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Home Eurosurveillance Weekly Release  2003: Volume 7/ Issue 27 Article 3
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Eurosurveillance, Volume 7, Issue 27, 03 July 2003

Citation style for this article: Editorial team. Source of US monkeypox outbreak of identified, and CDC issues updated interim guidance for prevention and treatment of monkeypox. Euro Surveill. 2003;7(27):pii=2251. Available online:

Source of US monkeypox outbreak of identified, and CDC issues updated interim guidance for prevention and treatment of monkeypox

Editorial team (, Eurosurveillance editorial office.

The Centers for Disease Control and Prevention (CDC) in the United States (US) believes it has identified the source of the current outbreak of monkeypox, after confirming the presence of monkeypox virus in one Gambian giant rat, three dormice, and two rope squirrels that were part of a shipment of African rodents imported into the US on 9 April. (1)

As of 1 July, 81 cases of human monkeypox had been reported to CDC (2). CDC and local US state health departments continue to investigate cases among persons who had contact with pet prairie dogs or other small mammals (3). Thirty two (40%) of the 81 cases have been laboratory confirmed for monkeypox (2).

The reported cases are widely dispersed over the midwestern states. So far there have been reports from Illinois (16), Indiana (22), Kansas (one), Missouri (two), Ohio (one), and Wisconsin (39). No cases of monkeypox that could be attributed exclusively to person to person contact have been confirmed (3).

CDC has issued updated interim guidance on the use of smallpox vaccine, cidofovir, and vaccinia immunoglobulin for prevention and treatment in the setting of an outbreak of monkeypox, and an updated case definition for human cases of monkeypox (4,5). CDC has also issued interim guidance calling for the euthanasia of animals that were imported from Ghana on 9 April, or that have been exposed to other animals infected with monkeypox (6). Up to date information on the outbreak is available at

  1. CDC. CDC Confirms monkeypox in rodents. Interim recommendations aim to curb further spread. Press release, 2 July 2003. ( [accessed 3 July 2003]
  2. CDC. Monkeypox report of cases in the United States case count, 1 July 2003. 2 July 2003. ( [accessed 3 July 2003]
  3. CDC. Update: multistate outbreak of Monkeypox - Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin, 2003. MMWR Morb Mortal Wkly Rep 2003; 52: 589-90. (
  4. CDC. Interim guidance for use of smallpox vaccine, cidofovir, and VIG for prevention and treatment in the setting of an outbreak of monkeypox infections. 2 July 2003. ( [accessed 3 July 2003]
  5. CDC. Updated interim case definition for human case of monkeypox. 2 July 2003. ( [accessed 3 July 2003]
  6. CDC. Interim guidance to state and local governments for the removal of state- and locally imposed quarantine orders and the euthanasia of animals affected by the monkeypox outbreak. 1 July 2003. ( [accessed 3 July 2003]

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