Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers

Aaron T. Fleischauer, James C. Kile, Molly Davidson, Marc Fischer, Kevin L. Karem, Robert Teclaw, Hans Messersmith, Pamela Pontones, Bradley A. Beard, Zachary H. Braden, Joanne Cono, James J. Sejvar, Ali S. Khan, Inger Damon, Matthew J. Kuehnert

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)689-694
Number of pages6
JournalClinical Infectious Diseases
Volume40
Issue number5
DOIs
StatePublished - Mar 1 2005

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Monkeypox
Delivery of Health Care
Orthopoxvirus
Signs and Symptoms
Smallpox
Infection Control Practitioners
Infection
Sciuridae
Serum
Disease Outbreaks
Vaccination

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Fleischauer, A. T., Kile, J. C., Davidson, M., Fischer, M., Karem, K. L., Teclaw, R., ... Kuehnert, M. J. (2005). Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers. Clinical Infectious Diseases, 40(5), 689-694. https://doi.org/10.1086/427805

Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers. / 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.

In: Clinical Infectious Diseases, Vol. 40, No. 5, 01.03.2005, p. 689-694.

Research output: Contribution to journalArticle

Fleischauer, AT, Kile, JC, Davidson, M, Fischer, M, Karem, KL, Teclaw, R, Messersmith, H, Pontones, P, Beard, BA, Braden, ZH, Cono, J, Sejvar, JJ, Khan, AS, Damon, I & Kuehnert, MJ 2005, 'Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers', Clinical Infectious Diseases, vol. 40, no. 5, pp. 689-694. https://doi.org/10.1086/427805
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. / Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers. In: Clinical Infectious Diseases. 2005 ; Vol. 40, No. 5. pp. 689-694.
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abstract = "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.",
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AU - Davidson, Molly

AU - Fischer, Marc

AU - Karem, Kevin L.

AU - Teclaw, Robert

AU - Messersmith, Hans

AU - Pontones, Pamela

AU - Beard, Bradley A.

AU - Braden, Zachary H.

AU - Cono, Joanne

AU - Sejvar, James J.

AU - Khan, Ali S.

AU - Damon, Inger

AU - Kuehnert, Matthew J.

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N2 - 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.

AB - 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.

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