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Monkeypox Update: Bans, Vaccinations

Don't Release Infected Animals Into the Wild, CDC says

By Jeanie Lerche Davis

WebMD Medical News Reviewed By Michael Smith, MD

on Wednesday, June 11, 2003

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June 11, 2003 -- As the number of human monkeypox cases climbs to 54, bans have been placed on rodents, including prairie dogs. Public health officials are also gearing up to vaccinate a "limited number of people" with the smallpox vaccine.

"Do not, do not release these sick animals into the wild," David Fleming, CDC deputy director, said at a news conference today. "We want to avoid introducing monkeypox into the natural wildlife."

In Wisconsin, 20 cases of monkeypox were reported. Indiana has 23, Illinois has 10, and one case has occurred in New Jersey. About 10 of those people have been hospitalized, Fleming reports.

Bans Effective Immediately

To control the outbreak, the following measures are effective immediately, Fleming says:

An embargo on the importation of rodents from Africa. Rodents from Africa are believed to be how monkeypox arrived in the U.S.

A ban on the sale or transportation of these rodents in the U.S.

A ban on the sale or movement of prairie dogs between states or within state boundaries.

"Of course, if someone needs to take a sick prairie dog to a veterinarian, they can do that," he says. "This pertains to commercial movement of prairie dogs."

The CDC has been working with public health officials at both the state and local levels in outbreak investigation, Fleming says. In addition, the CDC has deployed 11 epidemiologists to states involved.

Limited Smallpox Vaccination

Because monkeypox is similar to smallpox, CDC officials say that the smallpox vaccine can help prevent monkeypox from occurring in people. "Smallpox is about 85% effective in preventing monkeypox in people," Fleming says.

The vaccinations will be "very targeted and focused" -- given only in the regions affected, and only to public health investigators, health-care workers who may be treating people hospitalized with monkeypox, family members of people sick with monkeypox, and people who have had contact with sick prairie dogs or other animals confirmed to have monkeypox, says Fleming.

"We're recommending vaccination up to four days after exposure has occurred, but it can be given up to two weeks after exposure," he says.

Symptoms in Animals, Humans

People who may have prairie dogs or other small rodents in households as pets -- who got them since April 15 -- should watch for these signs of monkeypox in their animals:

oozing eyes

breathing problems

rash -- "When they're petting the animal, they should be able to feel the bumps," says Fleming.

"If you think the animal has been infected, contact your veterinarian to make sure the animal is properly diagnosed," he says. "Contact the veterinarian beforehand to make sure measures are taken to avoid exposure to the virus."

Anyone who had contact with a sick animal should contact a doctor immediately if they or a family member develops symptoms -- fever, chills, muscle aches, or rash.

The Investigation

Gambian rats carrying the infection have been traced to Texas, where an animal importer obtained them from Africa. CDC officials are working with public health officials in Texas and other states to track these animals and others that may have come in contact with them and sent them across the country.

"Monkeypox is fairly easily transferred from animal to animal through direct contact," says Fleming. "We're moving quickly to prevent this from spreading."

Thus far, public health officials have identified only one other animal species -- a rabbit -- that became ill from infection by a sick prairie dog, he says. There have been reports of gerbils exposed to sick prairie dogs in pet shops. "We are in the process of tracking that," says Fleming.

Sick animals that are diagnosed as infected with monkeypox will be euthanized, he adds.

Global Reach

"We're living in a world that's increasingly become globalized," Fleming says. West Nile virus, SARS -- "these all are related to globalization, so we should expect that these will be happening more frequently."

Though there have been a few human deaths in Africa due to monkeypox, that isn't likely to happen in the U.S., he says. "There are lots of reasons -- improved medical treatment, nutrition. But we do need to be prepared that monkeypox is a potentially fatal disease; that's why we are recommending vaccination for people who have been potentially exposed."

Within the U.S., there has been no person-to-person infection. That's not likely to happen, he says. "Monkeypox is a disease that's possibly transmissible, but at a fairly low level. It's not the same kind of problem as with SARS."

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SOURCE: David Fleming, CDC deputy director.

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