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Monkeypox is a zoonotic illness caused by the monkeypox virus, an Orthopoxvirus in the same genus as the variola, vaccinia, and cowpox viruses. Since the detection of the first human case in the Democratic Republic of the Congo in 1970, the disease has caused sporadic infections and outbreaks, mainly restricted to some countries in west and central Africa. In July, 2022, WHO declared monkeypox a Public Health Emergency of International Concern, on account of the unprecedented global spread of the disease outside previously endemic countries in Africa and the need for global solidarity to address this previously neglected disease. The 2022 outbreak has been primarily associated with close intimate contact (including sexual activity) and most cases have been diagnosed among men who have sex with men, who often present with novel epidemiological and clinical characteristics. In the 2022 outbreak, the incubation period ranges from 7 days to 10 days and most patients present with a systemic illness that includes fever and myalgia and a characteristic rash, with papules that evolve to vesicles, pustules, and crusts in the genital, anal, or oral regions and often involve the mucosa. Complications that require medical treatment (eg, antiviral therapy, antibacterials, and pain control) occur in up to 40% of patients and include rectal pain, odynophagia, penile oedema, and skin and anorectal abscesses. Most patients have a self-limited illness; between 1% and 13% require hospital admission (for treatment or isolation), and the case-fatality rate is less than 0·1%. A diagnosis can be made through the presence of Orthopoxvirus DNA in PCRs from lesion swabs or body fluids. Patients with severe manifestations and people at risk of severe disease (eg, immunosuppressed people) could benefit from antiviral treatment (eg, tecovirimat). The current strategy for post-exposure prophylaxis or pre-exposure prophylaxis for people at high risk is vaccination with the non-replicating modified vaccinia Ankara. Antiviral treatment and vaccines are not yet available in endemic countries in Africa. [ABSTRACT FROM AUTHOR]

Mpox (formerly known as monkeypox) is a zoonotic viral disease endemic in parts of Africa. In May, 2022, the world was alerted to circulation of monkeypox virus in many high-income countries outside of Africa. Continued spread resulted in a WHO declaration of a Public Health Emergency of International Concern. Although there has been much attention on the global outbreak, most of the focus has been on high-income countries outside of Africa, despite the fact that monkeypox virus has been causing disease in parts of Africa for at least 50 years. Furthermore, the long-term consequences of this event, especially the risk that mpox fills the niche vacated through smallpox eradication, have not been sufficiently considered. The heart of the problem is the historical neglect of mpox in Africa where the disease is endemic, and the actual and potential consequences if this neglect is left uncorrected. [ABSTRACT FROM AUTHOR]

Summary The WHO declared smallpox eradicated in 1980. However, concern over its potential use by terrorists or in biowarfare has led to striking growth in research related to this much-feared disease. Modern molecular techniques and new animal models are advancing our understanding of smallpox and its interaction with the host immune system. Rapid progress is likewise being made in smallpox laboratory diagnostics, smallpox vaccines, and antiviral medications. WHO and several nations are developing stockpiles of smallpox vaccine for use in the event the disease is reintroduced. National and international public-health agencies have also drawn up plans to help with early detection of and response to a smallpox outbreak. These plans hinge on physicians' ability to recognise the clinical features of smallpox and to distinguish it from other illnesses characterised by rashes. [ABSTRACT FROM AUTHOR]

Offers an article from the department of medical history on the earliest vaccination. Benjamin Jesty as the lesser known architect of the methods despite the conventional belief that Edward Jenner was the inventor; Background on Jesty and his role in the society of the time; Details on the smallpox epidemic of the era; What Jesty did to protect his family from the outbreak; His recording reasonings behind his decision.

The authors discuss the success of the public health campaigns led by the World Health Organization (WHO) to eradicate smallpox. They note that authorized variola virus inventories are conducted in the U.S. Centers for Disease Control and Prevention (CDC) and Russia's State Research Centre of Virology and Biotechnology. They also discuss the study of monkeypox, a mild smallpox-like disease in west and central Africa and suggest for handiness of smallpox vaccines to decimate this disease.

