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Monkeypox virus (MPXV) is a reemerging virus of global concern. An outbreak of clade I MPXV affected 20 captive chimpanzees in Cameroon in 2016. We describe the epidemiology, virology, phylogenetics, and clinical progression of this outbreak. Clinical signs included exanthema, facial swelling, perilaryngeal swelling, and eschar. Mpox can be lethal in captive chimpanzees, with death likely resulting from respiratory complications. We advise avoiding anesthesia in animals with respiratory signs to reduce the likelihood of death. This outbreak presented a risk to animal care staff. There is a need for increased awareness and a One Health approach to preparation for outbreaks in wildlife rescue centers in primate range states where MPXV occurs. Control measures should include quarantining affected animals, limiting human contacts, surveillance of humans and animals, use of personal protective equipment, and regular decontamination of enclosures. [ABSTRACT FROM AUTHOR]

Background: Monkeypox is a poorly described emerging zoonosis endemic to Central and Western Africa.Methods: Using surveillance data from Tshuapa Province, Democratic Republic of the Congo during 2011-2015, we evaluated differences in incidence, exposures, and clinical presentation of polymerase chain reaction-confirmed cases by sex and age.Results: We report 1057 confirmed cases. The average annual incidence was 14.1 per 100 000 (95% confidence interval, 13.3-15.0). The incidence was higher in male patients (incidence rate ratio comparing males to females, 1.21; 95% confidence interval, 1.07-1.37), except among those 20-29 years old (0.70; .51-.95). Females aged 20-29 years also reported a high frequency of exposures (26.2%) to people with monkeypox-like symptoms.The highest incidence was among 10-19-year-old males, the cohort reporting the highest proportion of animal exposures (37.5%). The incidence was lower among those presumed to have received smallpox vaccination than among those presumed unvaccinated. No differences were observed by age group in lesion count or lesion severity score.Conclusions: Monkeypox incidence was twice that reported during 1980-1985, an increase possibly linked to declining immunity provided by smallpox vaccination. The high proportion of cases attributed to human exposures suggests changing exposure patterns. Cases were distributed across age and sex, suggesting frequent exposures that follow sociocultural norms. [ABSTRACT FROM AUTHOR]

Background. Human infection by orthopoxviruses is being reported with increasing frequency, attributed in part to the cessation of smallpox vaccination and concomitant waning of population-level immunity. In July 2015, a female resident of interior Alaska presented to an urgent care clinic with a dermal lesion consistent with poxvirus infection. Laboratory testing of a virus isolated from the lesion confirmed infection by an Orthopoxvirus. Methods. The virus isolate was characterized by using electron microscopy and nucleic acid sequencing. An epidemiologic investigation that included patient interviews, contact tracing, and serum testing, as well as environmental and small-mammal sampling, was conducted to identify the infection source and possible additional cases. Results. Neither signs of active infection nor evidence of recent prior infection were observed in any of the 4 patient contacts identified. The patient’s infection source was not definitively identified. Potential routes of exposure included imported fomites from Azerbaijan via the patient’s cohabiting partner or wild small mammals in or around the patient’s residence. Phylogenetic analyses demonstrated that the virus represents a distinct and previously undescribed genetic lineage of Orthopoxvirus, which is most closely related to the Old World orthopoxviruses. Conclusions. Investigation findings point to infection of the patient after exposure in or near Fairbanks. This conclusion raises questions about the geographic origins (Old World vs North American) of the genus Orthopoxvirus. Clinicians should remain vigilant for signs of poxvirus infection and alert public health officials when cases are suspected. [ABSTRACT FROM AUTHOR]

The novel poxvirus described here can infect humans and may be associated with equine contact. It causes an infection that appears to mimic the symptoms and clinical course typical of nondisseminated, lesion-associated poxvirus infections such as those caused by parapoxviruses.Background. Some human poxvirus infections can be acquired through zoonotic transmission. We report a previously unknown poxvirus infection in 2 patients, 1 of whom was immunocompromised; both patients had known equine contact.Methods. The patients were interviewed and clinical information was abstracted from the patients’ medical files. Biopsies of the skin lesions were collected from both patients for histopathology, immunohistochemistry, and transmission electron microscopy analysis. Oral and skin swabs were collected from animals with frequent contact with the patients, and environmental sampling including rodent trapping was performed on the farm where the immunosuppressed patient was employed. “Pan-pox and high Guanine-cytosine” polymerase chain reaction assays were performed on patient, animal, and environmental isolates. Amplicon sequences of the viral DNA were used for agent identification and phylogenetic analysis.Results. Specimens from both human cases revealed a novel poxvirus. The agent shares 88% similarity to viruses in the Parapoxvirus genus and 78% to those in the Molluscipoxvirus genus but is sufficiently divergent to resist classification as either. All animal and environmental specimens were negative for poxvirus and both patients had complete resolution of lesions.Conclusions. This report serves as a reminder that poxviruses should be considered in cutaneous human infections, especially in individuals with known barnyard exposures. The clinical course of the patients was similar to that of parapoxvirus infections, and the source of this virus is currently unknown but is presumed to be zoonotic. This report also demonstrates the importance of a comprehensive approach to diagnosis of human infections caused by previously unknown pathogens. [ABSTRACT FROM PUBLISHER]

