<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Infectious Disorders - Drug Targets</journal-id><journal-title-group><journal-title xml:lang="en">Infectious Disorders - Drug Targets</journal-title><trans-title-group xml:lang="ru"><trans-title>Infectious Disorders - Drug Targets</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1871-5265</issn><issn publication-format="electronic">2212-3989</issn><publisher><publisher-name xml:lang="en">Bentham Science</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">645438</article-id><article-id pub-id-type="doi">10.2174/1871526523666230823105945</article-id><article-categories><subj-group subj-group-type="toc-heading"><subject>Medicine</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Emergence of Monkeypox (MPX): A Close Relative of Small Pox During COVID-19 Era</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kour</surname><given-names>Ivneet</given-names></name><email>info@benthamscience.net</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name><surname>Singhal</surname><given-names>Lipika</given-names></name><email>info@benthamscience.net</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name><surname>Mehta</surname><given-names>Sonia</given-names></name><email>info@benthamscience.net</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name><surname>Gupta</surname><given-names>Varsha</given-names></name><email>info@benthamscience.net</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff id="aff1"><institution>Department of Microbiology, Government Medical College &amp; Hospital</institution></aff><aff id="aff2"><institution>Department of Microbiology, MMU</institution></aff><pub-date date-type="pub" iso-8601-date="2024-01-01" publication-format="electronic"><day>01</day><month>01</month><year>2024</year></pub-date><volume>24</volume><issue>1</issue><history><date date-type="received" iso-8601-date="2025-01-11"><day>11</day><month>01</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2024, Bentham Science Publishers</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="en">Bentham Science Publishers</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/></permissions><self-uri xlink:href="https://journals.eco-vector.com/1871-5265/article/view/645438">https://journals.eco-vector.com/1871-5265/article/view/645438</self-uri><abstract xml:lang="en"><p id="idm46466589630544">After the eradication of smallpox (SPX), a new zoonotic threat that can trigger outbreaks has emerged. It may be fatal during the COVID19 outbreak. Humanity continues to be threatened due to re-emergence of the outbreaks. In most cases, new emerging viral agents originate from nonhuman hosts with zoonotic origins. Recent outbreaks of zoonotic infectious diseases with the potential to cause epidemics and pandemics continue to pose a major threat to the health security of entire regions, continents, and the world at large. Around five decades backthat Monkeypox (MPX) was reported for the first time in the Democratic Republic of the Congo (DRC) and was then confined to Central Africa only. Over the time, it has spread to other regions of Africa as well as outside Africa. As of August 2022, 40398 infections have been confirmed in almost 68 countries that have never reported MPX before. The majority of infections have been reported in Europe and Southeast Asia. On 23rd August 2022, MPX was declared a public health emergency of international concern, a step below declaring any disease as a pandemic. The article discusses the recent history of MPX outbreaks, as well as the evolving clinical manifestations of the disease, and the possible causes of the increase in cases, including the cessation of SPX vaccinations.</p></abstract><kwd-group xml:lang="en"><kwd>Eradication of small pox</kwd><kwd>emerging zoonotic disease</kwd><kwd>MPX and SPX</kwd><kwd>vaccines</kwd><kwd>COVID-19</kwd><kwd>democratic republic of the congo (DRC).