A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo
Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these ca...
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| Veröffentlicht in: | The American journal of tropical medicine and hygiene 2021-02, Vol.104 (2), p.604-611 |
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| creator | Hughes, Christine M Liu, Lindy Davidson, Whitni B Radford, Kay W Wilkins, Kimberly Monroe, Benjamin Metcalfe, Maureen G Likafi, Toutou Lushima, Robert Shongo Kabamba, Joelle Nguete, Beatrice Malekani, Jean Pukuta, Elisabeth Karhemere, Stomy Muyembe Tamfum, Jean-Jacques Okitolonda Wemakoy, Emile Reynolds, Mary G Schmid, D Scott McCollum, Andrea M |
| description | Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to investigate MPX/VZV coinfections. A coinfection was defined as a patient with at least one Orthopoxvirus/MPX-positive sample and at least one VZV-positive sample within the same disease event. Between September 2009 and April 2014, 134 of the 1,107 (12.1%) suspected MPX cases were confirmed as MPX/VZV coinfections. Coinfections were more likely to report symptoms than VZV-alone cases and less likely than MPX-alone cases. Significantly higher lesion counts were observed for coinfection cases than for VZV-alone but less than MPX-alone cases. Discernible differences in symptom and rash severity were detected for coinfection cases compared with those with MPX or VZV alone. Findings indicate infection with both MPX and VZV could modulate infection severity. Collection of multiple lesion samples allows for the opportunity to detect coinfections. As this program continues, it will be important to continue these procedures to assess variations in the proportion of coinfected cases over time. |
| doi_str_mv | 10.4269/ajtmh.20-0589 |
| format | Article |
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The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to investigate MPX/VZV coinfections. A coinfection was defined as a patient with at least one Orthopoxvirus/MPX-positive sample and at least one VZV-positive sample within the same disease event. Between September 2009 and April 2014, 134 of the 1,107 (12.1%) suspected MPX cases were confirmed as MPX/VZV coinfections. Coinfections were more likely to report symptoms than VZV-alone cases and less likely than MPX-alone cases. Significantly higher lesion counts were observed for coinfection cases than for VZV-alone but less than MPX-alone cases. Discernible differences in symptom and rash severity were detected for coinfection cases compared with those with MPX or VZV alone. Findings indicate infection with both MPX and VZV could modulate infection severity. Collection of multiple lesion samples allows for the opportunity to detect coinfections. As this program continues, it will be important to continue these procedures to assess variations in the proportion of coinfected cases over time.</description><identifier>ISSN: 0002-9637</identifier><identifier>EISSN: 1476-1645</identifier><identifier>DOI: 10.4269/ajtmh.20-0589</identifier><identifier>PMID: 33289470</identifier><language>eng</language><publisher>United States: Institute of Tropical Medicine</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chicken pox ; Child ; Child, Preschool ; Coinfection - epidemiology ; Coinfection - virology ; Democratic Republic of the Congo - epidemiology ; Epidemiological Monitoring ; Female ; Herpes Zoster - epidemiology ; Herpesvirus 3, Human - genetics ; Herpesvirus 3, Human - isolation & purification ; Humans ; Infant ; Male ; Middle Aged ; Monkeypox virus - genetics ; Monkeypox virus - isolation & purification ; Mpox ; Mpox (monkeypox) - epidemiology ; Viral infections ; Young Adult</subject><ispartof>The American journal of tropical medicine and hygiene, 2021-02, Vol.104 (2), p.604-611</ispartof><rights>Copyright Institute of Tropical Medicine Feb 2021</rights><rights>The American Society of Tropical Medicine and Hygiene 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-f08b0dc8532f5325cdf3d2073d319f928503205533fe6e36b86340898fe390b53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866336/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866336/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,883,27911,27912,53778,53780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33289470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hughes, Christine M</creatorcontrib><creatorcontrib>Liu, Lindy</creatorcontrib><creatorcontrib>Davidson, Whitni B</creatorcontrib><creatorcontrib>Radford, Kay