Focuses on global pandemics and how countries should respond. Issue of vaccination; Description of the severe acute respiratory syndrome (SARS) that affected China; Assertion that if smallpox or SARS were to reappear, the outbreak would be quickly controlled; What communities can do to prepare for a pandemic.

The article offers information on rubella and its evolution since diagnosis in the mid-20th century. Topics include symptoms such as fever and red rash leading to serious sickness in the form of measles and death from a bout of smallpox, according to Australian ophthalmologist Norman Gregg, maternal rubella infection causing deafness and congenital blindness; and congenital rubella syndrome (CRS) evolved from the U.S. epidemic in 1964-65 showed damage to almost every organ system.

The authors comment on the discussion over the destruction of the last natural stocks of the variola virus stored in World Health Organization-approved laboratories. Topics discussed include synthetic biology, genomics and proteomics, the investigational antiviral drugs, and the repurpose of existing drugs. Also examined are the use of kinomics and the outbreaks of monkeypox in Congo.

The article focuses on the vital role of Cladius Galenus, also known as Galen of Pergamon, in the medical industry. Galen is renowned not only for his anatomical discoveries and medical doctrines, but he is also responsible for finding treatment for malaria, pandemic smallpox and other illnesses. Moreover, he is also considered the founding figure of clinical medicine.

The author reflects on the developments in the eradication of smallpox since the 1980s. The author references the Expanded Programme on Immunization (EPI) established by the World Health Organization (WHO). The author points out that the success of global smallpox eradication will only be realized if factors like continued presence of variations in training, attitude and commitment in groups involved in vaccination will be acknowledged. Additionally, the author notes other insights than can be gained from the eradication efforts.

This article focuses on the 60th anniversary of the World Health Organisation (WHO). The article chronicles the achievements made by the WHO, arguing that its efforts to control diseases such as smallpox and SARS have been some its greatest successes. Another success noted is the 1978 Alma Ata Declaration, a plan assembled by governments of nations to create national policies, strategies, and plans of action for primary health care. The article also includes possible improvements to the WHO as suggested by global health experts.

Reason that the emergence of new terrorist threats creates new responsibilities for the medical community. How doctors would be expected to recognize and take action against ailments that may be inflicted through bioterrorism, such as botulism, anthrax, and smallpox; Efforts of the U.S. Centers for Disease Control to prioritize threats of biological agents based on the potential effects of each; Need for fundamental education and training of doctors regarding bioterrorist threats.

Editorial. Debates on the destruction of the remaining stocks of smallpox virus. Further studies on the virus genome; Cloning and sequencing of the genome of representative strains into bacterial plasmids; Merits of smallpox as a biological weapon; Absence of vaccination; Advisory committee of the World Health Organization.

The article presents the career profile of Bill Foege, who worked as a consultant for the U.S. Centers for Disease Control and Prevention (CDC) on smallpox eradication in a remote part of eastern Nigeria. It states that Foege was brought up in a rural farming community in Iowa. It states that he also worked as a Director of the CDC from 1977 to 1983 and under his stewardship CDC tackled controversies related to toxic shock syndrome and aspirin.

The article focuses on a portrait of Benjamin Jesty which was done in 1805 by Michel W. Sharp. Jesty was a farmer from England who faced a smallpox epidemic in 1774 and decide to make his own smallpox vaccine for his wife and two sons from cowpox lymph taken from lesions on the udder of a smallpox infected cow that he owned. In 1805 Jesty accepted an invitation to visit the offices of the Original Vaccine Pock Institution in London, where he met with the institution's physicians, surgeons and apothecaries to discuss his vaccination efforts. The group was so impressed with Jesty's work that they commissioned the painting to honor him.

Reports on the World Health Assembly's program to globally eradicate smallpox. Costs of such a program; Success of the program.

Presents a letter to the editor in regards to an article published in a previous issue which discussed smallpox vaccination in the shadow of Jenner.

Presents a letter to the editor in response to the article "Putting Jenner back in his place," by Gabriel Scally and Isabel Oliver in the October 4, 2003 issue.

