1Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.
2Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Trop Med Hyg. 2020 Dec 7;104(2):604-611. doi: 10.4269/ajtmh.20-0589.
Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to investigate MPX/VZV coinfections. A coinfection was defined as a patient with at least one Orthopoxvirus/MPX-positive sample and at least one VZV-positive sample within the same disease event. Between September 2009 and April 2014, 134 of the 1,107 (12.1%) suspected MPX cases were confirmed as MPX/VZV coinfections. Coinfections were more likely to report symptoms than VZV-alone cases and less likely than MPX-alone cases. Significantly higher lesion counts were observed for coinfection cases than for VZV-alone but less than MPX-alone cases. Discernible differences in symptom and rash severity were detected for coinfection cases compared with those with MPX or VZV alone. Findings indicate infection with both MPX and VZV could modulate infection severity. Collection of multiple lesion samples allows for the opportunity to detect coinfections. As this program continues, it will be important to continue these procedures to assess variations in the proportion of coinfected cases over time.
最近在刚果民主共和国（刚果（金））加强了猴痘（MPX）监测，该国有 MPX 地方性流行，发现了多例 MPX 和水痘-带状疱疹病毒（VZV）合并感染。本研究旨在验证是否存在合并感染，并描述这些病例的临床特征。使用临床、流行病学和实验室结果来调查 MPX/VZV 合并感染。合并感染定义为在同一疾病事件中至少有一个正痘病毒/MPX 阳性样本和至少一个 VZV 阳性样本的患者。2009 年 9 月至 2014 年 4 月，在 1107 例疑似 MPX 病例中，有 134 例（12.1%）被确诊为 MPX/VZV 合并感染。合并感染比 VZV 单一感染更有可能报告症状，但比 MPX 单一感染更少见。合并感染病例的皮损数明显高于 VZV 单一感染病例，但低于 MPX 单一感染病例。与 MPX 或 VZV 单一感染病例相比，合并感染病例的症状和皮疹严重程度存在明显差异。这些发现表明，同时感染 MPX 和 VZV 可能会调节感染的严重程度。采集多个皮损样本可提供检测合并感染的机会。随着该计划的继续，重要的是继续这些程序，以评估随着时间的推移合并感染病例的比例变化。
