Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo.
We describe the results of a prospective observational study of the clinical natural history of human monkeypox (mpox) virus (MPXV) infections at the remote L'Hopital General de Reference de Kole (Kole hospital), the rainforest of the Congo River basin of the Democratic Republic of the Congo (D...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-04-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0010384 |
| _version_ | 1797829899153571840 |
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| author | Phillip R Pittman James W Martin Placide Mbala Kingebeni Jean-Jacques Muyembe Tamfum Gaston Mwema Qingwen Wan Pierre Ewala Jules Alonga Guy Bilulu Mary G Reynolds Xiaofei Quinn Sarah Norris Michael B Townsend Panayampalli S Satheshkumar James Wadding Bryony Soltis Anna Honko Fernando B Güereña Lawrence Korman Kerry Patterson David A Schwartz John W Huggins Kole Human Mpox Infection Study Group |
| author_facet | Phillip R Pittman James W Martin Placide Mbala Kingebeni Jean-Jacques Muyembe Tamfum Gaston Mwema Qingwen Wan Pierre Ewala Jules Alonga Guy Bilulu Mary G Reynolds Xiaofei Quinn Sarah Norris Michael B Townsend Panayampalli S Satheshkumar James Wadding Bryony Soltis Anna Honko Fernando B Güereña Lawrence Korman Kerry Patterson David A Schwartz John W Huggins Kole Human Mpox Infection Study Group |
| author_sort | Phillip R Pittman |
| collection | DOAJ |
| description | We describe the results of a prospective observational study of the clinical natural history of human monkeypox (mpox) virus (MPXV) infections at the remote L'Hopital General de Reference de Kole (Kole hospital), the rainforest of the Congo River basin of the Democratic Republic of the Congo (DRC) from March 2007 until August 2011. The research was conducted jointly by the Institute National de Recherche Biomedical (INRB) and the US Army Medical Research Institute of Infectious Diseases (USAMRIID). The Kole hospital was one of the two previous WHO Mpox study sites (1981-1986). The hospital is staffed by a Spanish Order of Catholic Nuns from La Congregation Des Soeurs Missionnaires Du Christ Jesus including two Spanish physicians, who were members of the Order as well, were part of the WHO study on human mpox. Of 244 patients admitted with a clinical diagnosis of MPXV infection, 216 were positive in both the Pan-Orthopox and MPXV specific PCR. The cardinal observations of these 216 patients are summarized in this report. There were three deaths (3/216) among these hospitalized patients; fetal death occurred in 3 of 4 patients who were pregnant at admission, with the placenta of one fetus demonstrating prominent MPXV infection of the chorionic villi. The most common complaints were rash (96.8%), malaise (85.2%), sore throat (78.2%), and lymphadenopathy/adenopathy (57.4%). The most common physical exam findings were mpox rash (99.5%) and lymphadenopathy (98.6%). The single patient without the classic mpox rash had been previously vaccinated against smallpox. Age group of less than 5 years had the highest lesion count. Primary household cases tended to have higher lesion counts than secondary or later same household cases. Of the 216 patients, 200 were tested for IgM & IgG antibodies (Abs) to Orthopoxviruses. All 200 patients had anti-orthopoxvirus IgG Abs; whereas 189/200 were positive for IgM. Patients with hypoalbuminemia had a high risk of severe disease. Patients with fatal disease had higher maximum geometric mean values than survivors for the following variables, respectively: viral DNA in blood (DNAemia); maximum lesion count; day of admission mean AST and ALT. |
| first_indexed | 2024-04-09T13:27:31Z |
| format | Article |
| id | doaj.art-85b90ce10b314bb9bee54b58ffe7ab44 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-04-09T13:27:31Z |
| publishDate | 2023-04-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-85b90ce10b314bb9bee54b58ffe7ab442023-05-10T05:32:25ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352023-04-01174e001038410.1371/journal.pntd.0010384Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo.Phillip R PittmanJames W MartinPlacide Mbala KingebeniJean-Jacques Muyembe TamfumGaston MwemaQingwen WanPierre EwalaJules AlongaGuy BiluluMary G ReynoldsXiaofei QuinnSarah NorrisMichael B TownsendPanayampalli S SatheshkumarJames WaddingBryony SoltisAnna HonkoFernando B GüereñaLawrence KormanKerry PattersonDavid A SchwartzJohn W HugginsKole Human Mpox Infection Study GroupWe describe the results of a prospective observational study of the clinical natural history of human monkeypox (mpox) virus (MPXV) infections at the remote L'Hopital General de Reference de Kole (Kole hospital), the rainforest of the Congo River basin of the Democratic Republic of the Congo (DRC) from March 2007 until August 2011. The research was conducted jointly by the Institute National de Recherche Biomedical (INRB) and the US Army Medical Research Institute of Infectious Diseases (USAMRIID). The Kole hospital was one of the two previous WHO Mpox study sites (1981-1986). The hospital is staffed by a Spanish Order of Catholic Nuns from La Congregation Des Soeurs Missionnaires Du Christ Jesus including two Spanish physicians, who were members of the Order as well, were part of the WHO study on human mpox. Of 244 patients admitted with a clinical diagnosis of MPXV infection, 216 were positive in both the Pan-Orthopox and MPXV specific PCR. The cardinal observations of these 216 patients are summarized in this report. There were three deaths (3/216) among these hospitalized patients; fetal death occurred in 3 of 4 patients who were pregnant at admission, with the placenta of one fetus demonstrating prominent MPXV infection of the chorionic villi. The most common complaints were rash (96.8%), malaise (85.2%), sore throat (78.2%), and lymphadenopathy/adenopathy (57.4%). The most common physical exam findings were mpox rash (99.5%) and lymphadenopathy (98.6%). The single patient without the classic mpox rash had been previously vaccinated against smallpox. Age group of less than 5 years had the highest lesion count. Primary household cases tended to have higher lesion counts than secondary or later same household cases. Of the 216 patients, 200 were tested for IgM & IgG antibodies (Abs) to Orthopoxviruses. All 200 patients had anti-orthopoxvirus IgG Abs; whereas 189/200 were positive for IgM. Patients with hypoalbuminemia had a high risk of severe disease. Patients with fatal disease had higher maximum geometric mean values than survivors for the following variables, respectively: viral DNA in blood (DNAemia); maximum lesion count; day of admission mean AST and ALT.https://doi.org/10.1371/journal.pntd.0010384 |
| spellingShingle | Phillip R Pittman James W Martin Placide Mbala Kingebeni Jean-Jacques Muyembe Tamfum Gaston Mwema Qingwen Wan Pierre Ewala Jules Alonga Guy Bilulu Mary G Reynolds Xiaofei Quinn Sarah Norris Michael B Townsend Panayampalli S Satheshkumar James Wadding Bryony Soltis Anna Honko Fernando B Güereña Lawrence Korman Kerry Patterson David A Schwartz John W Huggins Kole Human Mpox Infection Study Group Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo. PLoS Neglected Tropical Diseases |
| title | Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo. |
| title_full | Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo. |
| title_fullStr | Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo. |
| title_full_unstemmed | Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo. |
| title_short | Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo. |
| title_sort | clinical characterization and placental pathology of mpox infection in hospitalized patients in the democratic republic of the congo |
| url | https://doi.org/10.1371/journal.pntd.0010384 |
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