Monkeypox outbreak, Harper District, Maryland County, Liberia, December 2017

Abstract

Introduction: Monkeypox is a viral zoonotic disease caused by orthopoxyvirus. In Liberia, one confirmed case of monkeypox constitutes an outbreak. A District Surveillance Officer (DSO) of Harper District, Maryland County reported a suspected case of monkeypox on December 5, 2017. We investigated to verify the diagnosis, identify the source of the disease, assess the magnitude of the outbreak, and implement evidence-based control measures. Methods: We interviewed family and community members, and health workers to identify additional cases and contacts, and to obtain information on the source of the illness. We collected samples (whole blood and lesion swabs) for confirmation of the disease. We monitored the contacts for 21 days for signs and symptoms of monkeypox signs. We also conducted environmental assessment on source of the infection. Results: We identified one confirmed case of monkeypox in a 5-year old male from Tenken Community Maryland County in Liberia, who tested positive for West African strain of monkeypox virus. The case-patient had no history of direct contact with wild animals nor consumption of bush, and no travel history or contact with a sick person. The patient was isolated and recovered after three weeks of treatment on analgesics and antibiotics. We identified 35 contacts, none of whom developed signs and symptoms during 21 days of follow up. Conclusion: This was a confirmed monkeypox outbreak in Maryland County. Laboratory confirmation was delayed, and the source of infection remained unknown.