Clinical characterization of human monkeypox infections in the Democratic Republic of the Congo
2022-10-21 7:14Clinical characterization of human monkeypox infections in the Democratic Republic of the Congo
Clinical characterization of human monkeypox infections in the Democratic Republic of the Congo
Abstract
We describe the results of a prospective observational study of the clinical natural history of human Monkeypox virus (MPXV) infections at Kolé General Reference Hospital (Kolé Hospital), located in the rainforest of the
Congo River in the Democratic Republic of Congo (DRC), from March 2007 to August 2011. The research was conducted jointly by the National Institute of Biomedical Research (INRB) and the US Army Medical Research Institute of Infectious Diseases (USAMRIID). The hos-
Kole Hospital was one of two previous sites of the WHO monkeypox study (MPX) (1981-1986). The hospital is staffed by a Spanish order of Catholic nuns from the Congregation of the Missionary Sisters of Christ Jesus. Two
Spanish doctors, also members of the order, participated in the WHO study on human smallpox. Of 244 patients admitted with a clinical diagnosis of MPXV infection, 216 were positive for both Pan-Orthopox and MPXV-specific PCR.
Cardinal observations of these 216 patients are summarized in this report. There were three deaths (3/216) among these hospitalized patients; fetal death occurred in 4 of the 5 (80 %) patients who were pregnant at the time of admission. The most common complaints
The most common were rash (96.8 %), malaise (85.2 %), sore throat (78.2 %), and lymphadenopathy/adenopathy (57.4 %). The most common physical examination findings were MPX rash (99.5 %) and lymphadenopathy (98.6 %). The age group under 5 years had the highest number of lesions. Primary familial cases tended to have a higher number of lesions than secondary or subsequent familial cases. Of the 216 patients, 200 were tested for IgM and IgG antibodies (Abs) to orthopoxviruses. All 200 patients had IgG antibodies to orthopoxvirus, while 189/200 were positive for IgM. Patients with hypoalbuminemia were at high risk for severe disease. Patients with fatal disease had significantly higher maximum geometric mean values than survivors for the following variables, respectively: viral DNA in blood (DNAemia, p=0.0072); maximum lesion count (p=0.0025); mean AST and ALT on the day of admission (p=0.0002 and p=0.0224, respectively, adjusted p-values).
Author's Summary: This is a prospective observational study of human smallpox, an emerging infectious disease in parts of the African continent. It has certain differential characteristics compared to other venereal diseases. This article describes the symptoms and signs of monkeypox, laboratory findings, and makes recommendations for the medical treatment of patients with monkeypox.
Congo River in the Democratic Republic of Congo (DRC), from March 2007 to August 2011. The research was conducted jointly by the National Institute of Biomedical Research (INRB) and the US Army Medical Research Institute of Infectious Diseases (USAMRIID). The hos-
Kole Hospital was one of two previous sites of the WHO monkeypox study (MPX) (1981-1986). The hospital is staffed by a Spanish order of Catholic nuns from the Congregation of the Missionary Sisters of Christ Jesus. Two
Spanish doctors, also members of the order, participated in the WHO study on human smallpox. Of 244 patients admitted with a clinical diagnosis of MPXV infection, 216 were positive for both Pan-Orthopox and MPXV-specific PCR.
Cardinal observations of these 216 patients are summarized in this report. There were three deaths (3/216) among these hospitalized patients; fetal death occurred in 4 of the 5 (80 %) patients who were pregnant at the time of admission. The most common complaints
The most common were rash (96.8 %), malaise (85.2 %), sore throat (78.2 %), and lymphadenopathy/adenopathy (57.4 %). The most common physical examination findings were MPX rash (99.5 %) and lymphadenopathy (98.6 %). The age group under 5 years had the highest number of lesions. Primary familial cases tended to have a higher number of lesions than secondary or subsequent familial cases. Of the 216 patients, 200 were tested for IgM and IgG antibodies (Abs) to orthopoxviruses. All 200 patients had IgG antibodies to orthopoxvirus, while 189/200 were positive for IgM. Patients with hypoalbuminemia were at high risk for severe disease. Patients with fatal disease had significantly higher maximum geometric mean values than survivors for the following variables, respectively: viral DNA in blood (DNAemia, p=0.0072); maximum lesion count (p=0.0025); mean AST and ALT on the day of admission (p=0.0002 and p=0.0224, respectively, adjusted p-values).
Author's Summary: This is a prospective observational study of human smallpox, an emerging infectious disease in parts of the African continent. It has certain differential characteristics compared to other venereal diseases. This article describes the symptoms and signs of monkeypox, laboratory findings, and makes recommendations for the medical treatment of patients with monkeypox.