Background Monkeypox (MPX) is an endemic disease of public health importance in the Democratic Republic of the Congo (DRC). In 2010, the DRC Ministry of Health joined with external partners to improve MPX surveillance in the Tshuapa Health District of DRC. A pivotal component of the program is training of health zone personnel in surveillance methods and patient care. In this report we evaluate outcomes of the training program. Methods Health care worker knowledge of key concepts in the MPX training curriculum was assessed using an anonymous self-administered survey. Additionally, evaluators collected feedback about the capacity of participants to perform the surveillance tasks. Training impacts were determined by assessing various surveillance performance metrics. Results Correct trainee responses to questions about MPX symptoms and patient care increased significantly upon completion of training events. During the 12 months after the initial training, the proportion of suspected cases investigated increased significantly (from 6.7 to 37.3%), as compared to the 5 months prior. However, the proportion of reported cases that were ultimately confirmed remained unchanged, 20.1% (5/24) vs 23.3% (60/257). Conclusions We have demonstrated that the MPX curriculum developed for this initiative was effective in transferring knowledge and was associated with improved detection of human MPX cases. [ABSTRACT FROM PUBLISHER]

Data collected over the past 15 years in Colorado show that deer mice (Peromyscus maniculatus) collected in southeastern Colorado have a significantly lower Sin Nombre virus (SNV) antibody prevalence than mice from western Colorado. Based on mitochondrial sequences, P. maniculatus was recently subdivided into 6 clades. Clade 1a occurs throughout the mountainous regions of western Colorado and clade 2 crosses the short-grass steppe in southeastern Colorado. We used mitochondrial single nucleotide polymorphisms (SNPs) from this earlier study and 14 nuclear SNPs to test the hypothesis that clade 2 mice consist of a separate subspecies. Little genetic differentiation was detected (FST = 0.027) among 435 deer mice collected from 8 locations in western Colorado. In contrast, 171 deer mice collected from 4 locations in eastern Colorado were genetically differentiated from one another (FST = 0.168) and from those captured in western Colorado (FST = 0.256). During this survey we identified a single locality in central Colorado where both clade 1a and 2 mice are sympatric and have a high SNV seropositivity (52.2% in 2006; 24.4% in 2009). Antibody prevalence was 21.1% among clade 2 mice, lower than the 32.4% rate among clade 1a mice, suggesting that clade 2 mice may, for both genetic and environmental reasons, have lower susceptibility to SNV infection. [ABSTRACT FROM AUTHOR]

We examined den-site selection patterns for western spotted skunks (Spilogale gracilis) and striped skunks (Mephitis mephitis) co-occurring in mesquite brushland of Tom Green County, Texas. Sixteen S. gracilis and 14 M. mephitis were radiocollared to locate den sites from October 2001 through June 2003. Characteristics of dens were assessed using 23 habitat variables. S. gracilis favored den sites with dense mesquite (Prosopis glandulosa), shrubs, and cacti (Opuntia), whereas M. mephitis used these areas but also more open habitats. Den habitats of S. gracilis were more uniform than were those of M. mephitis, implying that S. gracilis is more specialized in den-site selection. Both species used multiple den sites, both above and below ground, rather than a primary den. Aboveground denning occurred year-round for both species. For S. gracilis, 56% (n = 60) of dens were above ground, but denning was more common above ground in the spring and summer. Aboveground denning was more common than belowground denning for M. mephitis in all seasons, representing 64% (n = 50) of all dens. Den habitat analysis suggests that S. gracilis, unlike M. mephitis, may be limited to areas with sufficient cover, including prickly pear cactus, for denning. [ABSTRACT FROM AUTHOR]