### Microbiology A pox virus. Formally Monkey Pox, now called MPox. Rather getting it from monkeys (not the host, btw), you have to worry about getting it from the head of the British secret service. ### Epidemiologic Risks Travel to or exposure to rodents from Central and West Africa. The reservoir remains unknown. Animal smuggling is hugely profitable (10 billion a year profitable [^1]) and people like odd pets. I think it is people with no personality who get a weird pet as a substitute. But with odd pets come odd infections and there was an outbreak of 71 cases of monkeypox traced to Gambian rats imported by a Texas exotic animal distributor. Exotic animals are different, I hope, from exotic dancers. I'll ask Trump; he would know. Can spread person to person, [^2] as the recent outbreak demonstrated. In that outbreak it was predominately a sexually transmitted disease. As smallpox immunity decreases and at risk populations rise, so shall the incidence of Mpox. I wonder if it will mutate in such a way as to become more infectious human to human and be the new smallpox. [^3] There is a [[Vaccine]]. ### Syndromes [[Fever]], headache followed by the pox and adenopathy. [^5] It is a mild smallpox. Lesions progress through 5 stages before falling off: Macules then Papules then Vesicles then Pustules then Scabs. The illness usually lasts for 2−4 weeks. In unvaccinated people, the case-fatality rate can be up to 10%, although lower for infection from West African than the Central African clades. ### Treatment Self-limited. [[Cidofovir]] may be effective. If you suspect MPox, the CDC will likely be involved. ### Notes Person-to-person spread is rare but can be mistaken for smallpox. As herd immunity to smallpox wanes, since we no longer vaccinate, cases of MPox are increasing. There are a variety of poxviruses besides MPox that can infect humans. I read in *Science* that there are 1.6 million undiscovered viruses in animals and about 600,000 are likely transmissible to humans. As an example, there was a novel poxvirus in an Alaskan. [^4] Well since only one person was infected, maybe it should be a short story pox virus. ### Rationalizations [^1]: https://en.wikipedia.org/wiki/Wildlife_smuggling [^2]: https://emergency.cdc.gov/han/2023/han00501.asp [^3]: Nguyen P, Ajisegiri W, Costantino V, et al. Reemergence of Human Monkeypox and Declining Population Immunity in the Context of Urbanization, Nigeria, 2017–2020. _Emerging Infectious Diseases_. 2021;27(4):1007-1014. doi:10.3201/eid2704.203569. [^4]: Springer YP, Hsu CH, Werle ZR, Olson LE, Cooper MP, Castrodale LJ, Fowler N, McCollum AM, Goldsmith CS, Emerson GL, Wilkins K, Doty JB, Burgado J, Gao J, Patel N, Mauldin MR, Reynolds MG, Satheshkumar PS, Davidson W, Li Y, McLaughlin JB. Novel Orthopoxvirus Infection in an Alaska Resident. Clin Infect Dis. 2017 Jun 15;64(12):1737-1741. doi: 10.1093/cid/cix219. PMID: 28329402; PMCID: PMC5447873. [^5]: Huhn GD, Chase RA, Dworkin MS. Monkeypox in the Western hemisphere. N Engl J Med. 2004 Apr 22;350(17):1790-1; author reply 1790-1. doi: 10.1056/NEJMc040476. PMID: 15103008.