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Smallpox was a major cause of human mortality until its eradication, but the threat of orthopox viruses has not disappeared. Since the eradication of smallpox and the cessation of the related vaccination campaigns, the threat has been growing, as evidenced by the currently ongoing worldwide Mpox outbreak. In addition to threats of an evolving Mpox, we must also be aware of a myriad of other threats that remain. Many countries still lack biosecurity regulations reflecting the recent technological advances, and the threat of bioterrorism remains ever present. Reconstruction of smallpox is a distinct possibility, as are other scenarios whereby other orthopox viruses may be made more fit for transmission in humans. To outline and discuss potential biosafety and biosecurity threats posed by orthopox viruses. Published scientific literature, news articles, and international agreements. It would be wise to take steps to mitigate these threats now. Vaccination campaigns should be considered in areas with frequent orthopox outbreaks, and more efforts must be made to put a final end to the Mpox outbreak. In many countries, national biosafety and biosecurity regulations may need to be revised and strengthened to better reflect the threats posed by new technologies, including controls on synthesis of smallpox sequences. Furthermore, more international cooperation and aid is needed. The present global Mpox outbreak could likely have been prevented had areas where Mpox is endemic not been neglected. Future outbreaks could be much worse. [ABSTRACT FROM AUTHOR]

• Two years after its discovery in 1798, the smallpox vaccine was introduced in France. • A privately funded vaccine committee was established in 1800 to evaluate its value. • An official vaccine society was established in 1804 to distribute the vaccine in France. • Vaccination activities were supported by Napoleon Bonaparte. • Different medals and tokens were issued to commemorate vaccine introduction. The smallpox vaccine developed by Jenner in 1798 was successfully introduced in France in 1800 with the support of Napoleon Bonaparte. The medals and tokens (coin-like medals) issued to encourage early-day vaccination activities are described in the context of the changing political situation in that country. In 1800 a private society of subscribers, led by the Duke of La Rochefoucauld-Liancourt was created, along with a Vaccine Committee charged with evaluating the safety and efficacy of vaccination before deciding if vaccination should be extended to the entire population. The Vaccine Committee published a positive report in 1803, and in 1804, the Ministry of the Interior established the "Society for the extinction of smallpox in France by means of the propagation of the vaccine". The creation of the Society made smallpox vaccination an official activity of the empire, facilitating collaboration between government agencies. The vaccine institution, established by Napoleon in 1804, continued its functions until 1820 when the Royal Academy of Medicine was created and took over those functions. This case exemplifies the collaboration that was needed between science and politics to rapidly bring the recently developed smallpox vaccine to the needed population. [ABSTRACT FROM AUTHOR]

Although there has been much writing and speculation on the deliberate use of smallpox as a tool of genocide, this article documents the use of the bluff threat of spreading smallpox as a tool of power and manipulation in the early days of European trade and settlement in the Pacific Northwest. By documenting ten cases when a bluff threat was used, the article argues that it was a common strategy of Europeans when they felt threatened or thwarted. Because it was compatible with existing Indigenous beliefs about the spread of disease, it was highly credible and was occasionally used by Indigenous people to manipulate others. While Europeans in this era did not actually have the power to control smallpox, the fact that outbreaks of the disease often occurred following a threat to spread it gave credence to the threat and to today's widespread belief that some or all of the epidemics were deliberate genocide. Recognizing bluff threat bioterrorism as a tool in the newcomer's arsenal is essential to understanding how the heavily outnumbered and out-gunned newcomers were so often able to manipulate Indigenous people and then establish the settlements that eventually evolved into full scale colonial occupations of Indigenous territory. [ABSTRACT FROM AUTHOR]

Mpox (formerly known as monkeypox) virus and some related poxviruses including smallpox virus pose a significant threat to public health, and effective prevention and treatment strategies are needed. This study utilized a reverse vaccinology approach to retrieve conserved epitopes for monkeypox virus and construct a vaccine that could provide cross-protection against related viruses with similar antigenic properties. The selected virulent proteins of monkeypox virus, MPXVgp165, and Virion core protein P4a, were subjected to epitope mapping for vaccine construction. Two vaccines were constructed using selected T cell epitopes and B cell epitopes with PADRE and human beta-defensins adjuvants conjugated in the vaccine sequence. Both constructs were found to be highly antigenic, non-allergenic, nontoxic, and soluble, suggesting their potential to generate an adequate immune response and be safe for humans. Vaccine construct 1 was selected for molecular dynamic simulation studies. The simulation studies revealed that the TLR8-vaccine complex was more stable than the TLR3-vaccine complex. The lower RMSD and RMSF values of the TLR8 bound vaccine compared to the TLR3 bound vaccine suggested better stability and consistency of hydrogen bonds. The Rg values of the vaccine chain bound to TLR8 indicated overall stability, whereas the vaccine chain bound to TLR3 showed deviations throughout the simulation. These results suggest that the constructed vaccine could be a potential preventive measure against monkeypox and related viruses however, further experimental validation is required to confirm these findings. [ABSTRACT FROM AUTHOR]

