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Officials Fear Spread of Monkeypox

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ATLANTA - Health officials are concerned that monkeypox, a little-known disease from African rainforests that has infected some Midwesterners could wreak havoc now that it has entered new territory.

"Whenever you hear about a new virus being introduced into an ecosystem where it's not been present before, you have to be very, very concerned about the public health threat," Dr. Stephen Ostroff at the Centers for Disease Control and Prevention said Monday.

Authorities in Wisconsin, Illinois and Indiana are investigating at least 33 possible cases of monkeypox among people who have come into contact with prairie dogs. The patients are recovering, with six remaining in the hospital, said Ostroff, deputy director of the CDC's National Center for Infectious Diseases. Four cases have been confirmed, marking the first outbreak of the smallpox-like virus in the Western Hemisphere.

The virus apparently was transmitted from a Gambian giant rat to prairie dogs when the species were housed together by an exotic pet dealer near Chicago.

Both types of animals are sold as pets in the United States.

It appears the virus hasn't spread among people, but the CDC in Atlanta hasn't ruled that out.

At least one rabbit has contracted the disease, leading health officials to worry that it could be transmitted to other animals, potentially expanding the risk to humans.

"Even if we do manage to bring the prairie dog problem under control ... (there is) the opportunity for potential cases from other sources," Ostroff said.

The behavior of a disease once it infiltrates a new country or species is nearly impossible to predict.

Mosquito-borne West Nile virus appeared in New York in 1999 and spread throughout most of the country by last summer, infecting more than 4,100 people and killing 284.

SARS _ the new respiratory disease that has infected more than 8,400 people and killed 784 worldwide _ came from civet cats sold as exotic meat in southern China markets, according to a respected theory.

Most of the scant information on monkeypox is from the Democratic Republic of Congo, which has had periodic outbreaks, including one in 1996-97.

A study of 338 cases from the 1980s in Congo found a fatality rate of 9.8 percent for people who hadn't received the smallpox vaccine. About 9.3 percent of cases were spread between family members, though further transmission was rare.

The smallpox vaccine was 85 percent effective in preventing monkeypox. U.S. health authorities are talking about recommending the vaccine for people who may have been exposed to ill prairie dogs.

Better nutrition and medical care in the United States could make the virus less lethal here, health officials say. But the lack of immunity in humans and animals that results from prior exposure also could make the situation worse.

"Experience in one location doesn't necessarily indicate what might happen when a pathogen like this is introduced into a new location," Ostroff said.

Like smallpox, monkeypox causes fever, pain, chills and sweating, usually followed one to 10 days later by a rash leading to blisters that scab over.

Of the 33 possible cases, 18 are in Wisconsin, 10 are in Indiana and five are in Illinois. The patients range in age from four to 48 years old.

Some cases involve workers at veterinary clinics or pet shops, but most had contact with prairie dogs at home.

State health officials have instructed prairie dog owners not to release the animals into the wild, which could allow the virus to spread uncontrollably.

The first human monkeypox cases appeared in early- to mid-May but weren't reported to the CDC until Wednesday. The agency dispatched a team to collect specimens. After the team returned Friday and tests found monkeypox on Saturday, the CDC held a news conference to announce the finding.

Given the similarities to smallpox and a heightened concern for bioterrorism, some people questioned whether federal authorities should have been alerted earlier.

"We too are very interested in looking into the specific details of when information may have been available," Ostroff said. "I think it's a little bit premature to raise the alarm that maybe there were some missed opportunities here."

David Wahlberg writes for The Atlanta Journal-Constitution. E-mail:

Cox News Service

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