Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers
Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers
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DOI：
10.1086/427805
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发表时间：
2005-03-01
影响因子：
11.8
通讯作者：
Kuehnert, MJ
中科院分区：
文献类型：
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作者：
Fleischauer, AT;Kile, JC;Kuehnert, MJ
背景2003年，人类猴痘首次在美国被发现。这次疫情与接触受感染的草原土拨鼠有关，但人与人之间传播的可能性令人担忧。本研究探讨卫生保健工作者（HCW）暴露于3例确诊猴痘。暴露的HCW，定义为HCW谁进入周围2米半径确诊猴痘病例患者，由感染控制从业人员确定。一个自我管理的问卷调查和配对血清标本的分析确定了暴露状态，免疫反应，以及猴痘的表现和症状。在81名接触HCW的人中，有57人（70%）参与了这项研究。在57名参与者中，40名（70%）有大于或等于1次无保护暴露;没有人报告与猴痘疾病一致的体征或症状。一个暴露HCW（2%），谁在过去一年内接种了天花疫苗，最近正痘病毒感染的血清学证据;急性和恢复期血清标本检测抗正痘病毒IgM阳性。未发现与猴痘相关的症状和体征。超过四分之三的暴露HCW报告至少有一次与患有猴痘的患者发生无保护接触。1例无症状HCW显示近期正痘病毒感染的实验室证据，这可能归因于近期感染或天花疫苗接种。猴痘的传播在卫生保健环境中可能是一种罕见的事件。
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 greater than or equal to1 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.