</kwd></kwd-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Chauhan V, Thakur S, Kelkar D, et al. Why should RNA viruses have all the fun - Monkeypox, a close relative of smallpox and a DNA virus. J Glob Infect Dis 2022; 14(2): 47-9. doi: 10.4103/jgid.jgid_104_22 PMID: 35910829</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Woolhouse MJ, Adair K, Brierley L. RNA viruses: A case study of the biology of emerging infectious diseases. Microbiol Spectr 2013; 1(1)</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Mourya D, Yadav P, Ullas PT, et al. Emerging/re-emerging viral diseases &amp; new viruses on the Indian horizon. Indian J Med Res 2019; 149(4): 447-67. doi: 10.4103/ijmr.IJMR_1239_18 PMID: 31411169</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Sklenovská N, Van Ranst M. Emergence of monkeypox as the most important orthopoxvirus infection in humans. Front Public Health 2018; 6: 241. doi: 10.3389/fpubh.2018.00241 PMID: 30234087</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Woolhouse MEJ, Brierley L, McCaffery C, Lycett S. Assessing the epidemic potential of RNA and DNA Viruses. Emerg Infect Dis 2016; 22(12): 2037-44. doi: 10.3201/eid2212.160123 PMID: 27869592</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Ejaz H, Junaid K, Younas S, et al. Emergence and dissemination of monkeypox, an intimidating global public health problem. J Infect Public Health 2022; 15(10): 1156-65. doi: 10.1016/j.jiph.2022.09.008 PMID: 36174285</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Shafaati M, Zandi M. Human monkeypox (hMPXV) re‐emergence: Host immunity status and current vaccines landscape. J Med Virol 2023; 95(1): e28251. doi: 10.1002/jmv.28251 PMID: 36271768</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Riedel S. Smallpox and biological warfare: A disease revisited. Proc Bayl Univ Med Cent 2005; 18(1): 13-20.</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Singhal L, Kour I, Gupta V. Diagnostic Stewardship in Times of COVID-19 Pandemic. Infect Disord Drug Targets 2022; 22(5): e270122200587. doi: 10.2174/1871526522666220127115718 PMID: 35086460</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Commemorating Smallpox Eradication. A legacy of hope, for COVID-19 and other diseases. 2022. Available from: https://www.who.int/news/item/08-05-2020-commemorating-smallpox-eradication-a-legacy-of (cited 13 July 2022)</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Ligon BL. Monkeypox: A review of the history and emergence in the Western hemisphere. Semin Pediatr Infect Dis 2004; 15(4): 280-7. doi: 10.1053/j.spid.2004.09.001 PMID: 15494953</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Colavita F, Antinori A, Nicastri E, Focosi D, Girardi E, Vaia F, et al. Monkeypox virus in human body sites and fluids: evidence for transmission. Lancet Infect Dis 2022; 23(1): 6-8. PMID: 36183708</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Ladnyj ID, Ziegler P, Kima E. A human infection caused by monkeypox virus in basankusu territory, democratic republic of the congo. Bull World Health Organ 1972; 46(5): 593-7. PMID: 4340218</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Reynolds MG, Doty JB, McCollum AM, Olson VA, Nakazawa Y. Monkeypox re-emergence in Africa: A call to expand the concept and practice of One Health. Expert Rev Anti Infect Ther 2019; 17(2): 129-39. doi: 10.1080/14787210.2019.1567330 PMID: 30625020</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Monkeypox: Experts give virus variants new names. 2022. Available from: https://www.who.int/news/item/12-08-2022-monkeypox--experts-give-virus-variants-new-names (cited 16 August 2022).</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>Monkeypox. . 