Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, USA.
Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
Ecohealth. 2020 Mar;17(1):64-73. doi: 10.1007/s10393-019-01459-7. Epub 2019 Dec 24.
Experimental studies have suggested a larger inoculum of monkeypox virus may be associated with increased rash severity; however, little data are available on the relationship between specific animal exposures and rash severity in endemic regions. Using cross-sectional data from an active surveillance program conducted between 2005 and 2007 in the Sankuru Province of the Democratic Republic of the Congo, we explored the possible relationship between rash severity and exposures to rodents and non-human primates among confirmed MPX cases. Among the 223 PCR-confirmed MPX cases identified during active surveillance, the majority of cases (n = 149) presented with mild rash (5-100 lesions) and 33% had a more serious presentation (> 100 lesions). No association between exposure to rodents and rash severity was found in the multivariable analysis. Those that self-reported hunting NHP 3 weeks prior to onset of MPX symptoms had 2.78 times the odds of severe rash than those that did not report such exposure (95% CI: 1.18, 6.58). This study provides a preliminary step in understanding the association between animal exposure and rash severity and demonstrates correlation with exposure to NHPs and human MPX presentation. Additional research exploring the relationship between rash severity and NHPs is warranted.
实验研究表明，猴痘病毒的接种量越大，皮疹的严重程度可能越高；然而，在流行地区，关于特定动物接触与皮疹严重程度之间的关系的数据很少。本研究利用刚果民主共和国桑库鲁省 2005 年至 2007 年开展的主动监测项目的横断面数据，探索了在确诊猴痘病例中皮疹严重程度与接触啮齿动物和非人类灵长类动物之间可能存在的关系。在主动监测期间发现的 223 例经 PCR 确诊的猴痘病例中，大多数病例（n=149）表现为轻度皮疹（5-100 个皮损），33%的病例表现为更严重的皮疹（>100 个皮损）。多变量分析未发现接触啮齿动物与皮疹严重程度之间存在关联。与未报告此类接触的病例相比，在出现猴痘症状前 3 周内自行报告猎捕非人类灵长类动物的病例发生严重皮疹的可能性是其 2.78 倍（95%CI：1.18，6.58）。本研究初步探讨了动物接触与皮疹严重程度之间的关联，并表明与接触非人类灵长类动物和人类猴痘发病有关。有必要开展更多研究来探索皮疹严重程度与非人类灵长类动物之间的关系。
