2003 Midwest monkeypox outbreak

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Outbreak of monkeypox in the United States in 2003


2003 Midwest Monkeypox Outbreak

The 2003 Midwest monkeypox outbreak was a significant event in the United States, marking the first time that human monkeypox was reported outside of Africa. The outbreak occurred in the Midwestern United States, primarily affecting the states of Wisconsin, Illinois, Indiana, Kansas, Missouri, and Ohio.

Map of the Midwest region of the United States

Background

Monkeypox is a viral zoonotic disease caused by the monkeypox virus, a member of the Orthopoxvirus genus, which also includes the variola virus (the cause of smallpox). The disease is endemic to Central and West Africa, where it is typically transmitted to humans from wild animals such as rodents and primates.

Transmission

The 2003 outbreak in the United States was traced back to a shipment of animals from Ghana that included Gambian pouched rats, dormice, and rope squirrels. These animals were imported by a Texas animal distributor and subsequently housed with prairie dogs, which are native to North America. The prairie dogs became infected and were sold as pets, leading to human cases of monkeypox.

Outbreak

The outbreak began in early June 2003, with the first human cases reported in Wisconsin. A total of 47 confirmed and probable cases were identified during the outbreak. Symptoms in humans included fever, headache, muscle aches, and a characteristic rash. The rash typically progressed from macules to papules, vesicles, pustules, and finally crusts.

Response

The Centers for Disease Control and Prevention (CDC) and state health departments quickly responded to the outbreak. Measures included the quarantine of infected animals, the tracing of animal and human contacts, and the provision of smallpox vaccine to individuals at risk, as the vaccine is known to provide cross-protection against monkeypox.

Impact

The outbreak highlighted the risks associated with the importation of exotic animals and led to increased regulations. The CDC and the U.S. Food and Drug Administration (FDA) issued a joint order banning the importation of African rodents and the sale, distribution, transport, and release of prairie dogs and six specific genera of African rodents.

Prevention

Preventive measures include avoiding contact with animals that could harbor the virus, practicing good hygiene, and using personal protective equipment when handling potentially infected animals. The smallpox vaccine is effective in preventing monkeypox and was used during the outbreak to protect healthcare workers and close contacts of infected individuals.

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Contributors: Prab R. Tumpati, MD