Presents a letter to the editor in response to the article "Putting Jenner back in his place," by Gabriel Scally and Isabel Oliver in the October 4, 2003 issue.

Focuses on the statue of Edward Jenner, a scientist who developed the smallpox vaccine. Modern concerns about smallpox being used as a biological weapon.

Mentions several web sites. A site devoted to the issue of diabetes in India; Dengue fever web site; Other web sites with information about mad cow disease and smallpox.

Reports that United States military officials are expecting that Iraq will use chemical and biological weapons against the U.S. and allied forces in the event of a war. How Iraqi President Saddam Hussein has used such weapons in the past; Statement that U.S. officials suspect that Saddam's arsenal includes nerve agents such as Soman and sarin; How U.S. troops have been vaccinated against anthrax and smallpox; Detection devices that trigger whenever they detect anything that resembles a chemical or biological weapon; Report that U.S. troops have been equipped with auto-injection kits so they can give themselves injections of the nerve-agent antidote atropine followed by 2-pralidoxime.

Discusses U.S. strategies for dealing with a possible smallpox attack. Recommendation of the Advisory Committee for Immunization Practices of a surveillance-and- containment strategy in which only those in direct contact with the virus receive immunizations; Study by Edward Kaplan and colleagues which suggested that mass vaccination might be more affective; Plans to vaccinate health and emergency workers in advance.

Discusses the use of hexadecyloxy-propyl-cidofovir (HDP-cidofovir), an oral drug, against smallpox. Comparison of HDP-cidofovir to cidofovir, which must be taken intravenously, by research Karl Hostetler, including their effectiveness in treating herpesvirus; Thoughts on Tom Monath of drug company Acambis on the licensing of this drug.

Focuses on efforts of public health officials to confront the threat of bioterrorism. Campaign of D.A. Henderson, who believes that anthrax and smallpox are weapons of the future, for a more transparent and more efficient public-health system; Death of Robert Stevens in Florida from inhalational anthrax exposure; Reassurances given to Great Britain by the Chief Medical Officer that Britain was well prepared to face bioterrorist attacks.

Reports that health and security experts in India have accused the United States and Russia of deliberately delaying the destruction of the remaining samples of smallpox virus they hold. Concern that samples retained at the U.S. Centers of Disease Control and the Russian State Center of Virology and Biotechnology could be used for biological warfare; How the World Health Assembly has repeatedly supported keeping samples despite the recommendations of the World Health Organization's orthopox virus committee.

Offers various medical related news briefs as of December 18, 1999. Includes how psychiatrist Heinrich Gross who faces charges in connection with the murder of nine children during Hitler's program of racial cleansing, may face further charges; Recommendation for more research to be done on smallpox prior to 2002; How the names Sharon and Tracey have become synonymous with young girls of easy virtue in Great Britain.

Reports on the 191-nation annual World Health Assembly (WHA) held in Switzerland in May 1999. The WHA approval of a working budget; Keynote speaker, Amartya Sen, 1998 Nobel economic prize winner; Passage of a resolution for the retention of variola virus stocks until 2002; The Revised Drug Strategy that will support efforts to protect consumers from unsafe drugs. INSET: Zuma is given Tobacco Free World award by WHO, by Adele Baleta.

Editorial. Offers opinions on the possibility of a smallpox outbreak. Experts' belief that stocks of smallpox virus exist beyond laboratories at the United States Centers for Disease Control and Prevention in Georgia and the Russian state Research Center of Virology and Biotechnology; Unavailability of the vaccines; Details of the debate over the destruction of the remaining stocks of smallpox; Suggestion to replenish the vaccine supplies to prevent an epidemic.

Presents several brief news articles related to medicine for May 1, 1999. Plans for a delay in the destruction of United States stocks of smallpox virus; Trial of Turkish doctor Cumhur Akpinar; Number of HIV-positive defense personnel in the Indian army.

Reports on the World Health Organization Ad Hoc Committee on Orthopoxvirus's decision to destroy the remaining stock of small pox virus kept in the United States and Russia.