U.S. Urges Smallpox Vaccine for Monkeypox Exposure

CHICAGO (Reuters) - U.S. health authorities on Wednesday recommended smallpox vaccinations for anyone exposed to "monkeypox" either from infected pets or from the roughly 63 human cases, all but one in the U.S. Midwest.

The U.S. government also banned the importation or trade of African rodents, including Gambian rats believed to be the original source of the smallpox-like illness previously unseen in the Western Hemisphere, said David Fleming, deputy director of the Centers for Disease Control and Prevention in Atlanta.

"I'm confident that everything that can be done is being done to prevent the spread of this virus," Fleming told reporters, citing efforts to track down and euthanize infected animals.

The source of the illness was believed to be a shipment of Gambian rats from Africa to Texas that later infected prairie dogs native to the U.S. Plains. Both species are part of a growing trade in so-called exotic pets.

Some infected animals were sold to an Illinois distributor, and the virus has been spread to pet shops, pet brokers and pet owners via formal and informal sales in Wisconsin, Indiana and Illinois. Some states quickly declared bans on trade in the animals.

State health departments have reported 29 confirmed or suspected cases in Indiana, 21 in Wisconsin, 12 in Illinois and one sickened boy in New Jersey who apparently contracted the illness on a recent visit to the Midwest.

While monkeypox is not as harmful as smallpox, authorities fear a sickened animal, which displays cold-like symptoms such as a runny nose and eyes plus a rash, might escape or be discarded into the wild and spread the virus to squirrels or other species. One pet rabbit exposed to a prairie dog was infected.

The smallpox vaccine has been found to be roughly 85 percent effective in warding off monkeypox in humans, which kills between 1 percent and 10 percent of its victims in the rain forests of central and western Africa, Fleming said.

The CDC recommended that local public health authorities vaccinate health investigators, veterinary staff, relatives of monkeypox victims, and others who believed they were exposed to the virus as long as two weeks ago.

"We need to be prepared for the fact that monkeypox can be a fatal disease," Fleming said. "We are recommending smallpox vaccine for a limited number of people -- we feel the risk is sufficient to warrant recommending it, (even) for pregnant women and children."

The vaccine, which has been stockpiled in recent months because of a perceived bioterror threat, is potentially dangerous for some recipients -- a few people in every million can be expected to die from the vaccine. The recent limited vaccination program has produced some unforeseen side effects, including 21 people who have suffered inflammation of the heart or a membrane around the heart.

There is no treatment for monkeypox, which usually runs its course within two weeks after causing flu-like symptoms and pus-filled blisters on the body. There has been no evidence to date of human-to-human transmission in the United States, although it does occur in Africa.

Mystery virus leaves its mark

Mystery virus leaves its mark
By Stacy St. Clair Daily Herald Staff Writer
Posted June 11, 2003

When the first lesion appeared on his right forearm, 17-year-old Julian Glenn assumed it was a spider bite.

Then the red bumps began popping up by the dozen. They smothered his torso and hid in his ears. They lined the teen's throat and mouth, making it impossible to eat anything other than a Popsicle.

They looked - and itched - like chicken pox. But the 400 lesions were something far worse and far more mysterious.

Glenn appears to have contracted monkeypox, a virus indigenous to Africa and now being spread in the Midwest by prairie dogs.

Investigators were searching seven states Tuesday for prairie dogs and other animals that may have spread the disease. Nine cases are being studied in Illinois, with one confirmed victim. There are four confirmed cases in Wisconsin and 48 under investigation nationwide.

After a brief stay at Central DuPage Hospital last weekend, Julian Glenn was readmitted Tuesday at his mother's request. He remains in good condition under quarantine.

"I feel terrible," the Warrenville teen said. "I itch all over. It hurts to even drink water. I can't even breathe in the morning because my lymph nodes are so swollen."

Glenn's is among four suspected monkeypox cases in DuPage County. He says his girlfriend and another friend have been diagnosed with the virus, though county health officials will not confirm it, citing confidentiality laws.