W</creatorcontrib><creatorcontrib>Wilkins, Kimberly</creatorcontrib><creatorcontrib>Monroe, Benjamin</creatorcontrib><creatorcontrib>Metcalfe, Maureen G</creatorcontrib><creatorcontrib>Likafi, Toutou</creatorcontrib><creatorcontrib>Lushima, Robert Shongo</creatorcontrib><creatorcontrib>Kabamba, Joelle</creatorcontrib><creatorcontrib>Nguete, Beatrice</creatorcontrib><creatorcontrib>Malekani, Jean</creatorcontrib><creatorcontrib>Pukuta, Elisabeth</creatorcontrib><creatorcontrib>Karhemere, Stomy</creatorcontrib><creatorcontrib>Muyembe Tamfum, Jean-Jacques</creatorcontrib><creatorcontrib>Okitolonda Wemakoy, Emile</creatorcontrib><creatorcontrib>Reynolds, Mary G</creatorcontrib><creatorcontrib>Schmid, D Scott</creatorcontrib><creatorcontrib>McCollum, Andrea M</creatorcontrib><title>A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo</title><title>The American journal of tropical medicine and hygiene</title><addtitle>Am J Trop Med Hyg</addtitle><description>Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to investigate MPX/VZV coinfections. A coinfection was defined as a patient with at least one Orthopoxvirus/MPX-positive sample and at least one VZV-positive sample within the same disease event. Between September 2009 and April 2014, 134 of the 1,107 (12.1%) suspected MPX cases were confirmed as MPX/VZV coinfections. Coinfections were more likely to report symptoms than VZV-alone cases and less likely than MPX-alone cases. Significantly higher lesion counts were observed for coinfection cases than for VZV-alone but less than MPX-alone cases. Discernible differences in symptom and rash severity were detected for coinfection cases compared with those with MPX or VZV alone. Findings indicate infection with both MPX and VZV could modulate infection severity. Collection of multiple lesion samples allows for the opportunity to detect coinfections. As this program continues, it will be important to continue these procedures to assess variations in the proportion of coinfected cases over time.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chicken pox</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Coinfection - epidemiology</subject><subject>Coinfection - virology</subject><subject>Democratic Republic of the Congo - epidemiology</subject><subject>Epidemiological Monitoring</subject><subject>Female</subject><subject>Herpes Zoster - epidemiology</subject><subject>Herpesvirus 3, Human - genetics</subject><subject>Herpesvirus 3, Human - isolation & purification</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monkeypox virus - genetics</subject><subject>Monkeypox virus - isolation & purification</subject><subject>Mpox</subject><subject>Mpox (monkeypox) - epidemiology</subject><subject>Viral infections</subject><subject>Young Adult</subject><issn>0002-9637</issn><issn>1476-1645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc9vFCEcxYnR2G316NWQePEyFfgCAx5MmrX-SGpMzNqDF8LOQJd1BrYwo_a_l-3WRj18wzd5Hx68PISeUXLKmdSv7HYaN6eMNEQo_QAtKG9lQyUXD9GCEMIaLaE9QselbAmhilH6GB0BMKV5SxYoneGVHRxOHq9-JnwZ8lxceY2XKUTvuimkWPbipxS_u5td-oVt7PGlzaFzw2Dxt1Qmlw_3cIh42jj81o2py3YKHf7idvN6qEu1WKZ4lZ6gR94OxT29O0_Q13fnq-WH5uLz-4_Ls4um41RMjSdqTfpOCWC-juh6Dz0jLfRAtddMCQKMCAHgnXQg10oCJ0or70CTtYAT9ObgW98fXd-5OGU7mF0Oo803Jtlg_lVi2Jir9MO0SkoAWQ1e3hnkdD27MpkxlNvM0aW5GMalAqY1g4q--A_dpjnHGs8wARQ416ytVHOgupxKyc7ff4YSs6_S3FZpGDH7Kiv__O8E9_Sf7uA3wq2aZw</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Hughes, Christine M</creator><creator>Liu, Lindy</creator><creator>Davidson, Whitni B</creator><creator>Radford, Kay W</creator><creator>Wilkins, Kimberly</creator><creator>Monroe, Benjamin</creator><creator>Metcalfe, Maureen G</creator><creator>Likafi, Toutou</creator><creator>Lushima, Robert Shongo</creator><creator>Kabamba, Joelle</creator><creator>Nguete, Beatrice</creator><creator>Malekani, Jean</creator><creator>Pukuta, Elisabeth</creator><creator>Karhemere, Stomy</creator><creator>Muyembe Tamfum, Jean-Jacques</creator><creator>Okitolonda Wemakoy, Emile</creator><creator>Reynolds, Mary G</creator><creator>Schmid, D Scott</creator><creator>McCollum, Andrea M</creator><general>Institute of Tropical Medicine</general><general>The American Society of Tropical Medicine and Hygiene</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210201</creationdate><title>A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo</title><author>Hughes, Christine M ; Liu, Lindy ; Davidson, Whitni B ; Radford, Kay W ; Wilkins, Kimberly ; Monroe, Benjamin ; Metcalfe, Maureen G ; Likafi, Toutou ; Lushima, Robert Shongo ; Kabamba, Joelle ; Nguete, Beatrice ; Malekani, Jean ; Pukuta, Elisabeth ; Karhemere, Stomy ; Muyembe Tamfum, Jean-Jacques ; Okitolonda