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/monkeypox</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>Kozlov M. Monkeypox in Africa: the science the world ignored. Nature 2022; 607(7917): 17-8. doi: 10.1038/d41586-022-01686-z PMID: 35739391</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Bunge EM, Hoet B, Chen L, et al. The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis 2022; 16(2): e0010141. doi: 10.1371/journal.pntd.0010141 PMID: 35148313</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Nigeria Centre for Disease Control Nigeria monkeypox monthly situation report. 2019. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/5a1a9820f21136842ba43f186b8d09e7.pdf</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Shanmugaraj B, Phoolcharoen W, Khorattanakulchai N. Emergence of monkeypox: Another concern amidst COVID-19 crisis. Asian Pac J Trop Med 2022; 15(5): 193-5. doi: 10.4103/1995-7645.346081</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Fenner F, Henderson DA, Arita I, Jezek Z, Ladnyi ID. Smallpox and its eradication. Geneva: World Health Organization 1988.</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Schneider WH. Smallpox in Africa during colonial rule. Med Hist 2009; 53(2): 193-227. doi: 10.1017/S002572730000363X PMID: 19367346</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Doty J, Malekani J, Kalemba L, et al. Assessing monkeypox virus prevalence in small mammals at the human-animal interface in the democratic republic of the Congo. Viruses 2017; 9(10): 283. doi: 10.3390/v9100283 PMID: 28972544</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Concern grows that human monkeypox outbreak will establish virus in animals outside Africa. 2022. Available from: https://www.science.org/content/article/concern-grows-human-monkeypox-outbreak-willestablish-well (cited 10 October 2022).</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Centers for Disease Control and Prevention. Preliminary report: Multistate outbreak of monkeypox in persons exposed to pet prairie dogs. Available from: http://www.cdc.gov/ncidod/monkeypox/report060903.htm</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>The Lancet Regional Health - Europe. Lessons from COVID-19 are shaping the response to monkeypox outbreak. Lancet Reg Health Eur 2022; 18: 100463. doi: 10.1016/j.lanepe.2022.100463 PMID: 35791347</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Multi-country monkeypox outbreak: situation update. 2022. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON396 (cited 10 October 2022).</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Philip S. 35-yr-old from Kerala is Indias first monkeypox case; Centre sends team. The Indian Express 2022; p. 3.</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Yadav PD, Reghukumar A, Sahay RR, et al. First two cases of Monkeypox virus infection in travellers returned from UAE to India, July 2022. J Infect 2022; 85(5): e145-8. doi: 10.1016/j.jinf.2022.08.007</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Haller SL, Peng C, McFadden G, Rothenburg S. Poxviruses and the evolution of host range and virulence. Infect Genet Evol 2014; 21: 15-40. doi: 10.1016/j.meegid.2013.10.014 PMID: 24161410</mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation>Hutson CL, Olson VA, Carroll DS, et al. A prairie dog animal model of systemic orthopoxvirus disease using West African and Congo Basin strains of monkeypox virus. J Gen Virol 2009; 90(2): 323-33. doi: 10.1099/vir.0.005108-0 PMID: 19141441</mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation>Alakunle EF, Okeke MI. Monkeypox virus: A neglected zoonotic pathogen spreads globally. Nat Rev Microbiol 2022; 20(9): 507-8. doi: 10.1038/s41579-022-00776-z PMID: 35859005</mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation>Iñigo Martínez J, Gil Montalbán E, Jiménez Bueno S, et al. Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022. Euro Surveill 2022; 27(27): 2200471. doi: 10.2807/1560-7917.ES.2022.27.27.2200471 PMID: 35801519</mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation>Word Health Organization (WHO). Disease Outbreak News Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON393 (accessed on 15 June 2022).