{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T15:01:20Z","timestamp":1790521280625,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,5,22]],"date-time":"2019-05-22T00:00:00Z","timestamp":1558483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe varicella cases in Tshuapa Province of the Democratic Republic of the Congo identified during monkeypox surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Demographic, clinical and epidemiological data were collected from each suspected monkeypox case 2009\u20132014. Samples were tested by\n                      <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\n                      for both Orthopoxviruses and varicella\u2010zoster virus (\n                      <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content>\n                      ); a subset of\n                      <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content>\n                      \u2010positive samples was genotyped. We defined a varicella case as a rash illness with laboratory\u2010confirmed\n                      <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 366 varicella cases were identified; 66% were \u226419 years old. Most patients had non\u2010typical varicella rash with lesions reported as the same size and stage of evolution (86%), deep and profound (91%), on palms of hands and\/or soles of feet (86%) and not itchy (49%). Many had non\u2010typical signs and symptoms, such as lymphadenopathy (70%) and sensitivity to light (23%). A higher proportion of persons aged \u226520 years than persons aged \u226419 years had \u226550 lesions (79%\n                      <jats:italic>vs<\/jats:italic>\n                      . 65%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.007) and were bedridden (15%\n                      <jats:italic>vs<\/jats:italic>\n                      . 9%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.056). All\n                      <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content>\n                      isolates genotyped from 79 varicella cases were clade 5. During the surveillance period, one possible\n                      <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content>\n                      \u2010related death occurred in a 7\u2010year\u2010old child.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A large proportion of patients presented with non\u2010typical varicella rash and clinical signs and symptoms, highlighting challenges identifying varicella in an area with endemic monkeypox. Continued surveillance and laboratory diagnosis will help in rapid identification and control of both monkeypox and varicella and improve our understanding of varicella epidemiology in Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.13243","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T21:19:46Z","timestamp":1557177586000},"page":"839-848","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Varicella in Tshuapa Province, Democratic Republic of Congo, 2009\u20132014"],"prefix":"10.1111","volume":"24","author":[{"given":"Jessica","family":"Leung","sequence":"first","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"McCollum","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Radford","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Hughes","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana S.","family":"Lopez","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Anne J.","family":"Guagliardo","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GA USA"},{"name":"Epidemic Intelligence Service Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Nguete","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toutou","family":"Likafi","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Kabamba","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Malekani","sequence":"additional","affiliation":[{"name":"Department of Biology University of Kinshasa Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Shongo Lushima","sequence":"additional","affiliation":[{"name":"Ministry of Health Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Pukuta","sequence":"additional","affiliation":[{"name":"Institut National de Recherche Biom\u00e9dicale Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stomy","family":"Karhemere","sequence":"additional","affiliation":[{"name":"Institut National de Recherche Biom\u00e9dicale Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Jacques","family":"Muyembe Tamfum","sequence":"additional","affiliation":[{"name":"Institut National de Recherche Biom\u00e9dicale Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary G.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emile","family":"Wemakoy Okitolonda","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Scott","family":"Schmid","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Marin","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,22]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"SewardJF MarinM;on behalf of the Sage VZV Working Group.Varicella Disease Burden and Varicella Vaccines. (Available from:https:\/\/www.scribd.com\/document\/365929945\/2-SAGE-April-VZV-Seward-Varicella) [12 April 2018]."},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/B978-1-4160-3611-1.50039-8","volume-title":"Vaccines","author":"Gershon A","year":"2008"},{"key":"e_1_2_7_4_1","unstructured":"WHO. World Health Organization SAGE working group on varicella and herpes zoster vaccines.Background paper on varicella vaccine;2014. (Available from:http:\/\/www.who.int\/immunization\/sage\/meetings\/2014\/April\/1_SAGE_varicella_background_paper_FINAL.pdf) [20 April 2016]."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpped.2015.12.006"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002233"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2018.1546525"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2017.1343669"},{"key":"e_1_2_7_9_1","first-page":"480","article-title":"Seroprevalence of varicella zoster antibodies among children with malnutrition, malignancies and HIV infection","volume":"85","author":"Admani B","year":"2008","journal-title":"East Afr Med J"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001750"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2815-9"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/595552"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2009.80.503"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.4065\/82.2.175"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005857"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihu017"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taw042"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.1998.00316.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.epidem.2010.11.003"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5359.30744"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.2174\/157339609791317315"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69561-5"},{"key":"e_1_2_7_23_1","first-page":"2016","volume-title":"Fields Virology","author":"Arvin AM","year":"2013"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit703"},{"key":"e_1_2_7_25_1","first-page":"297","article-title":"Human monkeypox: confusion with chickenpox","volume":"45","author":"Jezek Z","year":"1988","journal-title":"Acta Trop"},{"key":"e_1_2_7_26_1","unstructured":"United Nations.DESA Population Division. World Population Prospects;2017. (Available from:https:\/\/esa.un.org\/unpd\/wpp\/) [12 April 2018]."},{"key":"e_1_2_7_27_1","unstructured":"RoseAN McKeeJJ UrbanML BrightEA.LandScan2017[digital raster data] (Available from:https:\/\/landscan.ornl.gov\/) [22 Aug 2018]."},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/iht029"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.78.15.8349-8358.2004"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1099\/jgv.0.000772"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu058"},{"key":"e_1_2_7_32_1","unstructured":"QGIS Development Team (YEAR).QGIS Geographic Information System. Open Source Geospatial Foundation Project. (Available from:http:\/\/qgis.osgeo.org)."},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-4362.2002.01646_2.x"},{"key":"e_1_2_7_34_1","first-page":"839","article-title":"The diagnosis of atypical varicella","volume":"45","author":"Kipps A","year":"1971","journal-title":"S Afr Med J"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/000155599750010760"},{"key":"e_1_2_7_36_1","unstructured":"Democratic Republic of Congo Ministry of Health.Integrated Behavioral Surveillance Survey and Seroprevalence in Democratic Republic of Congo;2014."},{"key":"e_1_2_7_37_1","unstructured":"Democratic Republic of Congo Ministry of Public Health.National programme to fight HIV\/AIDS and STI. Epidemiological Report on HIV\/AIDS Surveillance in Pregnant Women Frequenting the Services of EIC\u20102013;2014."},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2010.08.014"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1306.061540"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268800068308"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2001.64.131"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1017\/S095026881300174X"},{"key":"e_1_2_7_43_1","first-page":"311","article-title":"Comparisons between chickenpox in a tropical and a European country","volume":"66","author":"Maretic Z","year":"1963","journal-title":"J Trop Med Hyg"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12040"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(05)70313-5"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000151034.15747.4a"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-3741"},{"key":"e_1_2_7_48_1","first-page":"120","article-title":"Fever with rash surveillance in India","volume":"22","author":"Jezek Z","year":"1978","journal-title":"Indian J Public Health"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2004.09.004"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.08.022"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.13243","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13243","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.13243","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T11:24:19Z","timestamp":1694258659000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.13243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,22]]},"references-count":49,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1111\/tmi.13243"],"URL":"https:\/\/doi.org\/10.1111\/tmi.13243","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,22]]},"assertion":[{"value":"2019-05-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}