In this paper, we introduce a new mathematical epidemic model with the effect of vaccination. We formulate a Susceptible-High risk-Infective-Recovered-Vaccinated (SHIRV) model in which the susceptible individuals with a higher probability of being infected (H) are selected as a separate class. We study the dynamical behavior of this model and define the basic reproductive number, R0. It is proved that the disease-free equilibrium is asymptotically stable if R0 < 1, and it is unstable if R0 1. Also, we investigate the existence and stability of the endemic equilibrium point analytically. For the system of differential equations of the SHIRV model, we give an approximating solution by using the Legendre-Ritz-Galerkin method. Finally, we study the influence of vaccination on measles and smallpox, two cases of the epidemic, using the proposed method in this paper. Numerical results showed that choosing high-risk people for vaccination can prevent them from getting infected and reduce mortality in the community. [ABSTRACT FROM AUTHOR]

Objective Different library construction methods, combined with high-throughput sequencing methods, were used to understand the genetic characteristics of the virus of the first confirmed imported monkeypox case in mainland China, and to compare the advantages and disadvantages of different library types. Methods The herpetic fluids and nasopharyngeal swabs of the first imported monkeypox case in the Chinese mainland were used as samples. After nucleic acid extraction and quantification, the library was directly constructed or the amplicon library was constructed using the monkeypox virus whole genome capture kit, and the whole genome sequence of the virus was obtained by high-throughput sequencing. Combined with 34 monkeypox virus sequences downloaded from the NCBI and GISAID databases, a phylogenetic evolutionary tree was constructed using vaccinia, variola, and cowpox sequences as out groups. Results The whole genome sequence of the virus was obtained by both library construction methods, named hMpxV/China/CQ-CQCDC-001/2022, which belongs to the monkeypox virus branch lib, located in the same branch as hMpxV/Germany/BE-ChVir28656/2022 belonging to the IIb B.1 branch. Metagenomic libraries have more uniform sequence coverage than amplicon libraries, but the sequencing depth is lower and the effective data volume accounts for less. Conclusion Clade IIb B.1 monkeypox viruses have already been introduced into the mainland China, and the sequencing of subsequently discovered monkeypox viruses should be based on the sample size and sequencing timeframe, sequencing cost-effectiveness ratio, and other factors to choose the appropriate library construction method. [ABSTRACT FROM AUTHOR]

Background: Little is known about research in Foundling Hospitals during the 18th century. Summary: The London "Hospital for the Maintenance and Education of Exposed and Deserted Young Children" opened in 1741, after fundraising by the former shipmaster Thomas Coram and a Charter by King George II. From 1741 to 1756, fewer than 100 infants a year were admitted by lot. With onset of the Seven Years' War in 1756, the House of Commons resolved and financed the admission of all deserted babies. The number of admitted babies rose to 4,000 per year, and their mortality increased. The Institution was not intended as a research and teaching facility but soon became a site for gaining knowledge of young infants. Appointed physicians included Richard Conyers, William Cadogan, William Watson, and William Buchan. Their research focused on frequent conditions in the hospital's infirmary such as scabies, fever, measles, chilblains and scorbutic eruptions, and set standards for infant care and nutrition in the English-speaking world during the 18th century. They described the dangers connected with tight swaddling, meconium purgation, artificial feeding, and the difficulty to obtain wet nurses in the big cities. A major topic was their fight against smallpox, then fatal for 80% if infected infants, and the development of an effective technique of inoculation. Key Messages: Research at the London Foundling Hospital differed from modern understanding of controlled clinical trials but revealed systematic, hypothesis-driven approaches in the mid-18th century. As in other Foundling Hospitals, absent parental interference facilitated innovations. [ABSTRACT FROM AUTHOR]

Variola virus (VARV), the etiological agent of smallpox, had enormous impacts on global health prior to its eradication. In the absence of global vaccination programs, mpox virus (MPXV) has become a growing public health threat that includes endemic and nonendemic regions across the globe. While human mpox resembles smallpox in clinical presentation, there are considerable knowledge gaps regarding conserved molecular pathogenesis between these 2 orthopoxviruses. Thus, we sought to compare MPXV and VARV infections in human monocytes through kinome analysis. We performed a longitudinal analysis of host cellular responses to VARV infection in human monocytes as well as a comparative analysis to clade I MPXV-mediated responses. While both viruses elicited strong activation of cell responses early during infection as compared to later time points, several key differences in cell signaling events were identified and validated. These observations will help in the design and development of panorthopoxvirus therapeutics. [ABSTRACT FROM AUTHOR]

