Monkeypox: A New Threat?

The global vaccination programme against smallpox led to its successful eradication and averted millions of deaths. Monkeypox virus (MPXV) is a close relative of the Variola (smallpox) virus. Due to antigenic similarity, smallpox vaccines cross-protect against MPXV. However, over 70% of people living today were never vaccinated against smallpox. Symptoms of monkeypox (MPX) include fever, head- and muscle ache, lymphadenopathy and a characteristic rash that develops into papules, vesicles and pustules which eventually scab over and heal. MPX is less often fatal (case fatality rates range from <1% to up to 11%) than smallpox (up to 30%). MPXV is endemic in sub-Saharan Africa, infecting wild animals and causing zoonotic outbreaks. Exotic animal trade and international travel, combined with the increasing susceptibility of the human population due to halted vaccination, facilitated the spread of MPXV to new areas. The ongoing outbreak, with >10,000 cases in >50 countries between May and July 2022, shows that MPXV can significantly spread between people and may thus become a serious threat to public health with global consequences. Here, we summarize the current knowledge about this re-emerging virus, discuss available strategies to limit its spread and pathogenicity and evaluate its risk to the human population.

Automated summary

The global smallpox vaccination programme successfully eliminated the virus, but the halted vaccination and increasing susceptibility have led to the spread of monkeypox virus. Monkeypox virus, a close relative of smallpox virus, can be cross-protected by smallpox vaccines. However, over 70% of people have never been vaccinated against smallpox. Monkeypox symptoms include fever, headache, muscle ache, and characteristic rash, with lower fatality rates compared to smallpox. Monkeypox virus is endemic in sub-Saharan Africa and spreads through exotic animal trade and international travel.