Abstract
During May and June 2003, the first cluster of human monkeypox cases in the United States was reported. Most patients with this febrile vesicular rash illness presumably acquired the infection from prairie dogs. Monkeypox virus was demonstrated by using polymerase chain reaction in two prairie dogs in which pathologic studies showed necrotizing bronchopneumonia, conjunctivitis, and tongue ulceration. Immunohistochemical assays for orthopoxviruses demonstrated abundant viral antigens in surface epithelial cells of lesions in conjunctiva and tongue, with less amounts in adjacent macrophages, fibroblasts, and connective tissues. Viral antigens in the lung were abundant in bronchial epithelial cells, macrophages, and fibroblasts. Virus isolation and electron microscopy demonstrated active viral replication in lungs and tongue. These findings indicate that both respiratory and direct mucocutaneous exposures are potentially important routes of transmission of monkeypox virus between rodents and to humans. Prairie dogs offer insights into transmission, pathogenesis, and new vaccine and treatment trials because they are susceptible to severe monkeypox infection.
Highlights
During May and June 2003, the first cluster of human monkeypox cases in the United States was reported
Most human case-patients with this febrile vesicular rash illness were believed to have acquired the infection from prairie dogs (Cynomys spp.) that became ill after contact with various exotic African rodents (Funiscuirus spp., Heliosciurus spp., Cricetomys spp., Atherurus spp., Graphiurus spp., and Hybomys spp.) shipped from Ghana to the United States in April 2003 [1,2]
Immunohistochemical (IHC), electron microscopy (EM), and molecular findings in two monkeypox virus–infected prairie dogs associated with the recent outbreak of the disease in humans in the United States
Summary
During May and June 2003, the first cluster of human monkeypox cases in the United States was reported. Virus isolation and electron microscopy demonstrated active viral replication in lungs and tongue These findings indicate that both respiratory and direct mucocutaneous exposures are potentially important routes of transmission of monkeypox virus between rodents and to humans. Immunohistochemical (IHC), electron microscopy (EM), and molecular findings in two monkeypox virus–infected prairie dogs associated with the recent outbreak of the disease in humans in the United States. These results help elucidate the pathogenesis of naturally occurring monkeypox virus infections in mammals and shed light on possible routes of viral transmission between rodents and to humans during this outbreak
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