The Mpox (formerly named Monkeypox) virus is the etiological cause of a recent multi-country outbreak, with thousands of distinct cases detected outside the endemic areas of Africa as of December 2023. In this article, we analyze the sequences of full genomes of Mpox virus from Europe and compare them with all available Mpox sequences of historical relevance, annotated by year and geographic origin, as well as related Cowpox and Variola (smallpox) virus sequences. Our results show that the recent outbreak is most likely originating from the West African clade of Mpox, with >99 % sequence identity with sequences derived from historical and recent cases, dating from 1971 to 2017. We analyze specific mutations occurring in viral proteins between the current outbreak, previous Mpox and Cowpox sequences, and the historical Variola virus. Genome-wide sequence analysis of the recent outbreak and other Mpox/Cowpox/Variola viruses shows a very high conservation, with 97.9 % (protein-based) and 97.8 % (nucleotide-based) sequence identity. We identified significant correlation in human transcriptional responses as well, with a conserved immune pathway response induced in human cell cultures by the three families of Pox virus. The similarities identified between the major strains of Pox viruses, as well as within the Mpox clades, both at the genomic and transcriptomic levels, provide a molecular basis for the observed efficacy of Variola vaccines in other Poxviruses. [ABSTRACT FROM AUTHOR]

Monkeypox virus (MPXV), the pathogen responsible for the infectious disease monkeypox, causes lesions on the skin, lymphadenopathy, and fever. It has posed a global public health threat since May 2022. Highly sensitive and specific detection of MPXV is crucial for preventing the spread of the disease. Pyrococcus furiosus Argonaute (PfAgo) is an artificial DNA-guided restriction cleavage enzyme programmable with 5′-phosphorylated ssDNA sequences, which can be developed to specifically detect nucleic acids of pathogens. Here, a PfAgo-based system was established for the detection of MPXV-specific DNA targeting the F3L gene. A short amplicon of 79 bp could be obtained through a fast PCR procedure, which was completed within 45 min. Two 5′-phosphorylation guide DNAs were designed to guide PfAgo to cleave the amplicon to obtain an 18 bp 5′-phosphorylation sequence specific to MPXV, not to other orthopoxviruses (cowpox, variola, and vaccinia viruses). The 18 bp sequence guided PfAgo to cleave a designed probe specific to MPXV to emit fluorescence. With optimized conditions for the PfAgo-MPXV system, it could be completed in 60 min for the detection of the extracted MPXV DNA with the limit of detection (LOD) of 1.1 copies/reaction and did not depend on expensive instruments. Successful application of the PfAgo-MPXV system in sensitively detecting MPXV in simulated throat swabs, skin swabs, sera, and wastewater demonstrated the system's good performance. The PfAgo platform, with high sensitivity and specificity established here, has the potential to prevent the spread of MPXV. [ABSTRACT FROM AUTHOR]

The human monkeypox virus (Mpox) is classified as a member of the Poxviridae family and belongs to the Orthopoxvirus genus. Mpox possesses double-stranded DNA, and there are two known genetic clades: those originating in West Africa and the Congo Basin, commonly known as Central African clades. Mpox may be treated with either the vaccinia vaccination or the therapeutics. Modifying the smallpox vaccine for treating and preventing Mpox has shown to be beneficial because of the strong link between smallpox and Mpox viruses and their categorization in the same family. Cross-protection against Mpox is effective with two Food and Drug Administration (FDA)-approved smallpox vaccines (ACAM2000 and JYNNEOSTM). However, ACAM2000 has the potential for significant adverse effects, such as cardiac issues, whereas JYNNEOS has a lower risk profile. Moreover, Mpox has managed to resurface, although with modified characteristics, due to the discontinuation and cessation of the smallpox vaccine for 40 years. The safety and efficacy of the two leading mRNA vaccines against SARS-CoV-2 and its many variants have been shown in clinical trials and subsequent data analysis. This first mRNA treatment model involves injecting patients with messenger RNA to produce target proteins and elicit an immunological response. High potency, the possibility of safe administration, low-cost manufacture, and quick development is just a few of the benefits of RNA-based vaccines that pave the way for a viable alternative to conventional vaccines. When protecting against Mpox infection, mRNA vaccines are pretty efficient and may one day replace the present whole-virus vaccines. Therefore, the purpose of this article is to provide a synopsis of the ongoing research, development, and testing of an mRNA vaccine against Mpox. [ABSTRACT FROM AUTHOR]

