Monkeypox is an exotic infectious disease caused by the monkeypox virus. The disease was first identified in laboratory monkeys hence its name but in its natural state it seems to infect rodents more often than primates. The disease is most prevalent in Central and West Africa but an outbreak occurred also in the United States in 2003.1

Human monkeypox is a zoonotic viral disease that occurs primarily in remote villages of Central and West Africa in proximity to tropical rainforests where there is more frequent contact with infected animals. Monkeypox is usually transmitted to humans from rodents pets and primates through contact with the animal's blood or through a bite. Human monkeypox can be difficult to distinguish clinically from smallpox (to which it is closely related) and chickenpox (to which it is not).2 Contents 1 Epidemiology 2 Monkeypox disease in animals 3 Monkeypox disease in humans 3.1 Symptoms and course 3.2 Prevention and treatment 3.3 2003 U.S. outbreak 4 See also 5 References 6 External links Epidemiology

In addition to monkeys giant pouched rats (Cricetomys sp.) dormice (Graphiurus sp.) and African squirrels (Heliosciurus Funisciurus) have all been implicated as reservoirs of the virus. The use of these animals as food may be an important source of transmission to humans.citation needed

Monkeypox as a disease in humans was first associated with an illness in the Democratic Republic of the Congo (formerly Zaire) in the town of Basankusu Equateur Province in 1970.3 A second outbreak of human illness was identified in DRC/Zaire in 19961997. In 2003 a small outbreak of human monkeypox in the United States occurred among owners of pet prairie dogs.4 The outbreak originated from Villa Park IL outside of Chicago when a exotic animal dealer kept young prairie dogs in close proximity to an infected Gambian pouched rat (Cricetomys gambianus) recently imported from West Africa. Seventy-three people were reportedly infected of which there were no fatalities.

A second African focus of infection has been discovered in Sudan. No infected patients died.5 Monkeypox disease in animals This section requires expansion.

The symptoms of a sick animal include: listlessness ocular and nasal discharges coughing hair loss sometimes accompanied by painful scabs and pneumonia. Look for nodules similar to mosquito bites and inflammation of the lymph glands. Monkeypox disease in humans Symptoms and course

In humans monkeypox is similar to smallpox although it is often milder. Unlike smallpox monkeypox causes lymph nodes to swell (lymphadenopathy). The incubation period for monkeypox is about 12 days (range 7 to 17 days). The illness begins with fever headache muscle aches backache swollen lymph nodes a general feeling of discomfort and exhaustion. Within 1 to 3 days (sometimes longer) after the appearance of fever the patient develops a papular rash i.e. raised bumps often first on the face but sometimes initially on other parts of the body. The lesions usually develop through several stages before crusting and falling off. With the raised bumps it causes pain.

It is assumed that vaccination against smallpox would provide protection against human monkeypox infection considering that they are closely related viruses and the vaccine protects animals from experimental lethal monkeypox challenge.6 This has not been conclusively demonstrated in humans because routine smallpox vaccination was discontinued following the apparent eradication of smallpox and due to safety concerns with the vaccine. Limited person-to-person spread of infection has been reported in disease-endemic areas in Africa. Case-fatality ratios in Africa have ranged from 1% to 10%.7 Prevention and treatment

