Varicella Coinfection in Patients with Active Monkeypox in the Democratic Republic of the Congo |
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| Authors: | Nicole A Hoff Douglas S Morier Neville K Kisalu Sara C Johnston Reena H Doshi Lisa E Hensley Emile Okitolonda-Wemakoy Jean Jacques Muyembe-Tamfum James O Lloyd-Smith Anne W Rimoin |
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| Institution: | 1.UCLA Fielding School of Public Health,Los Angeles,USA;2.National Institute of Allergy and Infectious Diseases,Bethesda,USA;3.Vaccine Research Center,National Institute of Allergy and Infectious Diseases,Bethesda,USA;4.United States Army Medical Research Institute of Infectious Diseases, Fort Detrick,Frederick,USA;5.Kinshasa School of Public Health,Kinshasa,Democratic Republic of the Congo;6.Institut National de Recherche Biomedicale,Kinshasa,Democratic Republic of the Congo |
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| Abstract: | From 2006 to 2007, an active surveillance program for human monkeypox (MPX) in the Democratic Republic of the Congo identified 151 cases of coinfection with monkeypox virus and varicella zoster virus from 1158 suspected cases of human MPX (13%). Using clinical and socio-demographic data collected with standardized instruments by trained, local nurse supervisors, we examined a variety of hypotheses to explain the unexpectedly high proportion of coinfections among the sample, including the hypothesis that the two viruses occur independently. The probabilities of disease incidence and selection necessary to yield the observed sample proportion of coinfections under an assumption of independence are plausible given what is known and assumed about human MPX incidence. Cases of human MPX are expected to be underreported, and more coinfections are expected with improved surveillance. |
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