United States; North America; America; Skin disease; Questionnaire; Vaccination; Health care staff; Asymptomatic; Laboratory; Occupational exposure; IgM; Prevention; Work safety; Serum; Transmission from man to man; Dog; Epidemic; Human; Fissipedia; Smallpox; Carnivora; Chordopoxvirinae; Immune response; Occupational disease; Acute; Orthopoxvirus; Virus; Infection; Immunoprophylaxis; Symptomatology; Vertebrata; Mammalia; Poxviridae; Viral disease; Animal; Occupational medicine; Monkey pox
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/427805

Background. In 2003, human monkeypox was first identified in the United States. The outbreak was associated with exposure to infected prairie dogs, but the potential for person-to-person transmission was a concern. This study examines health care worker (HCW) exposure to 3 patients with confirmed monkeypox. Methods. Exposed HCWs, defined as HCWs who entered a 2-m radius surrounding case patients with confirmed monkeypox, were identified by infection-control practitioners. A self-administered questionnaire and analysis of paired serum specimens determined exposure status, immune response, and postexposure signs and symptoms of monkeypox. Results. Of 81 exposed HCWs, 57 (70%) participated in the study. Among 57 participants, 40 (70%) had ⩾1 unprotected exposure; none reported signs or symptoms consistent with monkeypox illness. One exposed HCW (2%), who had been vaccinated for smallpox within the past year, had serological evidence of recent orthopoxvirus infection; acute- and convalescent-phase serum specimens tested positive for anti-orthopoxvirus IgM. No exposed HCWs had signs and symptoms consistent with monkeypox. Conclusion. More than three-quarters of exposed HCWs reported at least 1 unprotected encounter with a patient who had monkeypox. One asymptomatic HCW showed laboratory evidence of recent orthopoxvirus infection, which was possibly attributable to either recent infection or smallpox vaccination. Transmission of monkeypox likely is a rare event in the health care setting.