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Human monkeypox: secondary attack rates.

Z Jezek, B Grab, M V Szczeniowski

    Bulletin of the World Health Organization
    |January 1, 1988
    PubMed
    Summary
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    Human monkeypox virus shows inefficient person-to-person spread, with a low overall probability of illness following human exposure. Household transmission is most common, particularly in unvaccinated children, but sustained human transmission is unlikely.

    Area of Science:

    • Virology
    • Epidemiology
    • Public Health

    Background:

    • Human monkeypox is a zoonotic disease with potential for limited human-to-human transmission.
    • Understanding transmission dynamics is crucial for public health preparedness and response.

    Purpose of the Study:

    • To analyze human-to-human transmission patterns of monkeypox virus in Zaire.
    • To assess factors influencing secondary attack rates in close contacts of infected individuals.

    Main Methods:

    • Retrospective analysis of monkeypox cases and contacts from 1981-1986 in Zaire.
    • Calculation of secondary attack rates based on generation of spread and contact characteristics.

    Main Results:

    • Among 2278 close contacts of 245 monkeypox patients, 93 secondary cases were identified.

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  • Overall secondary attack rate was 3%, with highest rates in unvaccinated children (11.7%) within households.
  • Inefficient transmission observed even in high-exposure settings, with no increase in rates over time.

    • Conclusions:

    • Monkeypox virus demonstrates poor adaptation for sustained human-to-human transmission.
    • Interhuman spread is limited and does not represent a significant public health threat.
    • Household contact and vaccination status are key factors in transmission risk.