Imported Monkeypox from International Traveler, Maryland, USA, 2021

Abstract

A case of monkeypox was diagnosed in a returning traveler from Nigeria to Maryland, USA. Prompt infection control measures led to no secondary cases in 40 exposed healthcare workers. Given the global health implications, public health systems should be aware of effective strategies to mitigate the potential spread of monkeypox.

Keywords: Maryland; Nigeria; United States; global health; international traveler; monkeypox; monkeypox viruses; orthopoxvirus; travel medicine; viruses; zoonoses.

Figure 1

Cutaneous manifestations of imported monkeypox from international traveler, Maryland, USA, 2021. Numerous pustules on erythematous base with some central umbilication and acrofacial propensity are shown.

Figure 2

Imported monkeypox from international traveler, Maryland, USA, 2021. A) Epidermal necrosis, reticular necrosis, and vesiculation. In the dermis, a diffuse mixed superficial dermal infiltrate was observed. B, C) Higher magnification views showing dyskeratotic keratinocytes, neutrophil exocytosis, and intracytoplasmic inclusion bodies consistent with Guarnieri bodies in the epidermis. Hematoxylin and eosin stain; original magnification ×4 in panel A, ×20 in panel B, and ×40 in panel C.