Currently there is no proven safe treatment for monkeypox. Smallpox vaccine has been reported to reduce the risk of monkeypox among previously vaccinated persons in Africa. The United States Centers for Disease Control and Prevention (CDC) recommends that persons investigating monkeypox outbreaks and involved in caring for infected individuals or animals should receive a smallpox vaccination to protect against monkeypox. Persons who have had close or intimate contact with individuals or animals confirmed to have monkeypox should also be vaccinated. The people who have been infected can be vaccinated up to 14 days after exposure. CDC does not recommend preexposure vaccination for unexposed veterinarians veterinary staff or animal control officers unless such persons are involved in field investigations. This film produced by INCEF for distribution in communities prone to infection describes the nature of the illness and how best to confront it. 2003 U.S. outbreak This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (January 2008) Through June 18 2003 there were 93 cases of monkeypox in the United States including Wisconsin (44 cases) Indiana (24) Illinois (19) Ohio (4) Kansas (1) Missouri (1) and New Jersey (1). Analysis of the first 53 cases showed that 50 had contact with prairie dogs that were purchased from Phil's Pocket Pets of Villa Park Illinois.8 Electron microscopy and serologic studies were used to confirm that the disease was human monkeypox. The onset of the illness among the patients in the United States began in early May 2003. Patients typically experienced a prodrome consisting of fever headaches myalgias chills and drenching sweats. Roughly one-third of patients had nonproductive cough. This prodromal phase was followed 110 days later by the development of a papular rash that typically progressed through stages of vesiculation pustulation umbilication and crusting. In some patients early lesions had become ulcerated. Rash distribution and lesions occurred on head trunk and extremities; many of the patients had initial and satellite lesions on palms soles and extremities. Rashes were generalized in some patients. After onset of the rash patients generally manifested rash lesions in different stages. All patients reported direct or close contact with prairie dogs most of which were sick. Illness in prairie dogs was frequently reported as beginning with a blepharoconjunctivitis progressing to presence of nodular lesions in some cases. Some prairie dogs died from the illness while others reportedly recovered. See also Smallpox Zoonosis References Bayer-Garner IB (2005). "Monkeypox virus: histologic immunohistochemical and electron-microscopic findings". J. Cutan. Pathol. 32 (1): 2834. doi:10.1111/j.0303-6987.2005.00254.x. PMID 15660652.  Jezek Z Szczeniowski M Paluku KM Mutombo M Grab B (1988). "Human monkeypox: confusion with chickenpox". Acta Trop. 45 (4): 297307. PMID 2907258.  A human infection caused by monkeypox virus in Basankusu Territory Democratic Republic of the Congo - I. D. Ladnyj P. Ziegler and E. Kima "What You Should Know About Monkeypox" (PDF). Fact Sheet. Centers for disease control and prevention. 2003-06-12. http://www.cdc.gov/ncidod/monkeypox/pdf/factsheet2.pdf. Retrieved 2008-03-21.  Damon IK Roth CE Chowdhary V (2006). "Discovery of monkeypox in Sudan". N. Engl. J. Med. 355 (9): 9623. doi:10.1056/NEJMc060792. PMID 16943415. http://content.nejm.org/cgi/content/full/355/9/962.  Marriott KA Parkinson CV Morefield SI Davenport R Nichols R Monath TP (2008). "Clonal vaccinia virus grown in cell culture fully protects monkeys from lethal monkeypox challenge". Vaccine 26 (4): 5818. doi:10.1016/j.vaccine.2007.10.063. PMID 18077063. http://linkinghub.elsevier.com/retrieve/pii/S0264-410X(07)01257-1.  Hutin YJ Williams RJ Malfait P et al. (2001). "Outbreak of human monkeypox Democratic Republic of Congo 1996 to 1997". Emerging Infect. Dis. 7 (3): 4348. PMC 2631782. PMID 11384521. http://www.cdc.gov/ncidod/eid/vol7no3/hutin.htm.  Medscape Monkeypox Review External links CDC - Monkeypox Fact Sheet CDC Questions and Answers About Monkeypox CDC - Human Monkeypox -- Kasai Oriental Zaire 1996-1997 CDC - Outbreak of Human Monkeypox Democratic Republic of Congo 1996 to 1997 CDC Preliminary Report: Multistate Outbreak of Monkeypox in Persons Exposed to Pet Prairie Dogs INCEF education project to reduce Monkeypox transmission National Library of Medicine - Monkeypox virus Virology.net Picturebook: Monkeypox Note: much of the original text of this article is taken from public domain CDC (Center for Disease Control) and NIH (National Institute of Health) sources. v d eInfectious skin disease: Viral cutaneous conditions including viral exanthema (B00B09 050059) DNA virus Herpesviridae Alpha HSV (Herpes simplex Herpetic whitlow Herpes gladiatorum Herpetic keratoconjunctivitis Herpetic sycosis Neonatal herpes simplex Herpes genitalis Herpes labialis Eczema herpeticum Herpetiform esophagitis)  Herpes B virus (B virus infection) VZV (Chickenpox Herpes zoster Herpes zoster oticus Ophthalmic zoster Disseminated herpes zoster Zoster-associated pain Inflammatory skin lesions following zoster infection Modified varicella-like syndrome) Beta Human herpesvirus 6/Roseolovirus (Exanthema subitum Roseola vaccinia) Cytomegalic inclusion disease Gamma KSHV (Kaposi's sarcoma) Poxviridae Ortho Variola (Smallpox Eczema vaccinatum Alastrim)  MoxV (Monkeypox)  CV (Cowpox)  VV (Vaccinia Generalized vaccinia Progressive vaccinia) Buffalopox Para Farmyard pox: Milker's nodule  Bovine papular stomatitis  Pseudocowpox  Orf Sealpox Other Yatapoxvirus: Tanapox  Yaba monkey tumor virus MCV (Molluscum contagiosum) Papillomaviridae HPV (Wart/Plantar wart Heck's disease Genital wart (giant) Laryngeal papillomatosis Butcher's wart Bowenoid papulosis Epidermodysplasia verruciformis Verruca plana Pigmented wart Verrucae palmares et plantares ) BPV (Equine sarcoid) Parvoviridae Parvovirus B19 (Erythema infectiosum Reticulocytopenia Papular purpuric gloves and socks syndrome) RNA virus Paramyxoviridae MeV (Measles) Togaviridae Rubella virus (Rubella Congenital rubella syndrome)  Alphavirus infection  Chikungunya fever Picornaviridae CAV (Hand foot and mouth disease Herpangina)  FMDV (Foot-and-mouth disease)  Boston exanthem disease Ungrouped unknown/multiple: Asymmetric periflexural exanthem of childhood  Post-vaccination follicular eruption  Lipschtz ulcer  Eruptive pseudoangiomatosis  Viral-associated trichodysplasia  GianottiCrosti syndrome M: VIR virs(prot)/clss cutn/syst (hppv/hiva infl/zost/zoon)/epon drugJ(dnaa rnaa rtva vacc) M: INT SF LCT anat/phys/devp noco(i/b/d/q/u/r/p/m/k/v/f)/cong/tumr(n/e/d) sysi/epon proc drug (D2/3/4/5/8/11)