A narrative review of pox: smallpox vs monkeypox

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• Monkeypox virus (MPXV), a relative of the variola virus, causes a less severe febrile rash illness in humans.
• Historically, human monkeypox was a rare zoonotic disease confined to West and Central Africa.
• Declining smallpox vaccine-induced immunity in the global population correlates with increased MPXV cases and geographic spread.

Purpose of the Study:

• To explore the biology of the monkeypox virus (MPXV).
• To understand the recent global increase in MPXV outbreaks.
• To assess the potential public health implications of changing MPXV transmission patterns.

Main Methods:

• Review of MPXV biology.
• Analysis of recent global outbreak data.
• Epidemiological investigation of transmission patterns.

Main Results:

• MPXV is closely related to the variola virus.
• Human monkeypox cases and geographic distribution have significantly increased this century.
• Atypical outbreaks with high case numbers and no links to endemic regions have occurred since May 2022.

Conclusions:

• The decreasing immunity to smallpox may contribute to the rise in MPXV cases.
• The recent atypical outbreaks suggest a potential shift in MPXV transmission.
• The expanding reach of MPXV poses a significant global health concern.