{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:43:07Z","timestamp":1790066587650,"version":"4.0.1"},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Kenya is experiencing a clade Ib mpox outbreak, with 28 confirmed cases reported by the Ministry of Health from July to December 2024. Polymerase chain reaction testing was performed for varicella zoster virus (VZV). Testing was also part of the differential diagnosis for mpox, and a subset of cases was genetically sequenced. Of 277 specimens tested for mpox, 170 (61%) tested positive for VZV, including instances of coinfection with both viruses in four cases. Genome analysis was used to identify clade 5 human alphaherpesvirus 3 in eight of the genetically sequenced cases. Expanding laboratory capacity during this outbreak enhanced disease intelligence by confirming another etiology of rash among patients who tested negative for mpox, underscoring the need for a broad differential diagnosis when diseases present with overlapping clinical signs and symptoms.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0308","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T15:39:50Z","timestamp":1761233990000},"page":"1411-1414","source":"Crossref","is-referenced-by-count":1,"title":["High Prevalence of Varicella Zoster Virus Infection among Persons with Suspect Mpox Cases during an Mpox Outbreak in Kenya, 2024"],"prefix":"10.4269","volume":"113","author":[{"given":"Clayton","family":"Onyango","sequence":"first","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Z.","family":"Hines","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin","family":"Ochieng","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick","family":"Amon","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Lidechi","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elekiah","family":"Anguko","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute, Nairobi, 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Disease Control and Prevention, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abade","sequence":"additional","affiliation":[{"name":"Africa Field Epidemiology Network (AFENET), Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pius","family":"Mutuku","sequence":"additional","affiliation":[{"name":"Kenya Field Epidemiology and Laboratory Training Program, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Munyeki","sequence":"additional","affiliation":[{"name":"Kenya Field Epidemiology and Laboratory Training Program, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrick","family":"Mutisya","sequence":"additional","affiliation":[{"name":"Kenya Field Epidemiology and Laboratory Training Program, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Jepkorir","sequence":"additional","affiliation":[{"name":"Kenya Field Epidemiology and Laboratory Training Program, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Okunga","sequence":"additional","affiliation":[{"name":"Ministry of Health, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lang\u2019at","sequence":"additional","affiliation":[{"name":"Ministry of Health, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kiiru","sequence":"additional","affiliation":[{"name":"Ministry of Health, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly D.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Herman-Roloff","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Lucchi","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Nairobi, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Microbiol Resour Announc","first-page":"e0005025","article-title":"Complete genome of an mpox clade 1b virus from Kenya","volume":"14","author":"Langat","year":"2025"},{"key":"b2","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"379","article-title":"Clade Ib mpox outbreak \u2013 Kenya, July 2024\u2013February 2025","volume":"74","author":"Mutuku","year":"2025"},{"key":"b3","article-title":"Mpox Preparedness and Response Plan.","author":"Kenya Ministry of Health","year":"2024"},{"key":"b4","series-title":"PLoS Negl Trop Dis","first-page":"e0005857","article-title":"Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo","volume":"11","author":"Osadebe","year":"2017"},{"key":"b5","series-title":"Acta Trop","first-page":"297","article-title":"Human monkeypox: Confusion with chickenpox","volume":"45","author":"Jezek","year":"1988"},{"key":"b6","series-title":"Trop Med Int Health","first-page":"839","article-title":"Varicella in Tshuapa Province, Democratic Republic of Congo, 2009\u20132014","volume":"24","author":"Leung","year":"2019"},{"key":"b7","article-title":"Kenya National Immunization Policy Guidelines.","author":"Kenya Ministry of Health","year":"2023"},{"key":"b8","series-title":"East Afr Med J","first-page":"480","article-title":"Seroprevalence of varicella zoster antibodies among children with malnutrition, malignancies and HIV infection","volume":"85","author":"Admani","year":"2008"},{"key":"b9","series-title":"Epidemiol Infect","first-page":"e68","article-title":"Seroconversion and seroprevalence of TORCH infections in a pregnant women cohort study, Mombasa, Kenya, 2017-2019","volume":"152","author":"Hunsperger","year":"2024"},{"key":"b10","series-title":"J Virol Methods","first-page":"223","article-title":"Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA","volume":"169","author":"Li","year":"2010"},{"key":"b11","series-title":"J Clin Microbiol","first-page":"3909","article-title":"Effect of viral load on the outcome of herpes zoster","volume":"45","author":"Quinlivan","year":"2007"},{"key":"b12","series-title":"mBio","first-page":"e01491-15","article-title":"Virome capture sequencing enables sensitive viral diagnosis and comprehensive virome 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manifestations","volume":"39","author":"Rasizadeh","year":"2023"},{"key":"b17","series-title":"Am J Trop Med Hyg","first-page":"604","article-title":"A tale of two viruses: Coinfections of monkeypox and varicella zoster virus in the Democratic Republic of Congo","volume":"104","author":"Hughes","year":"2020"},{"key":"b18","series-title":"BMC Infect Dis","first-page":"717","article-title":"Varicella zoster virus-associated morbidity and mortality in Africa - a systematic review","volume":"17","author":"Hussey","year":"2017"},{"key":"b19","article-title":"Varicella and Herpes Zoster Vaccines: WHO Position Paper.","year":"2014"}],"container-title":["The American Journal of Tropical Medicine and 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