Smallpox was the most rampant infectious disease killer of the 20th century, yet much remains unknown about the pathogenesis of the variola virus. Using archived tissue from a study conducted at the Centers for Disease Control and Prevention we characterized pathology in 18 cynomolgus macaques intravenously infected with the Harper strain of variola virus. Six macaques were placebo-treated controls, six were tecovirimat-treated beginning at 2 days post-infection, and six were tecovirimat-treated beginning at 4 days post-infection. All macaques were treated daily until day 17. Archived tissues were interrogated using immunohistochemistry, in situ hybridization, immunofluorescence, and electron microscopy. Gross lesions in three placebo-treated animals that succumbed to infection primarily consisted of cutaneous vesicles, pustules, or crusts with lymphadenopathy. The only gross lesions noted at the conclusion of the study in the three surviving placebo-treated and the Day 4 treated animals consisted of resolving cutaneous pox lesions. No gross lesions attributable to poxviral infection were present in the Day 2 treated macaques. Histologic lesions in three placebo-treated macaques that succumbed to infection consisted of proliferative and necrotizing dermatitis with intracytoplasmic inclusion bodies and lymphoid depletion. The only notable histologic lesion in the Day 4 treated macaques was resolving dermatitis; no notable lesions were seen in the Day 2 treated macaques. Variola virus was detected in all three placebo-treated animals that succumbed to infection prior to the study's conclusion by all utilized methods (IHC, ISH, IFA, EM). None of the three placebo-treated animals that survived to the end of the study nor the animals in the two tecovirimat treatment groups showed evidence of variola virus by these methods. Our findings further characterize variola lesions in the macaque model and describe new molecular methods for variola detection. Author summary: The worldwide 2022 mpox outbreak renewed research interest in defining and countering threats posed by orthopoxviruses, including smallpox. In the absence of optimized prevention and treatment strategies, natural re-emergence of smallpox or its use as a bioweapon released into unvaccinated populations could result in avoidable illnesses and deaths. Here we applied recently developed techniques to study the relationship between smallpox lesion development and the fate of virus in three groups of animals exposed to smallpox virus: those treated with the FDA-approved antiviral tecovirimat 2 or 4 days after infection and a placebo-treated group. We were able to characterize the development of lesions at gross and microscopic levels and describe new molecular methods for studying the distribution and persistence of variola virus (VARV) in tissue samples that were collected from the three treatment groups. These findings can be used to fine-tune the timing of administering tecovirimat, other antivirals, and vaccines, as well as help characterize the performance of in-development orthopoxvirus countermeasures. [ABSTRACT FROM AUTHOR]

This article draws on archival materials from late Qing Turpan Prefecture to explore Qing colonialism within the context of mass vaccination efforts in Xinjiang from 1880 to 1911. Following the reconquest of the region in 1877, Xiang Army leaders established official vaccination bureaus across Xinjiang—a colonial administration that encompassed all of East Turkestan—to combat smallpox outbreaks within Musulman (Uyghur) communities and the Qing army garrison. The vaccination bureau in Turpan, although led by Han vaccinators from Inner China, depended heavily on the labor of Musulman graduates from the region's assimilationist Confucian schools. The Turpan Vaccination Bureau reinforced the Xiang Army's broader project of colonial assimilation by training Musulman apprentices in various Chinese medical texts and using them to disseminate these ideas across the prefecture through the medium of vaccination. However, Turpan's Musulmans possessed their own sophisticated body of knowledge regarding epidemics and healing and routinely resisted the imposition of normative Qing/Chinese medical behavior. [ABSTRACT FROM AUTHOR]

This review is based investigations on the Western Isles, Scotland, by Martin Martin, a notable Scottish Highlander, academic and medical doctor, of the 17th–18th century. His extensive observations of the geography and peoples of these Isles were recorded in his books, "On the Description of the Western Islands of Scotland Circa 1695" and "A Late Voyage to St Kilda". In these books and subsequent papers there were some noteworthy observations on the occurrence (and as he says non-occurrence) of "epidemical" diseases and conditions afflicting the peoples of The Isle of Skye and the Western Isles of Scotland in this period, and these are discussed in this review. Martin also gives details of a wide variety of remedies that were observed or reported by inhabitants around that time. Some of these remedies are interesting for their relevance to the period but others are of doubtful merit. These are reviewed here more for their significance in the understanding of the diseases and conditions of humans and even in some cases animals at that time. Introductions by Charles Withers and R.W. Munro, 11 and re-assessments of the contributions of Martin and colleagues of that time have given insight into the health and condition of peoples of the Western Isles of Scotland(the Occidental) (Martin 1695; Martin 1716). [ABSTRACT FROM AUTHOR]

