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Extended Human-to-Human Transmission during a Monkeypox Outbreak in the Democratic Republic of the Congo
Authors:Leisha Diane Nolen  Lynda Osadebe  Jacques Katomba  Jacques Likofata  Daniel Mukadi  Benjamin Monroe  Jeffrey Doty  Christine Marie Hughes  Joelle Kabamba  Jean Malekani  Pierre Lokwa Bomponda  Jules Inonga Lokota  Marcel Pie Balilo  Toutou Likafi  Robert Shongo Lushima  Benoit Kebela Ilunga  Frida Nkawa  Elisabeth Pukuta  Stomy Karhemere  Jean-Jacques Muyembe Tamfum  Beatrice Nguete  Emile Okitolonda Wemakoy  Andrea M. McCollum  Mary G. Reynolds
Abstract:A 600-fold 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.
Keywords:monkeypox   monkeypox virus   viruses   transmission   incubation   animal diseases   Africa   orthopoxvirus   zoonosis   Democratic Republic of the Congo
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