CDC TEAM RESPONDS TO MONKEYPOX OUTBREAK IN DRC

UNCLAS SECTION 01 OF 02 KINSHASA 000436 SIPDIS E.O. 12958: N/A TAGS: CDC ECON EAGR EAID SENV TBIO PGOV CG SUBJECT: CDC TEAM RESPONDS TO MONKEYPOX OUTBREAK IN DRC REF: KINSHASA ¶1. (U) Summary. The Center for Disease Control and Prevention (CDC) sent a team of three doctors to investigate a recent monkeypox outbreak in the Equateur Province of the Democratic Republic of the Congo (DRC). The CDC epidemiologists joined representatives from the GDRC Ministry of Health (MOH) and the DRC,s National Public Health Laboratory (INRB) in Equateur from May 5 - May 14 to educate local medical workers, collect and share specimen data, and study the source of the virus. While the CDC could not find answers to all of their questions, the team was able to train DRC health workers in monkeypox virus recognition, patient care, infection control, and specimen collection. In the interest of maintaining U.S. defenses against all potential bioterrorist threats, the CDC plans to test drugs already developed to combat smallpox on the monkeypox strain. End Summary. ¶2. (U) The first documented monkeypox outbreak in humans dates back to 1970, though an outbreak among primates was first recorded in 1958. The monkeypox virus is endemic to the heavily forested regions of West and Central Africa, but a shipment of animals from Ghana caused a small outbreak (47 cases) in the U.S. in 2003. The World Health Organization,s (WHO) Monkeypox Steering Committee was established in February 2008, five months after the WHO issued a monkeypox alert for Equateur. The CDC negotiated with the MOH in March and April 2008 for an invitation to assist in investigating a possible epidemic in Equateur, culminating in a CDC-sponsored study in Boende, Equateur Province. ¶3. (U) The CDC responded to the invitation by sending three doctors to Boende, along with two doctors from the UCLA School of Public Health, two from the MOH, one from INRB, and one zoology expert from the University of Kinshasa. The CDC team arrived in Kinshasa on April 26 and undertook field operations in Equateur province from May 5 until May 14. The first objective of the CDC mission was to educate 37 local healthcare workers from several health zones in Equateur. The team trained local practitioners to be able to recognize the monkeypox strain, care for patients that contracted the virus, control the spread of infection, and collect specimens for analysis. The CDC is going to release a ten-minute educational video on monkeypox in both French and Lingala to be distributed to local health centers. The CDC team also traced the source of the recent outbreak to a 17-year-old hunter near Boende that came into contact with an infected animal. Finally, the team carried out an ecological investigation, primarily through questionnaires for the local population, to determine dietary habits, levels of contact with animals, and land-use in the region. ¶4. (SBU) The CDC mission collected two full specimens from patients, including blood samples, plasma samples, and lesion swabs. The USG has already dedicated substantial funds to develop drugs in the event of a possible bioterrorist attack using smallpox. The subsequent analysis of the current monkeypox strain will help determine whether drugs used to treat smallpox will also be effective in combating monkeypox. ¶5. (U) This close relative of smallpox comes from animals that live near and are habituated to humans. It can be transferred by physical contact with lesions or through ingestion of droplets expelled by infected humans or animals. Children seem to be more susceptible because of their less-developed immune systems. It is unknown whether the disease can be passed from an expecting mother to her fetus, but it can be passed to babies through nursing. The symptoms include a fever and lesions similar to those common with smallpox, but that often contain fluid and concentrate around the limbs and head of infected patients. The recent outbreak also caused viral conjunctivitis in some patients that can lead to permanent blindness. The CDC trained local healthcare workers to isolate patients, and taught them basic prevention that includes avoiding contact with or consumption of monkeys and rodents. ¶6. (SBU) Comment: The CDC team noted a significant level of malnutrition in the Equateur Province, with many people eating one meal or less per day. A CDC doctor said malnutrition drives up the morbidity and mortality rates during outbreaks, but deterring local Congolese from coming into contact with the animals will prove difficult. With low levels of food sources and a significant lack of KINSHASA 00000436 002 OF 002 infrastructure to import food, the local population will likely continue to hunt and consume monkeys, despite the risk of contact with infected animals. ¶7. (SBU) Comment continued: The CDC has been unable to find the principal source or host of monkeypox in nature, nor can they determine why it is more prevalent in some countries than in others with similar ecologies. Though mortality rates of monkeypox are comparatively low at an estimated ten percent, the potential for another weapon of bioterrorism warrants continued monitoring of outbreaks and further studies of monkeypox prevention and treatment. End Comment. BROCK