http://www.cnn.com/2003/HEALTH/06/16/monkeypox.humans/index.html

Tests don't indicate human-to-human monkeypox spread

Two suspected cases would be first in Western Hemisphere

Monday, June 16, 2003 Posted: 7:46 PM EDT (2346 GMT)

Story Tools RELATED Interactive: Map of the monkeypox investigation    • One prairie dog linked to several monkeypox cases  • More diseases jumping from animals to humans  HEALTH LIBRARY • Health Library  • What is monkeypox?  • Infectious Diseases  MONKEYPOX •The disease is usually found in remote villages in Central and West Africa. •The disease was first discovered in laboratory monkeys in 1958. •Monkeypox is related to the virus that causes smallpox. There is no vaccine but smallpox vaccinations might protect against monkeypox. •Symptoms include a fever, headache, chills and a rash. Sources: The Associated Press/World Health Organization

MADISON, Wisconsin (CNN) -- Preliminary tests on two suspected cases of human-to-human transmission of monkeypox have proved negative, a Wisconsin public health official said Monday.

"The preponderance of the evidence is we don't have human-to-human transmission," said Herb Bostrom, director of the Bureau of Communicable Diseases in the Division of Public Health.

Although final test results could take weeks, "it's looking less and less" like human-to-human transmission occurred, he said.

The two suspected cases were a medical assistant and a nurse who became ill after coming into contact with patients with monkeypox. The nurse's boyfriend also came down with symptoms. Bostrom said there was no need to test his blood unless the nurse tested positive for the virus.

The patients were linked to an outbreak of the illness in seven Midwest states traced to infected prairie dogs sold as pets.

At least 91 cases are under investigation, 20 of them confirmed, health officials said Monday.

Wisconsin reported 41 cases, seven of them confirmed; Indiana, 26; Illinois, 19; Ohio, two; and Missouri, Kansas and Arizona, one each.

If the nurse, the nurse's boyfriend or the medical assistant are confirmed to have monkeypox, they would be the first known cases of human-to-human transmission of the disease in the Western Hemisphere, according to the Centers for Disease Control and Prevention.

Dr. Jeff Davis, Wisconsin's state epidemiologist and chief medical officer for communicable diseases, said Friday that the reported illnesses "do not appear to be cases of monkeypox."

Dr. Stephen Ostroff, deputy director of the National Center for Infectious Diseases, part of the CDC, said human-to-human transmission would not be a surprise but predicted it would never represent a significant concern, because the virus "tends to burn itself out in humans."

Transmission would most likely occur through direct contact with the pus-filled skin lesions that are hallmarks of the disease, Ostroff said.

Laboratory confirmation is critical because monkeypox symptoms -- which include fever, chills and cough, followed by a rash and sometimes accompanied by diarrhea, swollen lymph nodes, a sore throat and mouth sores -- can be caused by other diseases.

The outbreak is believed to have begun with a shipment of more than 800 rodents, including 50 Gambian giant pouched rats, from Africa to a distributor in Texas. The rats are believed to have passed the disease to the prairie dogs, which were then sold or traded in the Midwest.

No human deaths have been reported in this outbreak, though the disease typically has a 1 percent to 10 percent fatality rate in the rain forest countries of Central and West Africa, where monkeypox is more common.