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Volume 13, Number 9—September 2007

Spectrum of Infection and Risk Factors for Human Monkeypox, United States, 2003

Mary G. Reynolds*Comments to Author , Whitni B. Davidson*, Aaron T. Curns*, Craig S. Conover†, Gregory Huhn*‡, Jeffrey P. Davis§, Mark Wegner§, Donita R. Croft§, Alexandra Newman*§, Nkolika N. Obiesie¶, Gail R. Hansen¶, Patrick L. Hays¶, Pamela Pontones#, Brad Beard#, Robert Teclaw#, James F. Howell#, Zachary Braden*, Robert C. Holman*, Kevin L. Karem*, and Inger K. Damon*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Illinois Department of Public Health, Chicago, Illinois, USA; ‡Rush University, Chicago, Illinois, USA; §Wisconsin Department of Health and Family Services, Madison, Wisconsin, USA; ¶Kansas Department of Health and Environment, Topeka, Kansas, USA; #Indiana State Department of Health, Indianapolis, Indiana, USA;

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Table 2

Characteristics of monkeypox case-patients and controls selected from the population of persons exposed, monkeypox virus outbreak, United States, 2003

Characteristic Study classifications, no. (%)
Case-patients Case-patients infected but not diseased Controls
Illinois 8 (26.7) 1 (33.3) 8 (28.6)
Indiana 10 (33.3) 1 (33.3) 17 (60.7)
Kansas 1 (3.3) 0 0
Wisconsin 11 (36.7) 1 (33.3) 3 (10.7)
Age, y
<18 10 (33.3) 0 7 (25.0)
>18 20 (66.7) 3 (100) 21 (75.0)
History of smallpox vaccination
Yes 6 (20.0) 3 (100) 15 (53.6)
24 (80.0)
13 (46.4)
Setting in which exposure occurred*
Home 18 (60.0) 1 (33.3) 17 (60.7)
Neighbor’s home 3 (10.0) 0 6 (21.4)
Pet store 2 (6.7) 1 (33.3) 1 (3.6)
Veterinary clinic 7 (23.3) 1 (33.3) 4 (14.3)
Exposure source†‡
Prairie dog (PD) 30 (100) 3 (100) 28 (100)
PD and African animal 1 (3.3) 1 (33.3) 2 (7.1)
PD and other animal 1 (3.3) 0 2 (7.1)
Only other animal
Symptoms postexposure
Fever 28§ (93.3) 2 (66.7) 4 (14.3)
Rash 30 (100) 1 (33.3) 7 (25.0)
Lymphadenopathy 20 (66.7) 1 (33.3) 4 (14.3)
Mouth sores 8 (26.7) 0 1 (3.6)
Conjunctivitis 4 (13.3) 0 0
17 (56.7)
2 (7.1)
Total 30 3 28

*Indicates principal setting for exposure.
†Reported exposures pertain to animals with laboratory-confirmed monkeypox infections (15) or ones that had lesion-producing illnesses plus prior exposure to a confirmed infected animal. African animals included dormice, giant Gambian rats, jerboas, hedgehogs, striped mice, and pygmy mice.
‡Includes all reported exposures; categories not mutually exclusive.
§Self-reported information for fever was indicated as unknown or was missing for 2 persons who had laboratory-confirmed monkeypox infections.

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