Human monkeypox is a zoonotic smallpox-like disease caused by an orthopoxvi
rus of interhuman transmissibility too low to sustain spread in susceptible
populations. In February 1997, 88 cases of febrile pustular rash were iden
tified for the previous 12 months in 12 villages of the Katako-Kombe Health
Zone, Democratic Republic of Congo (attack rate = 22 per 1,000; case-fatal
ity rate = 3.7%). Seven were active cases confirmed by virus isolation. Ort
hopoxvirus-neutralizing antibodies were detected in 54% of 72 patients who
provided serum and 25% of 59 wild-caught animals, mainly squirrels. Hemaggl
utination-inhibition assays and Western blotting detected antibodies in 68%
and 73% of patients, respectively. Vaccinia vaccination, which protects ag
ainst monkeypox, ceased by 1983 after global smallpox eradication, leading
to an increase in the proportion of susceptible people.