Monkeypox outbreak: Swift action leads to identification of exotic virus

Public health officials say physicians should be alert to the infection's symptoms and ask patients about possible animal exposures.

By Victoria Stagg Elliott, AMNews staff. June 30, 2003.

The child had been treated with numerous rounds of antibiotics but was still feverish. She had several lesions on her body. Physicians at the Marshfield Clinic in Marshfield, Wis., were fairly sure her illness was linked to the bite from her pet prairie dog. But what was the infectious agent? Prime suspects such as tularemia, plague and anthrax had all been ruled out. And antibiotics weren't working.

"I had researched the pathogens carried by prairie dogs and did not find any viral transmission to humans," said John Melski, MD, a dermatologist and Marshfield's medical director of clinical informatics. He was part of the team that diagnosed this case.

"I was perplexed, but I was convinced it was some kind of viral syndrome," Dr. Melski said.

This child ultimately became the first diagnosed case of monkeypox in a spate of infections that began last month. Her parents also were infected. It was the call from Marshfield Clinic to the local health department that eventually tipped off the Centers for Disease Control and Prevention to determine that there was outbreak of a pathogen previously unseen in the Western hemisphere.

This monkeypox index case has since been traced to a shipment of more than 800 various small mammals, including many prairie dogs, which contracted the infection from a sick Gambian giant rat. At press time, more than 50 human cases in four states had been diagnosed, and public health officials were still in the process of tracking the hundreds of animals that have been shipped across the country.