Glenn's doctors are convinced he has the virus, but his condition remains unconfirmed until a determination from the national Centers for Disease Control.

The Wheaton-Warrenville South High School student first went to the hospital Saturday with a 102.5-degree fever.

Upon seeing the lesions, doctors assumed he had chicken pox. But his mother, Peggy, said she knew the diagnosis was incorrect because he had contracted that virus 12 years ago.

A short time later, Wisconsin officials informed Illinois hospitals about a monkeypox outbreak and linked the virus to prairie dogs sold in suburban Chicago in recent weeks.

It turned out Glenn and his girlfriend had purchased one in Streamwood less than a month ago.

"I never wanted it in our house," Peggy Glenn said. "I knew there would be a problem with it. And this is the price we're paying for it."

Doctors quarantined Glenn in the pediatric intensive care unit for 24 hours before releasing him Sunday. He was sent home with an antibiotic and instructions to keep the house as sterile as possible.

That same day, health officials came and took away his prairie dog, which he had named John in honor of his best friend. The animal was subsequently killed.

Glenn says he purchased John at Lee Watson's Reptile Swap in Streamwood on May 18. He had gone to the event to purchase a flying squirrel, but he couldn't refuse the deal on prairie dogs.

The teen had seen prairie dogs advertised for $125 apiece, but a woman at the swap was asking only $50. He and his girlfriend split the cost.

"What a great deal we got, huh?" Peggy Glenn asked.

The prairie dog was on a table right next to some giant Gambian rats, Julian Glenn said. Health officials contend the rats, native to Africa, spread the virus to prairie dogs when they were housed together at Phil's Pocket Pets in Villa Park.

Swap organizer Lee Watson says Shari Moberley - who owns Phil's Pocket Pets along with her husband, Phil - often sells animals at the semi-monthly event.

Watson says he checks animals at the show for any signs of disease. He acknowledges, however, that an infirm pet could pass a visual inspection.

"It's awfully hard to tell," he said.

Glenn kept John in a cage in his bedroom and played with him frequently.

Glenn says the prairie dog never bit or scratched him, save a couple of playful nips when they were fooling around. He doesn't recall the animal ever breaking his skin.

The prairie dog appeared ill a few weeks ago.

"I didn't play with him when he was sick," Glenn said. "But lately he wanted to play more."

The Glenn family now struggles with a virus that hadn't been diagnosed in the United States before last week. So far, neither Peggy Glenn nor her other son, 12-year-old Ashton, have shown any of the monkeypox symptoms, which officials say is unlikely to be passed among humans.

Not that it makes Peggy Glenn's job easier.

She has become the germ police, washing his clothes separately from the rest of the family's and making sure no one else uses his bathroom.

She scrubs the house constantly with a germicide the health department provided. Anything Julian touches is sprayed with Lysol.

In between scourings, Peggy Glenn cares for Julian like she did when he was a 5-year-old with chicken pox. She prepares Aveeno baths for him and spreads calamine lotion on his itchy lesions.

The entire situation frightens her because there's so little information available.

No one can tell her the long-term effects of the disease. She worries that Julian's throat may swell shut or that the virus will leave him sterile.

She is afraid of the nasty scars the pox could leave. Glenn's lesions aren't crusting over like chicken pox; rather they appear to be healing more like spider bites with big, purple scabs.

"I'm still not convinced there won't be other problems," she said. "I hate seeing my child in so much pain."

Peggy Glenn vehemently objected to the doctors' decision to release her son from the hospital Sunday. She believes he should be under medical supervision until more is known here about the virus.

After voicing her opinion on the matter repeatedly, doctors relented and Julian was returned to the hospital by ambulance Tuesday. Warrenville paramedics strapped on hazardous suits and masks before transporting him.

The 17-year-old was unhappy with that decision. Peggy Glenn doesn't care how angry he is. She just wants him to be well.

"I don't think I'm being overly dramatic," she said. "I thought he was going to die at first. I just want him to be OK. No mother wants to see their child like this."

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