</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation>Ribeiro S, Martins JV, Casaca P, Leite PP, Tavares M, Mansinho K, et al. Ongoing monkeypox virus outbreak, portugal, 29 april to 23 may 2022. euro surveillance: Bulletin europeen sur les maladies transmissibleeuropean. Commun Dis Bull 2022; 27(22)</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation>MikeS.If monkeypox spreads through sexual contact, is it an STD? Los Angeles Times 2022. ;7.</mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation>Multi-country outbreak of monkeypox, External situation report #3 - 10 August 2022. 2022. Available from: www.who.int/publications/m/item/multi-country-outbreak-of-monkeypox-external (cited 16 August 2022).</mixed-citation></ref><ref id="B38"><label>38.</label><mixed-citation>Wang Y, Leng P. Global transmission of Monkeypox virusa potential threat under the COVID-19 pandemic. Front Immunol 2023; 14: 1174223. doi: 10.3389/fimmu.2023.1174223</mixed-citation></ref><ref id="B39"><label>39.</label><mixed-citation>Lum FM, Torres-Ruesta A, Tay MZ, et al. Monkeypox: Disease epidemiology, host immunity and clinical interventions. Nat Rev Immunol 2022; 22(10): 597-613. doi: 10.1038/s41577-022-00775-4 PMID: 36064780</mixed-citation></ref><ref id="B40"><label>40.</label><mixed-citation>McCollum AM, Damon IK. Human monkeypox. Clin Infect Dis 2014; 58(2): 260-7. doi: 10.1093/cid/cit703 PMID: 24158414</mixed-citation></ref><ref id="B41"><label>41.</label><mixed-citation>Vivancos R, Anderson C, Blomquist P, et al. Community transmission of monkeypox in the United Kingdom, April to May 2022. Euro Surveill 2022; 27(22): 2200422. doi: 10.2807/1560-7917.ES.2022.27.22.2200422 PMID: 35656834</mixed-citation></ref><ref id="B42"><label>42.</label><mixed-citation>Guarner J, Johnson BJ, Paddock CD, et al. Monkeypox transmission and pathogenesis in prairie dogs. Emerg Infect Dis 2004; 10(3): 426-31. doi: 10.3201/eid1003.030878 PMID: 15109408</mixed-citation></ref><ref id="B43"><label>43.</label><mixed-citation>Bras G. Observations on the formation of smallpox scars. AMA Arch Pathol 1952; 54(2): 149-56. PMID: 14943347</mixed-citation></ref><ref id="B44"><label>44.</label><mixed-citation>Jezek Z, Szczeniowski M, Paluku KM, Mutombo M. Human monkeypox: Clinical features of 282 patients. J Infect Dis 1987; 156(2): 293-8. doi: 10.1093/infdis/156.2.293 PMID: 3036967</mixed-citation></ref><ref id="B45"><label>45.</label><mixed-citation>Likos AM, Sammons SA, Olson VA, et al. A tale of two clades: Monkeypox viruses. J Gen Virol 2005; 86(10): 2661-72. doi: 10.1099/vir.0.81215-0 PMID: 16186219</mixed-citation></ref><ref id="B46"><label>46.</label><mixed-citation>Simpson K, Heymann D, Brown CS, et al. Human monkeypox - After 40 years, an unintended consequence of smallpox eradication. Vaccine 2020; 38(33): 5077-81. doi: 10.1016/j.vaccine.2020.04.062 PMID: 32417140</mixed-citation></ref><ref id="B47"><label>47.</label><mixed-citation>Moss B. Smallpox vaccines: Targets of protective immunity. Immunol Rev 2011; 239(1): 8-26. doi: 10.1111/j.1600-065X.2010.00975.x PMID: 21198662</mixed-citation></ref><ref id="B48"><label>48.</label><mixed-citation>Spicknall IH, Pollock ED, Clay PA, et al. Modeling the impact of sexual networks in the transmission of monkeypox virus among gay, bisexual, and other men who have sex with men  united states, 2022. MMWR Morb Mortal Wkly Rep 2022; 71(35): 1131-5. doi: 10.15585/mmwr.mm7135e2 PMID: 36048619</mixed-citation></ref><ref id="B49"><label>49.</label><mixed-citation>Cursino M. Monkeypox: First deaths outside Africa in Brazil and Spain. BBC 2022.</mixed-citation></ref><ref id="B50"><label>50.</label><mixed-citation>World Health Organization. Vaccines and Immunization for Monkeypox: Interim Guidance.</mixed-citation></ref><ref id="B51"><label>51.</label><mixed-citation>von Krempelhuber A, Vollmar J, Pokorny R, et al. A randomized, double-blind, dose-finding Phase II study to evaluate immunogenicity and safety of the third generation smallpox vaccine candidate IMVAMUNE®. Vaccine 2010; 28(5): 1209-16. doi: 10.1016/j.vaccine.2009.11.030 PMID: 19944151</mixed-citation></ref><ref id="B52"><label>52.