A Surgeon’s Account of a Monkeypox Outbreak in the Central African Republic

Author(s):
Moustafa Moustafa; Rudolph Rustin

Background:

We present our experience with a nosocomial monkeypox outbreak in the Central African Republic (CAR) while on a humanitarian surgical mission trip in 2015-16.10 patients (7 adult and 2 children) presented to the hospital with high fevers, myalgias, and the eventual development of the characteristic vesicular rash. Two children died. The index case was ultimately traced to villager contact with bush meat and subsequent infections transmitted in a linear fashion. Monkeypox is a rare infectious disease caused by monkeypox virus (MPXV), which belongs to the Orthopox genus of the Poxviridae family. The most notable member of this family is variola virus (VARV) or smallpox, which the WHO declared as eradicated in 1980 after an exhaustive global vaccination campaign. The end of routine vaccination however has left much of the world susceptible to other zoonotic orthopox infections, to which smallpox vaccination confers some cross-immunity. Other recent global outbreaks of monkeypox have been reported, the largest of which was in 2003 in the United States. We will discuss our experience with the outbreak as it played out in the CAR, as well as the etiology, natural history, and current treatment of monkeypox. The logistical challenges of managing and containing a viral outbreak in a low resource setting are also discussed.

Hypothesis:

Case report

Methods:

Case report

Personal experience during outbreak. A brief literature review will be discussed.

Results:

Case report

7 adults and 3 children were affected, 2 children died.

Conclusions:

Case report

Zoonotic orthopox infectious outbreaks are more likely in the absense of routine smallpox vaccination. There are many challenges to managing and containing such epidemics in the low resource setting.