Clinical Characteristics of Human Monkeypox, and Risk Factors for Severe Disease
Top Cited Papers
Open Access
- 15 December 2005
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 41 (12), 1742-1751
- https://doi.org/10.1086/498115
Abstract
Background. Human monkeypox is an emerging smallpox-like illness that was identified for the first time in the United States during an outbreak in 2003. Knowledge of the clinical manifestations of monkeypox in adults is limited, and clinical laboratory findings have been unknown. Methods. Demographic information; medical history; smallpox vaccination status; signs, symptoms, and duration of illness, and laboratory results (hematologic and serum chemistry findings) were extracted from medical records of patients with a confirmed case of monkeypox in the United States. Two-way comparisons were conducted between pediatric and adult patients and between patients with and patients without previous smallpox vaccination. Bivariate and multivariate analyses of risk factors for severe disease (fever [temperature, ⩾38.3°C] and the presence of rash [⩾100 lesions]), activity and duration of hospitalization, and abnormal clinical laboratory findings were performed. Results. Of 34 patients with a confirmed case of monkeypox, 5 (15%) were defined as severely ill, and 9 (26%) were hospitalized for >48 h; no patients died. Previous smallpox vaccination was not associated with disease severity or hospitalization. Pediatric patients (age, ⩽18 years) were more likely to be hospitalized in an intensive care unit. Nausea and/or vomiting and mouth sores were independently associated with a hospitalization duration of >48 h and with having ⩾3 laboratory tests with abnormal results. Conclusion. Monkeypox can cause a severe clinical illness, with systemic signs and symptoms and abnormal clinical laboratory findings. In the appropriate epidemiologic context, monkeypox should be included in the differential diagnosis for patients with unusual vesiculopustular exanthems, mucosal lesions, gastrointestinal symptoms, and abnormal hematologic or hepatic laboratory findings. Clinicians evaluating a rash illness consistent with possible orthopoxvirus infection should alert public health officials and consider further evaluation.Keywords
This publication has 17 references indexed in Scilit:
- Human Monkeypox Infection: A Family Cluster in the Midwestern United StatesThe Journal of Infectious Diseases, 2004
- Monkeypox in the Western HemisphereThe New England Journal of Medicine, 2004
- The Detection of Monkeypox in Humans in the Western HemisphereThe New England Journal of Medicine, 2004
- A case of severe monkeypox virus disease in an American child: emerging infections and changing professional valuesThe Pediatric Infectious Disease Journal, 2003
- Outbreaks of Disease Suspected of Being Due to Human Monkeypox Virus Infection in the Democratic Republic of Congo in 2001Journal of Clinical Microbiology, 2002
- Outbreak of Human Monkeypox, Democratic Republic of Congo, 1996 to 1997Emerging Infectious Diseases, 2001
- Re-emergence of human monkeypox in Zaire in 1996The Lancet, 1997
- Human Monkeypox: Clinical Features of 282 PatientsThe Journal of Infectious Diseases, 1987
- Human Monkeypox: A Newly Emerged Orthopoxvirus Zoonosis in the Tropical Rain Forests of AfricaThe American Journal of Tropical Medicine and Hygiene, 1985
- Human Poxvirus Disease After Smallpox EradicationThe American Journal of Tropical Medicine and Hygiene, 1977