MONKEYPOX - USA: RECOMMENDATIONS FOR VETERINARIANS
A ProMED-mail post <www.promedmail.org>
ProMED-mail, a program of the International Society for Infectious Diseases
11 Jun 2003
Infections In Animals: Interim Guidance for Veterinarians and Pet Owners
As of 7 Jun 2003, at least 6 persons with probable monkeypox infection have been reported to be veterinarians or staff at veterinary hospitals.
Human monkeypox is a rare zoonotic viral disease that occurs primarily in the rain forest countries of central and west Africa. In humans, the illness produces a vesicular and pustular rash similar to that produced by smallpox.
incubation period from exposure to fever onset is about 12 days. In humans,
case-fatality ratios in Africa have ranged from 1 to 10 percent (for additional
information about monkeypox, see
These interim guidelines will be updated as new information becomes available and after consultation with additional public health partners.
In the current outbreak, illness in animals has been reported to include fever, cough, blepharoconjunctivitis, lymphadenopathy, followed by a nodular rash. Some animals have died while others reportedly recovered.
The types of animals that may become ill with monkeypox are currently unknown; as a precaution, all mammals should be considered susceptible at this time.
owners who suspect their animal may have an illness compatible with monkeypox
should immediately isolate the animal from humans and other animals and
contact their state or local health department. In most cases,
Owners should consider wearing a mask and gloves when handling the animal. The animal’s bedding should be collected and bagged and brought with the animal to the veterinary clinic for disposal as medically regulated waste.
bedding should not be disposed of as household trash. Following identification
of an animal with suspect monkeypox in a household, any animals (including
dogs and cats) who may have come in contact with the
of the ill animal to a veterinary clinic should be done by a single individual
to limit unnecessary exposure. At the time of animal transport, the owner
should also transport the sick animal’s bagged bedding for disposal. Care
should be taken to minimize driver exposure during transport. During transport
animals should be confined in a closed
Veterinarians examining sick prairie dogs, Gambian giant rats, or other mammals that may have come in contact with a suspected monkeypox case, should consider the diagnosis of monkeypox infection. Animals that currently appear healthy but have been implicated as a probable source of infection for a human case should also be treated as a suspected case of monkeypox. All suspected cases of monkeypox in animals should be reported immediately to state or local health department officials.
Veterinarians who have been notified of an arriving animal with suspected monkeypox should admit the animal through a separate entrance to a private room and place it in isolation; the animal should not be admitted to an open waiting room.
When examining or euthanizing sick rodents, lagomorphs, and exotic pets, especially prairie dogs, Gambian giant rats, or any ill mammal known to have been in contact with a case of monkeypox, the following precautions should be used:
hygiene after all contact with a sick animal and contaminated surfaces.
All animals with suspected monkeypox infection should be humanely euthanized to prevent further spread of the disease. Humane euthanasia options include pentobarbital injection or gas chamber using isoflurane or halothane for most animals. For small rodent species such as mice, cervical dislocation may be considered if performed by a trained person.
is not currently recommending euthanasia of asymptomatic animals that may
have been exposed to other infected animals. Exposed asymptomatic animals
should be confined to the home and not allowed to come into contact
Currently, CDC is not routinely requesting animal samples for testing. However, specimens can be collected and stored for possible future testing.
Consultation with the state epidemiologist and state health laboratory is necessary for samples to be sent to CDC for testing.<www.cste.org/members/state_and_territorial_epi.asp><www.aphl.org/public_health_labs/index.cfm>
to euthanasia, whole blood in EDTA tubes or serum can be collected and
refrigerated at 4 deg C. CDC is not recommending necropsies of animals
except in Biosafety level 3 laboratories by persons recently vaccinated
more information, contact your state or local health department or the
CDC Emergency Operations Center 770-488-7100. Additional information and
recommendations will be released as they become available. Updated
should be used in the context of a complete respiratory protection program
in accordance with OSHA regulations. This includes training and fit testing
to ensure a proper seal between the respirator’s sealing surface and the
wearer’s face. Detailed information on respirator programs, including fit
test procedures can be accessed at: