VZCZCXRO6504
RR RUEHBZ RUEHDU RUEHGI RUEHJO RUEHMR RUEHRN
DE RUEHKI #0436/01 1371605
ZNR UUUUU ZZH
R 161605Z MAY 08
FM AMEMBASSY KINSHASA
TO RUEHC/SECSTATE WASHDC 8002
INFO RUEHXR/RWANDA COLLECTIVE
RUCNSAD/SOUTHERN AF DEVELOPMENT COMMUNITY COLLECTIVE
RUEAUSA/DEPT OF HHS WASHDC
RHMFISS/HQ USEUCOM VAIHINGEN GE
RUZEJAA/JAC MOLESWORTH RAF MOLESWORTH UK
RUEHGV/USMISSION GENEVA 2147
RUEAIIA/CIA WASHDC
RHEFDIA/DIA WASHDC

UNCLAS SECTION 01 OF 02 KINSHASA 000436 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: CDC ECON EAGR EAID SENV TBIO PGOV CG
SUBJECT: CDC TEAM RESPONDS TO MONKEYPOX OUTBREAK IN DRC 
 
REF: KINSHASA 
 
¶1. (U) Summary.  The Center for Disease Control and 
Prevention (CDC) sent a team of three doctors to investigate 
a recent monkeypox outbreak in the Equateur Province of the 
Democratic Republic of the Congo (DRC).  The CDC 
epidemiologists joined representatives from the GDRC Ministry 
of Health (MOH) and the DRC,s National Public Health 
Laboratory (INRB) in Equateur from May 5 - May 14 to educate 
local medical workers, collect and share specimen data, and 
study the source of the virus.  While the CDC could not find 
answers to all of their questions, the team was able to train 
DRC health workers in monkeypox virus recognition, patient 
care, infection control, and specimen collection.  In the 
interest of maintaining U.S. defenses against all potential 
bioterrorist threats, the CDC plans to test drugs already 
developed to combat smallpox on the monkeypox strain.  End 
Summary. 
 
¶2. (U) The first documented monkeypox outbreak in humans 
dates back to 1970, though an outbreak among primates was 
first recorded in 1958.  The monkeypox virus is endemic to 
the heavily forested regions of West and Central Africa, but 
a shipment of animals from Ghana caused a small outbreak (47 
cases) in the U.S. in 2003.  The World Health Organization,s 
(WHO) Monkeypox Steering Committee was established in 
February 2008, five months after the WHO issued a monkeypox 
alert for Equateur.  The CDC negotiated with the MOH in March 
and April 2008 for an invitation to assist in investigating a 
possible epidemic in Equateur, culminating in a CDC-sponsored 
study in Boende, Equateur Province. 
 
¶3. (U) The CDC responded to the invitation by sending three 
doctors to Boende, along with two doctors from the UCLA 
School of Public Health, two from the MOH, one from INRB, and 
one zoology expert from the University of Kinshasa.  The CDC 
team arrived in Kinshasa on April 26 and undertook field 
operations in Equateur province from May 5 until May 14.  The 
first objective of the CDC mission was to educate 37 local 
healthcare workers from several health zones in Equateur. 
The team trained local practitioners to be able to recognize 
the monkeypox strain, care for patients that contracted the 
virus, control the spread of infection, and collect specimens 
for analysis.  The CDC is going to release a ten-minute 
educational video on monkeypox in both French and Lingala to 
be distributed to local health centers.  The CDC team also 
traced the source of the recent outbreak to a 17-year-old 
hunter near Boende that came into contact with an infected 
animal.  Finally, the team carried out an ecological 
investigation, primarily through questionnaires for the local 
population, to determine dietary habits, levels of contact 
with animals, and land-use in the region. 
 
¶4. (SBU) The CDC mission collected two full specimens from 
patients, including blood samples, plasma samples, and lesion 
swabs.  The USG has already dedicated substantial funds to 
develop drugs in the event of a possible bioterrorist attack 
using smallpox.  The subsequent analysis of the current 
monkeypox strain will help determine whether drugs used to 
treat smallpox will also be effective in combating monkeypox. 
 
¶5. (U) This close relative of smallpox comes from animals 
that live near and are habituated to humans.  It can be 
transferred by physical contact with lesions or through 
ingestion of droplets expelled by infected humans or animals. 
 Children seem to be more susceptible because of their 
less-developed immune systems.  It is unknown whether the 
disease can be passed from an expecting mother to her fetus, 
but it can be passed to babies through nursing.  The symptoms 
include a fever and lesions similar to those common with 
smallpox, but that often contain fluid and concentrate around 
the limbs and head of infected patients.  The recent outbreak 
also caused viral conjunctivitis in some patients that can 
lead to permanent blindness.  The CDC trained local 
healthcare workers to isolate patients, and taught them basic 
prevention that includes avoiding contact with or consumption 
of monkeys and rodents. 
 
¶6. (SBU) Comment:  The CDC team noted a significant level of 
malnutrition in the Equateur Province, with many people 
eating one meal or less per day.  A CDC doctor said 
malnutrition drives up the morbidity and mortality rates 
during outbreaks, but deterring local Congolese from coming 
into contact with the animals will prove difficult.  With low 
levels of food sources and a significant lack of 
 
KINSHASA 00000436  002 OF 002 
 
 
infrastructure to import food, the local population will 
likely continue to hunt and consume monkeys, despite the risk 
of contact with infected animals. 
 
¶7. (SBU) Comment continued:  The CDC has been unable to find 
the principal source or host of monkeypox in nature, nor can 
they determine why it is more prevalent in some countries 
than in others with similar ecologies.  Though mortality 
rates of monkeypox are comparatively low at an estimated ten 
percent, the potential for another weapon of bioterrorism 
warrants continued monitoring of outbreaks and further 
studies of monkeypox prevention and treatment.  End Comment. 
BROCK