The term clinical trial implies an investigation of a therapeutic intervention in the pursuit of evidence of benefit, short or sustained, and observations on the possibility of toxicity related to the therapeutic intervention. It is possible that the first clinical trial took place in the court of the Babylonian King Nebuchadnezzar circa 600 BC, as recorded in Chapter 1 of the Book of Daniel, verse 3-20. However, it is in the last 500 years that there has been good written documentation at attempts to interpret therapeutic benefit from the use of treatments. Lind's demonstration on the usefulness of oranges and lemons in the treatment of scurvy in 1747, and the unethical experiment by Edward Jenner (1749–1823) on the inoculation in 1796, of an 8-year-old boy, with cow pox obtained from a milk maid, followed by an attempt to give the young boy smallpox by direct inoculation 18 days later, are striking examples of clinical trials. Human ethics, strict clinical observations, statistics, the governed scientific purity of therapeutic agents, and safety testing of therapeutics, devices, and physical interventions, have created the basis for the modern clinical trial. [ABSTRACT FROM AUTHOR]

It is important to honor the contributions of scientific leaders who have dedicated their lives to advancing knowledge and serving their country. One way is to document their experiences and personalities in a documentary format, which can serve as a historical record and an inspiration for future generations. Dr. Mostafa Pourtaghva Shahrestani, a renowned physician and specialist in infectious diseases and tropical medicine, has made significant contributions to public health in Iran. He has played a crucial role in controlling infectious diseases such as smallpox, tuberculosis, rabies, plague, and cholera. Throughout his career, he has held various executive positions, including the head of Pasteur Hospital and the director of the Pasteur Institute of Iran. Dr. Pourtaghva's life is a testament to his unwavering dedication to public health services, as evidenced by his continuous effort, love, and interest in honest work. His inspiring story can serve as a model for those who seek to follow in his footsteps. [ABSTRACT FROM AUTHOR]

In Meiji-era Japan (1868–1912), the regime launched a vigorous national campaign to vaccinate the population against smallpox. This unfolded in the contexts of the persistent threat of smallpox, the growing science of public health, and the complex politics of vaccination. This article provides new perspectives on how Meiji Japan developed ideas of disease and disability around smallpox. For disability historians, this means an opportunity to examine how the contours of disability history took shape around social and medical discourses in modern Japan. More broadly, this article argues that by reorienting our historical methods toward including medical perspectives in the social analysis of disability, we can consider disability history (especially the disability history of Japan) in a new light. [ABSTRACT FROM AUTHOR]

In 1805, the pueblo of Tultitlan fell victim to an ostensibly mysterious new plague. After a year of curative treatment, it spread across what is now Mexico State, prompting urban officials to authorize the use of smallpox vaccination—an intervention that elicited fierce debate steeped in tensions around Indigeneity, religion, and parental rights. Drawing on newspapers and other colonial records, the article examines how different Nahua families responded, centering their concerns and expectations—of immunization and religious and public health officials—to reframe critical questions about the gender and racial politics of vaccine history and its contested relationship to colonial rule. [ABSTRACT FROM AUTHOR]

The presence of chilakwa (smallpox) in Choctaw villages between 1747 and 1748 complicated factionalism and civil war. Utilizing Sharla Fett's approach to health culture—defined as "the social relations of healing"—this article outlines how eighteenth-century Choctaws arrived at acceptable contingency plans when faced with illness and argues that community responses to smallpox helped ease factional tensions. Iksa (moiety) obligations for funeral rites—embodying the notion of iyyi kowa (generosity)—bridged political differences, accounting for a period of collaboration between groups best understood as the "smallpox peace." Smallpox, therefore, surprisingly did not immediately contribute to political instability, although its indirect consequences proved significant during later stages of the civil war. Choctaw health culture informed individual and communal responses to chilakwa, which in turn shaped Choctaw factionalism. [ABSTRACT FROM AUTHOR]

Argentina's 1879–85 Desert Campaign formed the basis for dispossessing the Indigenous community of its southern frontier. This article argues that the Desert Campaign should be understood as much as an epidemiological event as a military one, focusing on the most intense phase of a smallpox epidemic that ravaged communities of Indigenous survivors. More lives were lost to smallpox than to combat, particularly as the disease permeated prisoner camps. A general lack of concern for the health of Indigenous prisoners punctuated their experience of dispossession at the hands of the Argentine army and "distribution" into forced labor systems throughout the country. [ABSTRACT FROM AUTHOR]