Wemakoy, Emile ; Reynolds, Mary G ; Schmid, D Scott ; McCollum, Andrea M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-f08b0dc8532f5325cdf3d2073d319f928503205533fe6e36b86340898fe390b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Chicken pox</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Coinfection - epidemiology</topic><topic>Coinfection - virology</topic><topic>Democratic Republic of the Congo - epidemiology</topic><topic>Epidemiological Monitoring</topic><topic>Female</topic><topic>Herpes Zoster - epidemiology</topic><topic>Herpesvirus 3, Human - genetics</topic><topic>Herpesvirus 3, Human - isolation & purification</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monkeypox virus - genetics</topic><topic>Monkeypox virus - isolation & purification</topic><topic>Mpox</topic><topic>Mpox (monkeypox) - epidemiology</topic><topic>Viral infections</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hughes, Christine M</creatorcontrib><creatorcontrib>Liu, Lindy</creatorcontrib><creatorcontrib>Davidson, Whitni B</creatorcontrib><creatorcontrib>Radford, Kay W</creatorcontrib><creatorcontrib>Wilkins, Kimberly</creatorcontrib><creatorcontrib>Monroe, Benjamin</creatorcontrib><creatorcontrib>Metcalfe, Maureen G</creatorcontrib><creatorcontrib>Likafi, Toutou</creatorcontrib><creatorcontrib>Lushima, Robert Shongo</creatorcontrib><creatorcontrib>Kabamba, Joelle</creatorcontrib><creatorcontrib>Nguete, Beatrice</creatorcontrib><creatorcontrib>Malekani, Jean</creatorcontrib><creatorcontrib>Pukuta, Elisabeth</creatorcontrib><creatorcontrib>Karhemere, Stomy</creatorcontrib><creatorcontrib>Muyembe Tamfum, Jean-Jacques</creatorcontrib><creatorcontrib>Okitolonda Wemakoy, Emile</creatorcontrib><creatorcontrib>Reynolds, Mary G</creatorcontrib><creatorcontrib>Schmid, D Scott</creatorcontrib><creatorcontrib>McCollum, Andrea M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of tropical medicine and hygiene</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hughes, Christine M</au><au>Liu, Lindy</au><au>Davidson, Whitni B</au><au>Radford, Kay W</au><au>Wilkins, Kimberly</au><au>Monroe, Benjamin</au><au>Metcalfe, Maureen G</au><au>Likafi, Toutou</au><au>Lushima, Robert Shongo</au><au>Kabamba, Joelle</au><au>Nguete, Beatrice</au><au>Malekani, Jean</au><au>Pukuta, Elisabeth</au><au>Karhemere, Stomy</au><au>Muyembe Tamfum, Jean-Jacques</au><au>Okitolonda Wemakoy, Emile</au><au>Reynolds, Mary G</au><au>Schmid, D Scott</au><au>McCollum, Andrea M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo</atitle><jtitle>The American journal of tropical medicine and hygiene</jtitle><addtitle>Am J Trop Med Hyg</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>104</volume><issue>2</issue><spage>604</spage><epage>611</epage><pages>604-611</pages><issn>0002-9637</issn><eissn>1476-1645</eissn><abstract>Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to investigate MPX/VZV coinfections. A coinfection was defined as a patient with at least one Orthopoxvirus/MPX-positive sample and at least one VZV-positive sample within the same disease event. Between September 2009 and April 2014, 134 of the 1,107 (12.1%) suspected MPX cases were confirmed as MPX/VZV coinfections. Coinfections were more likely to report symptoms than VZV-alone cases and less likely than MPX-alone cases. Significantly higher lesion counts were observed for coinfection cases than for VZV-alone but less than MPX-alone cases. Discernible differences in symptom and rash severity were detected for coinfection cases compared with those with MPX or VZV alone. Findings indicate infection with both MPX and VZV could modulate infection severity. Collection of multiple lesion samples allows for the opportunity to detect coinfections. As this program continues, it will be important to continue these procedures to assess variations in the proportion of coinfected cases over time.</abstract><cop>United States</cop><pub>Institute of Tropical Medicine</pub><pmid>33289470</pmid><doi>10.4269/ajtmh.20-0589</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Chicken pox Child Child, Preschool Coinfection - epidemiology Coinfection - virology Democratic Republic of the Congo - epidemiology Epidemiological Monitoring Female Herpes Zoster - epidemiology Herpesvirus 3, Human - genetics Herpesvirus 3, Human - isolation & purification Humans Infant Male Middle Aged Monkeypox virus - genetics Monkeypox virus - isolation & purification Mpox Mpox (monkeypox) - epidemiology Viral infections Young Adult |
| title | A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo |
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