Human Monkeypox Outbreak, Sudan | CDC EID

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Volume 16, Number 10–October 2010
Research
Human Monkeypox Outbreak Caused by Novel Virus Belonging to Congo Basin Clade, Sudan, 2005

Pierre Formenty Comments to Author, Mohammed O. Muntasir, Inger Damon, Vipul Chowdhary, Martin L. Opoka, Charlotte Monimart, Elmangory M. Mutasim, Jean-Claude Manuguerra, Whitni B. Davidson, Kevin L. Karem, Jeanne Cabeza, Sharlenna Wang, Mamunur R. Malik, Thierry Durand, Abdalhalim Khalid, Thomas Rioton, Andrea Kuong-Ruay, Alimagboul A. Babiker, Mubarak E.M. Karsani, and Magdi S. Abdalla
Author affiliations: World Health Organization Global Alert and Response, Geneva, Switzerland (P. Formenty); Federal Ministry of Health, Khartoum, Sudan (M.O. Muntasir, A.A. Babiker, M.S. Abdalla); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Damon, W.B. Davidson, K.L. Karem); Médecins Sans Frontières France Office in Sudan, Khartoum (V. Chowdhary, C. Monimart, J. Cabeza, T. Durand, A. Khalid, T. Rioton); World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt (M.L. Opoka); Minister of Health of Unity State, Bentiu, Sudan (A. Kuong-Ruay); National Public Health Laboratory, Khartoum (E.M. Mutasim, M.E.M. Karsani); Institut Pasteur, Paris, France (Jean-Claude Manuguerra); and World Health Organization Country Office, Khartoum (S. Wang, M.R. Malik)

Suggested citation for this article

Abstract
To determine the outbreak source of monkeypox virus (MPXV) infections in Unity State, Sudan, in November 2005, we conducted a retrospective investigation. MPXV was identified in a sub-Sahelian savannah environment. Three case notification categories were used: suspected, probable, and confirmed. Molecular, virologic, and serologic assays were used to test blood specimens, vesicular swabs, and crust specimens obtained from symptomatic and recovering persons. Ten laboratory-confirmed cases and 9 probable cases of MPXV were reported during September–December 2005; no deaths occurred. Human-to-human transmission up to 5 generations was described. Our investigation could not fully determine the source of the outbreak. Preliminary data indicate that the MPXV strain isolated during this outbreak was a novel virus belonging to the Congo Basin clade. Our results indicate that MPXV should be considered endemic to the wetland areas of Unity State. This finding will enhance understanding of the ecologic niche for this virus.

Monkeypox virus (MPXV) is an orthopoxvirus and the causative agent for human monkeypox, a viral disease with clinical signs in humans similar to those seen in past smallpox patients (1,2). Human monkeypox is regularly reported in remote villages of central Africa near tropical rainforests where persons may have contact with infected animals (3–7). In 2003, human monkeypox was identified in the Western Hemisphere (8) after importation of rodents from Ghana.

In early November 2005, the medical team at the Médecins Sans Frontières France (MSF-F) hospital in Bentiu, Unity State, Sudan, reported several suspected case-patients with generalized vesicopustular rash that resembled rash caused by MPXV. Biologic samples were collected and sent to the World Health Organization (WHO) Collaborating Center for Smallpox and other Poxvirus Infections, Centers for Disease Control and Prevention (CDC), Atlanta, USA, where MPXV infection was confirmed (9). Because human monkeypox had been reported in a dry savannah area in Africa, an investigation team conducted a retrospective analysis of the outbreak. A description of virologic studies indicating that MPXV isolated from the Sudan outbreak is a novel virus in the Congo Basin clade will be detailed in a subsequent report. Here, we report the results of a retrospective investigation that was conducted in January 2006.

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Human Monkeypox Outbreak, Sudan | CDC EID


Suggested Citation for this Article

Formenty P, Muntasir MO, Damon I, Chowdhary V, Opoka ML, Monimart C, et al. Human monkeypox outbreak caused by novel virus belonging to Congo Basin clade, Sudan, 2005. Emerg Infect Dis [serial on the Internet]. 2010 Oct [date cited]. http://www.cdc.gov/EID/content/16/10/1539.htm

DOI: 10.3201/eid1610.100713

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Address for correspondence: Pierre Formenty, World Health Organization, Global Alert and Response, 20 Ave Appia, CH-1211 Geneva 27, Switzerland; email: formentyp@who.int