Factors affecting the likelihood of monkeypox's emergence and spread in the post-smallpox era.
In 1980, the World Health Assembly announced that smallpox had been successfully eradicated as a disease of humans. The disease clinically and immunologically most similar to smallpox is monkeypox, a zoonosis endemic to moist forested regions in West and Central Africa. Smallpox vaccine provided protection against both infections. Monkeypox virus is a less efficient human pathogen than the agent of smallpox, but absent smallpox and the population-wide immunity engendered during eradication efforts, could monkeypox now gain a foothold in human communities? We discuss possible ecologic and epidemiologic limitations that could impede monkeypox's emergence as a significant pathogen of humans, and evaluate whether genetic constrains are sufficient to diminish monkeypox virus' capacity for enhanced specificity as a parasite of humans.
US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, 1600 Clifton Rd. NE, Atlanta, GA 30333, USA. Nzr6@cdc.gov
Mary G
MG
Reynolds
Darin S
DS
Carroll
Kevin L
KL
Karem
D000350:Africa, Central / Q000453:epidemiology; D000354:Africa, Western / Q000453:epidemiology; D000818:Animals; D017753:Ecosystem; D006801:Humans; D045908:Mpox, Monkeypox / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission*; D008993:Monkeypox virus / Q000276:immunology / Q000472:pathogenicity; D018570:Risk Assessment; D015047:Zoonoses / Q000635:transmission*