</label><mixed-citation>Rao AK, Petersen BW, Whitehill F, et al. Use of jynneos (smallpox and monkeypox vaccine, live, nonreplicating) for preexposure vaccination of persons at risk for occupational exposure to orthopoxviruses: Recommendations of the advisory committee on immunization practices  united states, 2022. MMWR Morb Mortal Wkly Rep 2022; 71(22): 734-42. doi: 10.15585/mmwr.mm7122e1 PMID: 35653347</mixed-citation></ref><ref id="B53"><label>53.</label><mixed-citation>Jackson LA, Frey SE, El Sahly HM, et al. Safety and immunogenicity of a modified vaccinia Ankara vaccine using three immunization schedules and two modes of delivery: A randomized clinical non-inferiority trial. Vaccine 2017; 35(13): 1675-82. doi: 10.1016/j.vaccine.2017.02.032 PMID: 28256358</mixed-citation></ref><ref id="B54"><label>54.</label><mixed-citation>Nishiyama Y, Fujii T, Kanatani Y, Shinmura Y, Yokote H, Hashizume S. Freeze-dried live attenuated smallpox vaccine prepared in cell culture "LC16-KAKETSUKEN": Post-marketing surveillance study on safety and efficacy compliant with Good Clinical Practice. Vaccine 2015; 33(45): 6120-7. doi: 10.1016/j.vaccine.2015.09.067 PMID: 26455406</mixed-citation></ref><ref id="B55"><label>55.</label><mixed-citation>Petersen BW, Harms TJ, Reynolds MG, Harrison LH. Use of vaccinia virus smallpox vaccine in laboratory and health care personnel at risk for occupational exposure to orthopoxviruses-recommendations of the Advisory Committee on Immunization Practices (ACIP), 2015. MMWR Morb Mortal Wkly Rep 2016; 65(10): 257-62. doi: 10.15585/mmwr.mm6510a2 PMID: 26985679</mixed-citation></ref><ref id="B56"><label>56.</label><mixed-citation>Interim Clinical Considerations for Use of JYNNEOS and ACAM2000 Vaccines during the 2022 U.S. Mpox Outbreak. 2022. Available from: https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html</mixed-citation></ref><ref id="B57"><label>57.</label><mixed-citation>Grosenbach DW, Honeychurch K, Rose EA, et al. Oral tecovirimat for the treatment of smallpox. N Engl J Med 2018; 379(1): 44-53. doi: 10.1056/NEJMoa1705688 PMID: 29972742</mixed-citation></ref><ref id="B58"><label>58.</label><mixed-citation>Russo AT, Berhanu A, Bigger CB, et al. Co-administration of tecovirimat and ACAM2000 in non-human primates: Effect of tecovirimat treatment on ACAM2000 immunogenicity and efficacy versus lethal monkeypox virus challenge. Vaccine 2020; 38(3): 644-54. doi: 10.1016/j.vaccine.2019.10.049 PMID: 31677948</mixed-citation></ref><ref id="B59"><label>59.</label><mixed-citation>Correction to Lancet Infect Dis. Outcomes of flucytosine-containing combination treatment for cryptococcal meningitis in a South African national access programme: A cross-sectional observational study. Lancet Infect Dis 2022; 22(9): 1365-73. doi: 10.1016/S1473-3099(22)00234-1</mixed-citation></ref><ref id="B60"><label>60.</label><mixed-citation>Siegrist E, Sassine J. Antivirals with activity against monkeypox: A clinically oriented review. Clin Infect Dis 2022; 76(1): 155-64. PMID: 35904001</mixed-citation></ref><ref id="B61"><label>61.</label><mixed-citation>Dounias E, Ichikawa M. Seasonal bushmeat hunger in the congo basin. EcoHealth 2017; 14(3): 575-90. doi: 10.1007/s10393-017-1252-y PMID: 28707044</mixed-citation></ref><ref id="B62"><label>62.</label><mixed-citation>Bidaisee S, Macpherson CN. Zoonoses and one health: A review of the literature. J Parasitol Res 2014; 2014: 874345. doi: 10.1155/2014/874345</mixed-citation></ref><ref id="B63"><label>63.</label><mixed-citation>Di Gennaro F, Veronese N, Marotta C, et al. Human monkeypox: A comprehensive narrative review and analysis of the public health implications. Microorganisms 2022; 10(8): 1633. doi: 10.3390/microorganisms10081633 PMID: 36014051</mixed-citation></ref></ref-list></back></article>
