Factors affecting the likelihood of monkeypox's emergence and spread in the post-smallpox era

Curr Opin Virol. 2012 Jun;2(3):335-43. doi: 10.1016/j.coviro.2012.02.004. Epub 2012 Mar 6.


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.

Publication types

  • Review

MeSH terms

  • Africa, Central / epidemiology
  • Africa, Western / epidemiology
  • Animals
  • Ecosystem
  • Humans
  • Monkeypox / epidemiology*
  • Monkeypox / prevention & control
  • Monkeypox / transmission*
  • Monkeypox virus / immunology
  • Monkeypox virus / pathogenicity
  • Risk Assessment
  • Zoonoses / transmission*