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. 2017 Nov 3;4(4):ofx168.
doi: 10.1093/ofid/ofx168. eCollection 2017 Fall.

A Nosocomial Outbreak of Human Monkeypox in the Central African Republic

Emmanuel Nakoune  1 , Emmanuel Lampaert  2 , Séverin Gervais Ndjapou  3 , Carole Janssens  2 , Isabel Zuniga  2 , Michel Van Herp  2 , Jean Paul Fongbia  3 , Thomas Daquin Koyazegbe  4 , Benjamin Selekon  1 , Giscard Francis Komoyo  1 , Sandra Miriella Garba-Ouangole  1 , Casimir Manengu  4 , Jean-Claude Manuguerra  5 , Mirdad Kazanji  1 , Antoine Gessain  6   7 , Nicolas Berthet  5   7   8
Affiliations

A Nosocomial Outbreak of Human Monkeypox in the Central African Republic

Emmanuel Nakoune et al. Open Forum Infect Dis. .

Abstract

An outbreak of familial monkeypox occurred in the Central African Republic in 2015/2016 by 3 transmission modes: familial, health care-related, and transport-related. Ten people (3 children and 7 adults) were infected. Most presented with cutaneous lesions and fever, and 2 children died. The viral strain responsible was a Zaire genotype strain.

Keywords: Central African Republic; monkeypox; nosocomial outbreak.

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Figures

Figure 1.
Figure 1.
Disseminated cutaneous lesions consisting of macules, papules, and vesicles on the entire body of the primary case (case 1) (1A), on the face (1B) and legs (1C) of the mother (case 4), and rash and cervical lymph node of the hospital nurse (case 5) (1D).
Figure 2.
Figure 2.
Hypothetical pattern of viral transmission during the human monkeypox outbreak in Central Africa in 2015/2016. Cases are shown according to the date of disease onset. The number of the case, description of family ties with the index case, sex, and age for each infected person are shown on the left. The index case corresponds to number 1. The number of days after the estimated beginning of symptoms for the index case are shown at the top. Full arrows show confirmed transmission, whereas dotted arrows correspond to potential transmission. Indeed, we cannot be certain about the potential infectious contact or the date of infection because of the significant travel of the family members and ferryboat driver toward the village and hospital.
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