Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan;31(1):27-31.
doi: 10.3201/eid3101.241230. Epub 2024 Dec 3.

The Rise of Mpox in a Post-Smallpox World

Jennifer H McQuiston, Andrea McCollum, Athalia Christie, Fernando Torres, Jonathan Mermin, Daniel B Jernigan, Christina L Hutson

The Rise of Mpox in a Post-Smallpox World

Jennifer H McQuiston et al. Emerg Infect Dis. 2025 Jan.

Abstract

Reports of mpox are rising in Africa where the disease is endemic and in new countries where the disease has not been previously seen. The 2022 global outbreak of clade II mpox and an ongoing outbreak of the more lethal clade I mpox highlight the pandemic potential for monkeypox virus. Waning population immunity after the cessation of routine immunization for smallpox plays a key role in the changing epidemiologic patterns of mpox. Sustained human-to-human transmission of mpox is occurring widely in the context of insufficient population immunity, fueling genetic mutations that affect the accuracy of some diagnostic tests and that could lead to changing virulence. Additional research should address complex challenges for control of mpox, including improved diagnostics and medical countermeasures. The availability of vaccines should be expanded not only for outbreak response but also for broader routine use for persons in mpox-endemic countries.

Keywords: monkeypox virus; mpox; orthopox vaccine; outbreak; smallpox; vaccines; viruses.

PubMed Disclaimer

References

    1. Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, et al. The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis. 2022;16:e0010141. 10.1371/journal.pntd.0010141 - DOI - PMC - PubMed
    1. McQuiston JH, Braden CR, Bowen MD, McCollum AM, McDonald R, Carnes N, et al. The CDC domestic mpox response—United States, 2022–2023. MMWR Morb Mortal Wkly Rep. 2023;72:547–52. 10.15585/mmwr.mm7220a2 - DOI - PMC - PubMed
    1. World Health Organization. 2022–24 mpox (monkeypox) outbreak: global trends [cited 2024 Oct 24]. https://worldhealthorg.shinyapps.io/mpx_global/#34_Tables
    1. McQuiston JH, Luce R, Kazadi DM, Bwangandu CN, Mbala-Kingebeni P, Anderson M, et al.; CDC 2024 Clade I Mpox Response Team. CDC 2024 Clade I Mpox Response Team. U.S. preparedness and response to increasing clade I mpox cases in the Democratic Republic of the Congo—United States, 2024. MMWR Morb Mortal Wkly Rep. 2024;73:435–40. 10.15585/mmwr.mm7319a3 - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention. Mpox caused by human-to-human transmission of monkeypox virus in the Democratic Republic of the Congo with spread to neighboring countries [cited 2024 Aug 7]. https://emergency.cdc.gov/han/2024/han00513.asp

LinkOut - more resources