Certification is an essential stage in disease eradication efforts, encompassing epidemiological, managerial, and political complexities. The certification of smallpox eradication in the People’s Republic of China (PRC, or China) exemplifies the multifaceted nature of the certification. Despite eradicating smallpox in the early 1960s, before the Global Smallpox Eradication Programme (SEP) intensified in 1967, China was one of the last countries certified as smallpox-free by the World Health Organization (WHO) in 1979. The WHO encountered notable resistance during the certification of smallpox eradication in China. This article examines the underlying motivations propelling China’s resistance, the factors that contributed to the shifts in its stance, the challenges navigated by the WHO, and the ultimate achievement of certification despite controversies surrounding its transparency and credibility. Through the case of the certification of smallpox eradication, the article provides a historical context of China’s selective engagement in global health governance, emphasising the critical importance of building a trusting relationship between the WHO and its member states. It offers insights for fostering effective collaboration among diverse stakeholders driven by varied political agendas in addressing shared global health challenges such as the coronavirus disease (COVID-19) pandemic. [ABSTRACT FROM AUTHOR]

The 2022 mpox outbreak drew global attention to this neglected pathogen. While most of the world was taken by surprise, some countries have seen this pathogen emerge and become endemic several decades prior to this epidemic. This narrative review provides an overview of mpox epidemiology since its discovery through the 2022 global outbreak. We searched PubMed for relevant literature about mpox epidemiology and transmission through 28 February 2023. The emergence of human mpox is intertwined with the eradication of smallpox and the cessation of the global smallpox vaccination campaign. The first human clade I and II monkeypox virus (MPXV) infections were reported as zoonoses in Central and West Africa, respectively, around 1970 with sporadic infections reported throughout the rest of the decade. Over the next five decades, Clade I MPXV was more common and caused outbreaks of increasing size and frequency, mainly in the Democratic Republic of the Congo. Clade II MPXV was rarely observed, until its re-emergence and ongoing transmission in Nigeria, since 2017. Both clades showed a shift from zoonotic to human-to-human transmission, with potential transmission through sexual contact being observed in Nigeria. In 2022, clade II MPXV caused a large human outbreak which to date has caused over 86,000 cases in 110 countries, with strong evidence of transmission during sexual contact. By February 2023, the global epidemic has waned in most countries, but endemic regions continue to suffer from mpox. The changing epidemiology of mpox demonstrates how neglected zoonosis turned into a global health threat within a few decades. Thus, mpox pathophysiology and transmission dynamics need to be further investigated, and preventive and therapeutic interventions need to be evaluated. Outbreak response systems need to be strengthened and sustained in endemic regions to reduce the global threat of mpox. [ABSTRACT FROM AUTHOR]

This article discusses a palaeodermatological study of Grand Duke Ferdinando II de' Medici's smallpox infection and its long-term effects. The study analyzes artwork depicting the stages of the infection and later portraits of the Duke. The analysis reveals evidence of madarosis (eyebrow loss) and likely rosacea (reddening of the malar region) in addition to the smallpox infection. The article suggests that these conditions, along with the Duke's corpulence, may have contributed to his ultimate pathology and death. The study highlights the importance of considering the long-term effects of diseases and their impact on overall health. [Extracted from the article]

As COVID-19 and its variants spread across Australia at differing paces and intensity, the country's response to the risk of infection and contagion revealed an intensification of bordering practices as a form of risk mitigation with disparate impacts on different segments of the Australian community. Australia's international border was closed for both inbound and outbound travel, with few exceptions, while states and territories, Indigenous communities, and local government areas were subject to a patchwork of varying restrictions. By focusing on borders at various levels, our research traces how the logics of medico-legal bordering have filtered down from the international to the intra-national, and indeed, into hyper-local spaces. This is not just apparent in the COVID-19 moment but in previous pandemics of 1918 to 1919 influenza and smallpox, in which practices of quarantine and lockdowns were both unevenly distributed and implemented on multiple scales of social organization. An interdisciplinary approach between history and law reveals that human movement during pandemic times in Australia has been regulated in a manner that sees mobility as a risk to public health capable of mitigation through the strict enforcement of borders as a technology of both confinement and exclusion. [ABSTRACT FROM AUTHOR]

Smallpox was a highly contagious disease caused by the variola virus. The disease affected millions of people over thousands of years and variola virus ranked as one of the deadliest viruses in human history. The complete eradication of smallpox in 1980, a major triumph in medicine, was achieved through a global vaccination campaign using a less virulent poxvirus, vaccinia virus. Despite this success, the herd immunity established by this campaign has significantly waned, and concerns are rising about the potential reintroduction of variola virus as a biological weapon or the emergence of zoonotic poxviruses. These fears were further fueled in 2022 by a global outbreak of monkeypox virus (mpox), which spread to over 100 countries, thereby boosting interest in developing new vaccines using molecular approaches. However, poxviruses are complex and creating modern vaccines against them is challenging. This review focuses on the structural biology of the six major neutralization determinants on poxviruses (D8, H3, A27, L1, B5, and A33), the localization of epitopes targeted by neutralizing antibodies, and their application in the development of subunit vaccines. [ABSTRACT FROM AUTHOR]

