Monkeypox Virus

Authored by: Joseph E. Blaney , Reed F. Johnson

Manual of Security Sensitive Microbes and Toxins

Print publication date:  April  2014
Online publication date:  April  2014

Print ISBN: 9781466553965
eBook ISBN: 9781466553989
Adobe ISBN:


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Monkeypox virus (MPXV) is a zoonotic pathogen endemic to Central and West Africa that causes disease resembling human discrete ordinary-type smallpox but with a lower case fatality rate. The virus is maintained in several species of rodents in Africa and routinely enters the human population causing sporadic disease outbreaks. Fortunately, human-to-human transmission of MPXV is relatively low when compared to variola virus, the causative agent of smallpox, so disease outbreaks are limited. The threat posed to public health outside of Africa was illustrated by the recent introduction of MPXV to the United States in 2003 through importation of rodents for exotic pets. Thirty-seven individuals were confirmed to have been infected and several were hospitalized. While this event demonstrated that MPXV could spread to nonendemic regions by normal commerce or travel, there are also significant concerns that MPXV could be used for bioterrorism. While not as deadly or easily transmitted as variola virus, monkeypox would be considerably easier for a malefactor to obtain. A deliberate introduction of a virulent MPXV strain would likely cause significant morbidity and considerable social and economic interruption. Infection with MPXV results in disease characterized by the pathognomonic rash, fever, malaise, and lymphadenopathy. The case fatality rate has been reported to be between 1% and 10%. Currently, there is no approved countermeasure for treatment of MPXV disease. However, immunization with smallpox vaccine (vaccinia virus) does confer protective immunity to MPXV. Here, we describe the salient features of MPXV biology, epidemiology, clinical manifestations, diagnosis, and treatment with a focus on recent investigations. Remaining questions that confront the medical and research community are identified and proposed for future study.

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