Details:

Alternative Title:
Trop Med Int Health
Publisher's site:
http://dx.doi.org/10.1111/tmi.13243
Personal Author:
Leung, Jessica ; McCollum, Andrea M. ; Radford, Kay ; Hughes, Christine ; Lopez, Adriana S ; ... More +
Leung, Jessica ; McCollum, Andrea M. ; Radford, Kay ; Hughes, Christine ; Lopez, Adriana S ; Guagliardo, Sarah Anne J. ; Nguete, Beatrice ; Likafi, Toutou ; Kabamba, Joelle ; Malekani, Jean ; Shongo Lushima, Robert ; Pukuta, Elisabeth ; Karhemere, Stomy ; Muyembe Tamfum, Jean Jacques ; Reynolds, Mary G. ; Wemakoy Okitolonda, Emile ; Schmid, D Scott ; Marin, Mona Less -
Description:
Objectives:

To describe varicella cases in Tshuapa Province of the Democratic Republic of the Congo identified during monkeypox surveillance.

Methods:

Demographic, clinical, and epidemiological data were collected from each suspected monkeypox case during 2009–2014. Samples were tested by PCR for both Orthopoxviruses and varicella-zoster virus (VZV); a subset of VZV positive samples were genotyped. We defined a varicella case as a rash illness with laboratory-confirmed VZV.

Results:

There were 366 varicella cases were identified; 66% were ≤19 years old. Most patients had non-typical varicella rash with lesions reported as the same size and stage of evolution (86%), deep and profound (91%), on palms of hands and/or soles of feet (86%), and not itchy (49%). Many had non-typical signs and symptoms, including lymphadenopathy (70%) and sensitivity to light (23%). A higher proportion of persons aged ≥20 years compared with persons aged ≤19 years had ≥50 lesions (79% versus 65%, p = 0.007) and were bedridden (15% versus 9%, p = 0.056). All VZV isolates genotyped from 79 varicella cases were clade 5. During the surveillance period, one possible VZV-related death occurred in a 7-year-old child.

Conclusions:

A large proportion of patients presented with non-typical varicella rash and clinical signs and symptoms, highlighting challenges identifying varicella in an area with endemic monkeypox. Continued surveillance and laboratory diagnosis will help in rapid identification and control of both monkeypox and varicella and improve our understanding of varicella epidemiology in Africa.


Subjects:
[+]
Adolescent Adult Aged Aged, 80 And Over Child Child, Preschool Female Humans Infant Male Middle Aged Polymerase Chain Reaction Young Adult
Source:
Trop Med Int Health. 24(7):839-848
Pubmed ID:
31062445
Pubmed Central ID:
PMC8786670
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Place as Subject:
Democratic Republic of the Congo
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:82820f75f4d94d0fac846e1da97b719e957bbaa2f4082a990a6708509dbe721b
Download URL:
https://stacks.cdc.gov/view/cdc/113770/cdc_113770_DS1.pdf
File Type:

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