Monkeypox virus (MPXV), belonging to the Poxviridae family and Orthopoxvirus genus, is closely related to the smallpox virus. Initial prodromal symptoms typically include headache, fever, and lymphadenopathy. This review aims to detail various ocular manifestations and immune evasion associated with the monkeypox viral infection and its complications, making it appropriate as a narrative review. Common external ocular manifestations of MPXV typically involve a generalized pustular rash, keratitis, discharges, and dried secretions related to conjunctival pustules, photophobia, and lacrimation. Orthopoxviruses can evade host immune responses by secreting proteins that antagonize the functions of host IFNγ, CC and CXC chemokines, IL-1β, and the complement system. One of the most important transcription factors downstream of pattern recognition receptors binding is IRF3, which controls the expression of the crucial antiviral molecules IFNα and IFNβ. We strongly recommend that ophthalmologists include MPXV as part of their differential diagnosis when they encounter similar cases presenting with ophthalmic manifestations such as conjunctivitis, blepharitis, or corneal lesions. Furthermore, because non-vaccinated individuals are more likely to exhibit these symptoms, it is recommended that healthcare administrators prioritize smallpox vaccination for at-risk groups, including very young children, pregnant women, older adults, and immunocompromised individuals, especially those in close contact with MPXV cases. [ABSTRACT FROM AUTHOR]

In 1694, Queen Mary II (1662-1694) died at age 32 of hemorrhagic smallpox, a rare and fatal form of the viral infection. This contribution presents the clinical features of Queen Mary II's smallpox infection. It also reviews, from a modern-day perspective, the disseminated intravascular coagulopathy involved in the pathophysiology of hemorrhagic smallpox, which is characterized by thrombocytopenia, coagulation factor deficiency, and hypofibrinogenemia. [ABSTRACT FROM AUTHOR]

Poxviruses are considered slow-evolving viruses and are not expected to frequently mutate, though, APOBEC3, a crucial enzyme that restricts many viruses by generating mutations in their genomes, proved essential for mpox accelerated evolution and adaptation to humans. MPXV microevolution led to alterations in viral pathogenicity, rapid spread to non-endemic regions, and increased human-to-human-transmission in the 2022 mpox outbreak. Besides APOBEC3, mpox evolution can be driven by various mechanisms in humans and animals; whether it will lead to a virus with higher virulence or attenuation remains, at this time, unknown. The CAST/Eij mouse model can recapitulate the differences in pathogenicity recorded among the three mpox clades and is a relevant model for understanding mpox evolution at the single-gene level. Identification of genomic signatures signaling potential adaptation and virulence is crucial to foresee the dynamics of MPXV transmission and pathogenicity and should be considered in the discovery and development of vaccines and antivirals. Since May 2022, mpox virus (MPXV) has attracted considerable attention due to a multi-country outbreak. Marked differences in epidemiology, transmission, and pathology between the 2022 global mpox outbreak (clade IIb) and classical mpox disease, endemic in Africa (clades I and IIa) have been highlighted. MPXV genome analysis has identified the genomic changes characterizing clade IIb and the drivers of MPXV rapid evolution. Although mpox cases have largely declined, MPXV cryptic transmission and microevolution continues, which may lead to an MPXV of unpredictable pathogenicity. Vaccines and antivirals developed against variola virus, the agent that caused the extinguished plague smallpox, have been used to contain the 2022 mpox outbreak. In this review article, recent findings on MPXV origin and evolution and relevant models able to recapitulate differences in MPXV pathogenicity, which are important for drug and vaccine development, are discussed. [ABSTRACT FROM AUTHOR]

Italian medical history in the age of positivism showed a strong interest in epidemics. This can be seen in Alfonso Corradi's monumental Annali (1865-1895) and in works of other 19th-century historians who addressed major public health issues in the newly unified country. Local history was also widely practiced in Italy, and it was instrumental in discovering and publishing a wealth of documentation on past epidemic and endemic diseases, as well as on measures such as quarantines that were invented or introduced in the peninsula as early as the late Middle Ages. The way Italian historians looked at epidemics in the 20th century was shaped by politics, religion and literature more than by demography, epidemiology, or technical knowledge in the medical field. This article and its accompanying bibliography will focus on regional historiography and deal with the history of plague, smallpox, cholera and malaria, and other diseases addressed in works published after the 1980s. [ABSTRACT FROM AUTHOR]

