The detection of monkeypox in humans in the Western Hemisphere
The detection of monkeypox in humans in the Western Hemisphere
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DOI：
10.1056/nejmoa032299
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发表时间：
2004-01-22
影响因子：
158.5
通讯作者：
Damon, IK
中科院分区：
文献类型：
--
作者：
Reed, KD;Melski, JW;Damon, IK
背景：在2003年5月和6月期间，在美国中西部地区的人群中发生了一起发热性疾病伴水疱脓疱性皮疹的暴发，这些人与通过普通经销商获得的患病宠物草原犬接触。怀疑细菌或病毒病原体的人畜共患传播。方法：我们回顾了医疗记录，进行了访谈和检查，并收集了11名患者和一只草原犬鼠的血液和组织样本进行分析。进行组织学和电子显微镜检查，微生物培养和分子检测，以确定病原agent.Results：最初的威斯康星州的情况下，在这次疫情发生在5名男性和6名女性，年龄从3岁到43岁。所有患者都报告说，在出现皮肤出疹的发热性疾病之前，都曾直接接触过患病的草原土拨鼠。我们发现免疫组化或超微结构的证据痘病毒感染的皮肤病变组织从四个病人。从患者和草原土拨鼠的七个样本的细胞培养物中回收了猴痘病毒。该病毒是通过检测来自6名患者和草原犬鼠的组织或分离物中的猴痘特异性DNA序列来鉴定的。流行病学调查表明，草原土拨鼠已暴露于至少一种啮齿动物最近进口到美国从西非。结论：我们的调查文件猴痘病毒的分离和鉴定，从人类在西半球。人类的感染与直接接触被当作宠物饲养或出售的患病草原土拨鼠有关。
BACKGROUND:During May and June 2003, an outbreak of febrile illness with vesiculopustular eruptions occurred among persons in the midwestern United States who had had contact with ill pet prairie dogs obtained through a common distributor. Zoonotic transmission of a bacterial or viral pathogen was suspected.METHODS:We reviewed medical records, conducted interviews and examinations, and collected blood and tissue samples for analysis from 11 patients and one prairie dog. Histopathological and electron-microscopical examinations, microbiologic cultures, and molecular assays were performed to identify the etiologic agent.RESULTS:The initial Wisconsin cases evaluated in this outbreak occurred in five males and six females ranging in age from 3 to 43 years. All patients reported having direct contact with ill prairie dogs before experiencing a febrile illness with skin eruptions. We found immunohistochemical or ultrastructural evidence of poxvirus infection in skin-lesion tissue from four patients. Monkeypox virus was recovered in cell cultures of seven samples from patients and from the prairie dog. The virus was identified by detection of monkeypox-specific DNA sequences in tissues or isolates from six patients and the prairie dog. Epidemiologic investigation suggested that the prairie dogs had been exposed to at least one species of rodent recently imported into the United States from West Africa.CONCLUSIONS: Our investigation documents the isolation and identification of monkeypox virus from humans in the Western Hemisphere. Infection of humans was associated with direct contact with ill prairie dogs that were being kept or sold as pets.