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monkeypox A milder relative of smallpox that appeared in the United States for the first time when at least a dozen people had contact in 2003 with infected pet prairie dogs. Monkeypox was reported in humans for the first time in 1970, and until the recent outbreak in the United States, it was a disease never before seen in the Western Hemisphere. Rarely fatal, it causes pus-filled blisters, rashes, chills, and fever.

Cases of monkeypox first appeared in sick prairie dogs sold by a Milwaukee, Wisconsin, animal distributor who had obtained the animals, along with an ill Gambian giant rat, from an Illinois animal distributor. All patients reported contact with either a sick prairie dog or rabbit one to three weeks before the illness began.


Monkeypox in humans produces a vesicular and pustular rash similar to that of smallpox. The incubation period from exposure to fever onset is about 12 days, and the typical illness with fever, headache, muscle ache, and rash lasts from two to four weeks. The rash, which appears as raised, acne-like bumps, appears within a few days and goes through several stages before crusting and falling off.

No one has died of monkeypox in the United States, but at least 33 patients contracted the disease; 14 patients with symptoms were hospitalized, including a child in Indiana with a confirmed case who also has encephalitis.

Illness in the animals has included fever, cough, swollen, reddened eyes, and swollen glands followed by a rash and hair loss, although not all of these signs have been present in all animals. Some prairie dogs died and others recovered. The sick rabbit associated with one human case had prior contact with an ill prairie dog at a veterinary clinic. The prairie dogs appeared to have infected people through bites or when people rubbed their eyes or noses after touching discharges from the animals.


The virus that causes monkeypox is usually transmitted to humans through a bite by an infected animal, or by direct contact with the animal's lesions, body fluids, or blood. Although person-to-person transmission is extremely rare, monkeypox can be spread through direct contact with the body fluids of an infected person or with objects (such as bedding or clothing) that have become contaminated. one Wisconsin resident who apparently caught monkeypox from the prairie dog had "minimal" contact with the infected animal but slept in the same room as the caged animal.


The human mortality rate from monkeypox in Africa has ranged from one percent to 10 percent, but the virus may be less lethal in the United States because people typically are better nourished and medical technology is more advanced.

The federal government has recommended smallpox shots for people exposed to monkeypox. The vaccine can prevent the disease up to two weeks after exposure to the virus and is most effective in the first four days, but some health officials are wary because the vaccine in rare cases can cause serious and even fatal side effects.


The spread of monkeypox to humans can be prevented. The Centers for Disease Control and Prevention and the U.S. Food and Drug Administration (FDA) have prohibited the importation and sale of rodents from Africa, including Gambian giant pouched rats, dormice, striped mice, brush-tailed porcupines, tree squirrels, and rope squirrels.

mononucleosis An acute herpesvirus infection caused by the Epstein-Barr (EBV) virus and characterized by sore throat, fever, swollen lymph glands, and bruising. Transmitted in saliva, young people are most often infected. In childhood the disease is often mild; the older the patient, the more severe the symptoms are likely to be. Infection confers permanent immunity.


The disease is usually transmitted by droplets of EB virus, but it is not highly contagious.


From four to six weeks after infection, classic mononucleosis begins gradually with symptoms of sore throat, fatigue, swollen lymph glands, and occasional bruising. Although the symptoms usually disappear after about a month, the virus remains dormant in the throat and blood for the rest of the child's life. Periodically, the virus can reactivate and be found in saliva, although it does not usually cause symptoms.

sometimes the disease can start abruptly with a high fever and severe, swollen throat similar to a strep throat. Rarely, about 10 percent of patients have a third type, which causes a low persistent fever, nausea and vomiting, and stomach problems.

About half of all mononucleosis patients have an enlarged spleen, and a few have an enlarged liver or mild jaundice. A rash also can be seen in some cases.

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