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Monkeypox Outbreak Leads to Changes in US Health Policy - 2003-06-14


The outbreak of the monkeypox virus in the United States has led to several changes in government health policy and animal importation laws. And there may be more action ahead, if it's confirmed that there has been human-to-human transmission of the virus. Some health officials argue the outbreak may also highlight some holes in the nation's public health system.

The monkeypox virus has a long history in Africa. But the outbreak in the United States is apparently a first for the Western Hemisphere. It's believed that the human cases of monkeypox began with exposure to infected prairie dogs that were sold as pets. A giant Gambian rat imported from Africa apparently passed along the virus to the prairie dogs at an exotic pet distribution company.

One hotspot of the outbreak is the state of Wisconsin. City of Milwaukee Health Commissioner Seth Foldy says monkeypox can be added to the list of global viruses that will arrive suddenly and stay awhile. "In today's day and age, with both animals and humans moving at jet speed from rainforest to the steppes of the Himalayas, and everywhere else, any illness in the world can appear on the American doorstep in a matter of hours," he says.

Doctor Foldy says what he finds more troubling is that the U.S. public health system may not be ready for the rapid arrivals. "As you notice, it is local health departments like Waukesha County and Milwaukee City that have been bearing the brunt not just of monkeypox, where's it's least expected, but of West Nile and SARS," he says. "It is safe to say the public health infrastructure of this community is getting a little on the tired side and we'll need to remain just as alert for all those other diseases I've mentioned as we currently are for monkeypox. We simply can't leave SARS and move on to monkeypox like SARS never existed."

Monkeypox is fatal in about ten percent of cases in Africa. The Bush Administration is taking steps to reduce the risk of exposure and disease in the United States. Federal agencies have banned the sale and distribution of prairie dogs. And several species of rodents may no longer be imported from Africa. The government is also recommending that those who might be exposed to monkeypox get a smallpox vaccination. The two viruses are related. But not all local health officials are rushing to endorse use of the smallpox vaccine.

Milwaukee Health Commissioner Foldy says it's controversial. "I have questions either way. I know it will be a difficult decision for everyone to make whether or not they accept the vaccine if it is released," he says. "My opinions on the subject don't matter terribly much."

Anyone who agrees to take the smallpox vaccine will have to sign a document saying they've been informed of the vaccine's risks, which include fever, swollen glands and rare but possible life-threatening complications. There was a similar controversy earlier this year when the Bush Administration pushed for health care workers to be vaccinated against a possible terrorist attack involving smallpox. Health officials say some of the workers who were vaccinated are now taking care of monkeypox patients.

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