X-Message-Number: 21923
From: "Mark Plus" <>
Subject: Pox-Like Outbreak Reported 
Date: Sun, 08 Jun 2003 08:48:30 -0700


Pox-Like Outbreak Reported
19 Ill in Midwest; CDC Issues Alert
By Rob Stein
Washington Post Staff Writer
Sunday, June 8, 2003; Page A01

At least 19 people in three Midwestern states have contracted a disease 
related to smallpox, marking the first outbreak of the life-threatening 
illness in the United States, federal heath officials said yesterday.

The federal Centers for Disease Control and Prevention, concerned that the 
illness could spread, issued a nationwide alert to doctors and public health 
officials to be on the lookout for more cases.

"We have an outbreak," said James Hughes, director of the CDC's National 
Center for Infectious Diseases in Atlanta. "I'd like to keep it relatively 
small. I don't want any more cases. We're doing everything we can to try to 
contain this."

The disease, known as monkeypox, usually only occurs in central and western 
Africa. It is caused by a virus known as an orthopox virus, which is the 
family of viruses that includes the smallpox virus, one of the most 
dangerous diseases known to man and a feared biological weapon.

Officials said there was no indication that bioterrorism was involved. The 
disease was apparently spread by rodents known as prairie dogs, which have 
become popular as pets. The animals may have acquired the infection from 
another creature, known as a Gambian giant rat, sold by the same dealer of 
exotic animals, officials said.

The monkeypox virus causes symptoms that are very similar to smallpox -- 
fever, headache, cough and an extremely painful rash of pus-filled sores 
that spreads across the body.

While much about the monkeypox virus is unclear, it does not seem to be as 
deadly as smallpox. Authorities estimate that monkeypox has a mortality rate 
of between 1 percent and 10 percent, compared with a mortality rate of about 
30 percent for smallpox.

The monkeypox virus is believed to spread through physical contact with a 
sick person or infected animal, or through infected body fluids, although 
health officials said it apparently is not as easily spread as smallpox, 
which is highly infectious.

Monkeypox is untreatable, although there is some indication that an 
antiviral drug may have some usefulness. Because the disease has never been 
seen before in this part of the world, the severity of the threat is not 
completely clear. All patients and infected animals have been isolated -- 
and pet shops and one house where the prairie dogs lived have been 
quarantined -- to prevent spread of the disease.

The smallpox vaccine is believed to be protective against the monkeypox 
virus. The federal government recently launched a campaign to vaccinate 
thousands of emergency workers against smallpox so the country would be 
prepared in the event of a bioterrorist attack.

"This is an unusual event. As far as we can tell, there's never been a human 
or animal illness in the community setting in the Western hemisphere by a 
virus that is either a monkeypox virus or a very close variant of the 
monkeypox virus," said Hughes, who held a hastily arranged telebriefing last 
evening to announce the outbreak after CDC scientists confirmed that a 
monkeypox virus or one very close to it was involved.

"We've got a disease that's not been seen before in the Western Hemisphere, 
so it's prudent to take it very seriously," Hughes said in a telephone 
interview after the briefing.

Of the 19 cases reported so far, four of the victims have been hospitalized; 
none has died, Hughes said.

The outbreak came to light on May 16, when a 3 1/2-year-old child became 
ill, according to John Melski, who treated the child at the Marshfield 
Clinic in Marshfield, Wis.

The child's parents had bought two prairie dogs as a Mother's Day present 
for the child's mother. Both the mother and father subsequently became ill 
as well, although all appear to have recovered.

Officials determined that the prairie dogs had been purchased from a Villa 
Park, Ill., exotic pet dealer, who also became ill. The dealer also had a 
Gambian rat, which was ill. It is believed that animal passed the virus to 
the prairie dogs the dealer was selling.

The dealer sold the animals to SK Exotics, a Milwaukee pet distributor, 
which then sold the apparently infected prairie dogs to two pet stores in 
Milwaukee and at a "pet swap" in northern Wisconsin.

Most of the rest of the cases have been reported in the Milwaukee area, and 
are believed to have involved people who either worked at the stores or who 
handled the animals in the stores. Seventeen of the cases occurred in 
Milwaukee, with one case each having been reported in Illinois and Indiana.

Melski and his colleagues at the Marshfield Clinic contacted state health 
officials when they identified what appeared to be an orthopox virus in the 
sick family. State health officials then contacted the CDC, which confirmed 
the involvement of a monkeypox-like virus yesterday, prompting the 
nationwide alert and telebriefing.

The state of Wisconsin has temporarily banned the sale of prairie dogs.

"The full impact is hard to predict," said Seth Foldy, Milwaukee's health 
commissioner. "Our goal would be to isolate and eliminate the virus from 
both human and animal populations to the best of our ability. We do not know 
if it is the kind of agent that would or could thrive in North America, and 
we're not very interested in finding out that it is."

The last time a new infectious disease arrived in the United States was in 
1999, when the West Nile virus was first reported. That disease, which is 
transmitted by mosquitoes, has since spread nationwide.

Further tests are planned to confirm the identity of the pox-like virus.

The outbreak comes as the global epidemic of severe acute respiratory 
syndrome (SARS) appears to be coming under control.

"This is yet another reminder of why it's important to learn as much as you 
can about diseases that occur in faraway places," Hughes said.

  2003 The Washington Post Company

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