When mpox is not mpox: varicella and measles in DR Congo

The global epidemiology of eruptive skin diseases remains poorly characterised, particularly in settings with insufficient health-care access and weak surveillance systems.1,2 Eruptive rashes are a common feature of monkeypox virus, varicella-zoster virus (VZV), measles, syphilis, and other infections. Varicella is often mistaken for poxvirus infection despite having been clinically distinguished from smallpox as early as 1767.3 Ambiguity in clinical diagnosis paired with infrequent laboratory confirmation creates challenges in resource-limited settings, such as the DR Congo, where mpox and varicella outbreaks can co-occur.