Reed Kurt D, Melski John W, Graham Mary Beth, Regnery Russell L, Sotir Mark J, Wegner Mark V, Kazmierczak James J, Stratman Erik J, Li Yu, Fairley Janet A, Swain Geoffrey R, Olson Victoria A, Sargent Elizabeth K, Kehl Sue C, Frace Michael A, Kline Richard, Foldy Seth L, Davis Jeffrey P, Damon Inger K
Department of Pathology, Marshfield Clinic, Marshfield, Wisc, USA.
N Engl J Med. 2004 Jan 22;350(4):342-50. doi: 10.1056/NEJMoa032299.
During May and June 2003, an outbreak of febrile illness with vesiculopustular eruptions occurred among persons in the midwestern United States who had had contact with ill pet prairie dogs obtained through a common distributor. Zoonotic transmission of a bacterial or viral pathogen was suspected.
We reviewed medical records, conducted interviews and examinations, and collected blood and tissue samples for analysis from 11 patients and one prairie dog. Histopathological and electron-microscopical examinations, microbiologic cultures, and molecular assays were performed to identify the etiologic agent.
The initial Wisconsin cases evaluated in this outbreak occurred in five males and six females ranging in age from 3 to 43 years. All patients reported having direct contact with ill prairie dogs before experiencing a febrile illness with skin eruptions. We found immunohistochemical or ultrastructural evidence of poxvirus infection in skin-lesion tissue from four patients. Monkeypox virus was recovered in cell cultures of seven samples from patients and from the prairie dog. The virus was identified by detection of monkeypox-specific DNA sequences in tissues or isolates from six patients and the prairie dog. Epidemiologic investigation suggested that the prairie dogs had been exposed to at least one species of rodent recently imported into the United States from West Africa.
Our investigation documents the isolation and identification of monkeypox virus from humans in the Western Hemisphere. Infection of humans was associated with direct contact with ill prairie dogs that were being kept or sold as pets.
2003年5月至6月期间，美国中西部与通过同一经销商获得的患病宠物草原犬鼠有过接触的人群中，出现了伴有水疱脓疱疹的发热性疾病疫情。怀疑是细菌或病毒病原体的人畜共患病传播。
我们查阅了11名患者和1只草原犬鼠的病历，进行了访谈和检查，并采集了血液和组织样本进行分析。进行了组织病理学和电子显微镜检查、微生物培养及分子检测以确定病原体。
此次疫情中最初在威斯康星州评估的病例有5名男性和6名女性，年龄在3岁至43岁之间。所有患者均报告在出现伴有皮肤疹的发热性疾病之前，曾直接接触过患病的草原犬鼠。我们在4名患者皮肤病变组织中发现了痘病毒感染的免疫组化或超微结构证据。从7份患者样本和草原犬鼠样本的细胞培养物中分离出了猴痘病毒。通过检测6名患者和草原犬鼠组织或分离物中的猴痘特异性DNA序列鉴定出了该病毒。流行病学调查表明，这些草原犬鼠接触过至少一种最近从西非进口到美国的啮齿动物物种。
我们的调查记录了在西半球从人类身上分离和鉴定出猴痘病毒。人类感染与直接接触作为宠物饲养或出售的患病草原犬鼠有关。
