Experimental studies have suggested a larger inoculum of monkeypox virus may be associated with increased rash severity; however, little data are available on the relationship between specific animal exposures and rash severity in endemic regions. Using cross-sectional data from an active surveillance program conducted between 2005 and 2007 in the Sankuru Province of the Democratic Republic of the Congo, we explored the possible relationship between rash severity and exposures to rodents and non-human primates among confirmed MPX cases. Among the 223 PCR-confirmed MPX cases identified during active surveillance, the majority of cases (n = 149) presented with mild rash (5–100 lesions) and 33% had a more serious presentation (> 100 lesions). No association between exposure to rodents and rash severity was found in the multivariable analysis. Those that self-reported hunting NHP 3 weeks prior to onset of MPX symptoms had 2.78 times the odds of severe rash than those that did not report such exposure (95% CI: 1.18, 6.58). This study provides a preliminary step in understanding the association between animal exposure and rash severity and demonstrates correlation with exposure to NHPs and human MPX presentation. Additional research exploring the relationship between rash severity and NHPs is warranted.

中文翻译：

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刚果民主共和国的猴痘皮疹严重程度和动物暴露情况

实验研究表明，较大的猴痘病毒接种量可能与皮疹严重程度增加有关；然而，关于特定动物暴露与流行地区皮疹严重程度之间关系的数据很少。我们使用 2005 年至 2007 年在刚果民主共和国桑库鲁省开展的一项主动监测计划的横断面数据，探讨了在确诊的 MPX 病例中皮疹严重程度与接触啮齿动物和非人类灵长类动物之间的可能关系。在主动监测期间发现的 223 例 PCR 确诊 MPX 病例中，大多数病例（n = 149) 出现轻度皮疹（5-100 个皮损），33% 的患者出现更严重的皮疹（> 100 个皮损）。在多变量分析中未发现接触啮齿动物与皮疹严重程度之间存在关联。那些在 MPX 症状出现前 3 周自我报告狩猎 NHP 的人出现严重皮疹的几率是那些没有报告此类暴露的人的 2.78 倍 (95% CI: 1.18, 6.58)。本研究为理解动物暴露与皮疹严重程度之间的关联提供了初步步骤，并证明了与 NHPs 暴露和人类 MPX 表现的相关性。需要进一步研究探索皮疹严重程度与 NHP 之间的关系。