Conference Abstract | Volume 9 (ConfPro8): Abstract 109 | Published: 14 Oct 2026
Samuel Adolf Bosoka1,2,&, Mary Opoku1, Norbert Asimbalaam Appiah1, Felix Bosonkui1,3, Gameli Goka Kwesi1,4, Fafali Thywill Wormade1,4, Perpetual Asantewaa1,5, Joseph Yaw Jerela2, Amatus Nambagyira2, Samuel Dapaa1, Magdalene Akos Odikro1, Perfect Titiati6, Joseph Asamoah Frimpong1, Hectoria Awekeya7, Chrysantus Kubio7, Emmanuel Atsu Dodor7
1Ghana Field Epidemiology and Laboratory Training Programme, Ghana, 2Disease Surveillance Unit, Volta Regional Health Directorate, Ghana Health Service, Ho, Ghana, 3Environmental Health Directorate, Volta Region, Ho, Ghana; 4Food and Drugs Authority, Volta Region, Ho, Ghana, 5Veterinary Services Department, Volta Region, Ghana, 6Ho Municipal Health Directorate, Ho, Ghana, 7Volta Regional Health Directorate, Ghana Health Service, Ho, Ghana
&Corresponding author: Samuel Adolf Bosoka, Disease Surveillance Unit, Volta Regional Health Directorate, Ghana Health Service, Ho, Ghana, Email: samuelbosoka@gmail.com
Received: 11 Mar 2026, Accepted: 30 Aug 2026, Published: 14 Oct 2026
Domain: Infectious Disease Epidemiology
Keywords: Mpox, neonate, varicella zoster, diagnostic discordance, infection prevention, outbreak investigation, Ghana
©Samuel Adolf Bosoka et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Samuel Adolf Bosoka et al,. Solving the Mpox mystery in Volta Region, Ghana: Why a neonate tested positive while her mother tested negative, 2025. Journal of Interventional Epidemiology and Public Health. 2026;9(ConfPro8):109. https://doi.org/10.37432/JIEPH-CONFPRO8-00109
Mpox is a zoonotic viral disease with human-to-human spread. Neonatal cases are rare, and clinicians usually presume maternal infection. On 4 June 2025, the Volta Regional Health Directorate (VRHD) confirmed mpox in a 21-day-old neonate whose mother tested negative. We investigated this discordance.
We conducted a descriptive outbreak investigation. A suspected case was fever with at least one of headache, lymphadenopathy, or muscle pain, followed by progressive rash, in Volta Region between 29 April and 11 June 2025. We interviewed case patients using a semi-structured questionnaire, reviewed medical records, and searched actively for cases. We analysed data descriptively in STATA 17 and Microsoft Excel 2022.
A mother had a caesarean section on 14 May 2025 for hypertension. Her neonate, who had meconium aspiration syndrome, was admitted to the Neonatal Intensive Care Unit. On 16 May, the mother developed a widespread rash and was discharged to self-isolate on suspicion of varicella. Varicella Zoster Immunoglobulin was unavailable, so the neonate was discharged on 19 May without prophylaxis. She developed a rash around 26 May and, on 31 May, was admitted with vesicles covering the body, including palms and soles. Clinicians first treated varicella, then suspected mpox and collected lesion crust from her and blood from her mother on 2 June. The neonate tested positive and the mother negative. The investigation found healed palmar lesions on the mother, consistent with mpox. The neonate received acyclovir and was discharged on 9 June.
Mpox is difficult to distinguish from varicella in neonates, and the mother was misdiagnosed at delivery. Her blood sample was taken 17 days after rash onset, whereas the neonate’s sample was lesion crust, which may explain the discordance. The VRHD should train health workers to differentiate mpox from varicella and strengthen diagnostic protocols.
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