KINSHASA, 1 July 2008 (IRIN) - An outbreak of monkey pox in Democratic Republic of Congo's (DRC) Equateur province has killed 22 of the 470 people infected since the start of 2008, according to medical officials.

"The epidemic began in the Tshuapa health zone and has reached almost all parts of the province," said August Makaya, the chief epidemiologist in Equateur. "Cases of monkey pox have been registered all over Tshuapa health zone but also in Befale and Mopono health zones and more recently in Ingende health zone, near Mbandaka [the main town in the province]," he said.

"The epidemic is now heading northwards to Boende health zone; the east is in the middle of the epidemic and isolated cases have also appeared all over the province," added Makaya.

He explained that most years one or two people would be infected with the monkey pox virus, mainly in Tshuapa health zone.

The disease disappeared in the 1980s but made a comeback after routine vaccinations against smallpox, a related disease, were stopped.

"The disease reappeared because people here regularly eat monkeys and squirrels, which are reservoirs for the virus, and above all because smallpox vaccinations stopped," said Makaya.

People under 30 years of age who have never been vaccinated against smallpox are the most susceptible to monkey pox.

The trade in bush meat, coupled with human travel across the country, mean other areas of DRC, including the capital, are at risk of infections, he added, explaining that the greatest hurdle in tackling the disease was convincing people to change their diets.

Initial symptoms of monkey pox include headache, fever, aching muscles, swollen lymph nodes and extreme tiredness, followed by a rash.

There is no proven treatment for monkey pox, which in Africa has a fatality rate ranging from 1-10 percent.

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