<unk>  as a disease in humans was first associated with an illness in the Democratic Republic of the Congo (formerly Zaire), in the town of Basankusu, Équateur Province, in 1970. A second outbreak of human illness was identified in DRC/Zaire in 1996–1997. In 2003, a small outbreak of human<unk>  in the United States occurred among owners of pet prairie dogs. The outbreak originated from Villa Park, Illinois, outside of Chicago, when an exotic animal dealer kept young prairie dogs in close proximity to an infected Gambian pouched rat (Cricetomys gambianus) recently imported from Accra, Ghana. Seventy-one people were reportedly infected, in which no fatalities occurred. In 2005, 49 cases were reported Sudan for the first time. No one who was infected died. The genetic analysis suggests that the virus did not originate in Sudan but was imported, most likely from DRC. Many more<unk>  cases have been reported in Central and West Africa, and in the Democratic Republic of Congo in particular. The collected data is often incomplete and unconfirmed which hinders realistic estimations of the people affected and the number of cases of<unk>  over time. Nevertheless, it was suggested that the number of reported<unk>  cases has increased and that the geographical occurrence broadened in recent years. 2003 U.S. outbreak Gambian pouched rat In May 2003, a young child became ill with fever and rash after being bitten by a prairie dog purchased at a local swap meet near Milwaukee, Wisconsin. In total, 71 cases of<unk>  were reported through June 20, 2003. All cases were traced to Gambian pouched rats imported by a Texas exotic animal distributor, from Accra, Ghana, in April 2003. No deaths resulted. Electron microscopy and serologic studies were used to confirm that the disease was human<unk> . People with<unk>  typically experienced prodromal symptoms of fever, headaches, muscle aches, chills, and drenching sweats. Roughly one-third of infected people had nonproductive coughs. This prodromal phase was followed 1–10 days later by the development of a papular rash that typically progressed through stages of vesiculation, pustulation, umbilication, and crusting. In some people, early lesions had become ulcerated. Rash distribution and lesions occurred on head, trunk, and extremities; many of the people had initial and satellite lesions on palms, soles, and extremities. Rashes were generalized in some people. After onset of the rash, people generally manifested rash lesions in different stages. Everyone affected reported direct or close contact with prairie dogs, later found to be infected with the<unk>  virus. 2017–19 Nigeria outbreak<unk>  has been reportedly spread around southeast and south Nigeria. Some states and the federal government of Nigeria are currently seeking a way to contain it, as well as find a cure for the infected ones. It has spread to Akwa Ibom, Abia, Bayelsa, Benue, Cross River, Delta, Edo, Ekiti, Enugu, Imo, Lagos, Nasarawa, Oyo, Plateau, Rivers and Federal Capital Territory. The outbreak started in September 2017 and remains ongoing across multiple states as of May 2019. 2018 United Kingdom cases In September 2018, the United Kingdom's first case of<unk>  was recorded. The person, a Nigerian national, is believed to have contracted<unk>  in Nigeria before travelling to the United Kingdom. According to Public Health England, the person was staying in a naval base in Cornwall before being moved to the Royal Free Hospital's specialised infectious disease unit. People who had been in contact with the person since he contracted the disease were contacted. A second case was confirmed in the town of Blackpool, with a further case that of a medical worker who cared for the case from Blackpool. A fourth case occurred on 3 December 2019, when<unk>  was diagnosed in a person in south west England. They were travelling to the UK from Nigeria. 2019 Singapore case On 8 May 2019, a 38-year-old man who travelled from Nigeria was hospitalised in an isolation ward at the National Centre for Infectious Diseases in Singapore, after being confirmed as the country's first case of<unk> . As a result, 22 people were quarantined. The case may be linked to the ongoing outbreak in Nigeria. 2021 cases On 24 May in the UK, three cases of<unk>  from a single household were identified by Public Health Wales. The cases were also announced by Health Secretary Matt Hancock while addressing MPs. The index case was diagnosed on 24 May after traveling from Nigeria. The second case was reported on 2 June, and the third on 24 June. On 16 July in the US, an American returning from a trip in Nigeria was diagnosed with<unk> . They were promptly hospitalized and were reportedly in stable condition. It was reported that the chances of the disease spreading to others was low due to airport and plane requirements for everyone to wear masks for the COVID-19 pandemic. As of 20 July 2021, the CDC is monitoring 200 people across 27 US states for possible exposure.
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