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The transmission potential of monkeypox virus in human populations

P E Fine1, Z Jezek, B Grab

  • 1Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, UK.

Insights

Past smallpox vaccination provided 85% protection against monkeypox. As vaccine immunity wanes, monkeypox outbreaks may increase, but the virus is unlikely to persist in human populations.

Area of Science:

  • Epidemiology
  • Virology
  • Public Health

Background:

  • Smallpox vaccination was widely implemented globally until its eradication.
  • Monkeypox, a related orthopoxvirus, poses a potential public health threat, particularly in regions where smallpox vaccination has ceased.

Purpose of the Study:

  • To analyze monkeypox epidemiology in Zaire from 1980-1984.
  • To assess the protective effect of prior smallpox vaccination against monkeypox.
  • To evaluate the transmission potential of monkeypox in unvaccinated populations.

Main Methods:

  • Analysis of epidemiological data from Zaire (1980-1984).
  • Comparison of monkeypox attack rates in individuals with and without smallpox vaccination scars.
  • Modeling of virus transmission dynamics and epidemic potential.

Main Results:

  • Smallpox vaccination conferred approximately 85% protection against monkeypox.
  • Monkeypox virus is predicted to continue zoonotic spillover events.
  • Declining population immunity from smallpox vaccination may lead to larger and longer monkeypox epidemics.

Conclusions:

  • Routine smallpox vaccination is not recommended for monkeypox endemic areas.
  • Continued epidemiological surveillance for monkeypox is advised.
  • Monkeypox is less transmissible than smallpox and unlikely to become endemic in human populations without vaccination.

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