Smallpox caused by the variola virus (VARV) was one of the greatest infectious killers of mankind. Historical records trace back smallpox for at least a millennium while phylogenetic analysis dated the ancestor of VARV circulating in the 20th century into the 19th century. The discrepancy was solved by the detection of distinct VARV sequences first in 17th‐century mummies and then in human skeletons dated to the 7th century. The historical records noted marked variability in VARV virulence which scientists tentatively associated with gene losses occurring when broad‐host poxviruses narrow their host range to a single host. VARV split from camel and gerbil poxviruses and had no animal reservoir, a prerequisite for its eradication led by WHO. The search for residual pockets of VARV led to the discovery of the monkeypox virus (MPXV); followed by the detection of endemic smallpox‐like monkeypox (mpox) disease in Africa. Mpox is caused by less virulent clade 2 MPXV in West Africa and more virulent clade 1 MPXV in Central Africa. Exported clade 2 mpox cases associated with the pet animal trade were observed in 2003 in the USA. In 2022 a world‐wide mpox epidemic infecting more than 80,000 people was noted, peaking in August 2022 although waning rapidly. The cases displayed particular epidemiological characteristics affecting nearly exclusively young men having sex with men (MSM). In contrast, mpox in Africa mostly affects children by non‐sexual transmission routes possibly from uncharacterized animal reservoirs. While African children show a classical smallpox picture, MSM mpox cases show few mostly anogenital lesions, low‐hospitalization rates and 140 fatal cases worldwide. MPXV strains from North America and Europe are closely related, derived from clade 2 African MPXV. Distinct transmission mechanisms are more likely causes for the epidemiological and clinical differences between endemic African cases and the 2022 epidemic cases than viral traits. [ABSTRACT FROM AUTHOR]

Human and animal infections with Orthopoxvirus have become more prevalent in recent years. Although smallpox has been eradicated, vaccinations continue to play a role in controlling the spread of Orthopoxvirus diseases. First generation vaccines were successfully commercialized, and they were widely used previously. Besides, several second-generation vaccines that emphasize sterile cell culture techniques for vaccine production have been developed. Some of the third-generation vaccines also successfully trigger immune responses in the host, and they are being researched as safer substitutes for smallpox vaccines. Extensive work is still being done on the creation of fourth-generation smallpox vaccines, which include the creation of DNA subunit vaccines. Clinical studies must be conducted to evaluate the efficacies of these vaccines. Vaccine was effective in preventing smallpox infection. To achieve the Sustainable Development Goals of the United Nations, a new paradigm for vaccination research and product development must be established. [ABSTRACT FROM AUTHOR]

Smallpox was eradicated in less than 200 years after Edward Jenner's practice of cowpox variolation in 1796. The forty-three years of us living free of smallpox, beginning in 1979, never truly separated us from poxviruses. The recent outbreak of monkeypox in May 2022 might well warn us of the necessity of keeping up both the scientific research and public awareness of poxviruses. One of them in particular, the vaccinia virus (VACV), has been extensively studied as a vector given its broad host range, extraordinary thermal stability, and exceptional immunogenicity. Unceasing fundamental biological research on VACV provides us with a better understanding of its genetic elements, involvement in cellular signaling pathways, and modulation of host immune responses. This enables the rational design of safer and more efficacious next-generation vectors. To address the new technological advancement within the past decade in VACV research, this review covers the studies of viral immunomodulatory genes, modifications in commonly used vectors, novel mechanisms for rapid generation and purification of recombinant virus, and several other innovative approaches to studying its biology. [ABSTRACT FROM AUTHOR]

In African countries where mpox (monkeypox) is endemic, infection is caused by two genetically related clades—Clade I (formerly Congo Basin), and Clade IIa (formerly West Africa), both of which are potentially life-threatening infections. Prior to the 2022–2023 global outbreak, mpox infections among pregnant women caused by Clade I were reported to have a 75% perinatal case fatality rate in the Democratic Republic of Congo, including the only documented case of placental infection and stillbirth from the Congenital Mpox Syndrome, and the Clade IIa mpox infection was associated with stillbirths in Nigeria. The 2022–2023 global mpox outbreak, caused by a genetically distinct strain, Clade IIb, has focused attention on the effects of mpox on pregnant women and fetal outcomes. There have been at least 58 cases of mpox infection occurring in pregnant women during the 2022–2023 outbreak. No confirmed cases of adverse perinatal outcome, including stillbirth, have been reported. The absence of perinatal morbidity and mortality from Clade IIb corresponds to the overall case fatality rate among non-pregnant women of <0.1%, as this clade has been demonstrated to produce a less-severe disease than the mpox Clade I or IIa variants. Thus, there are apparently important differences between mpox clades affecting pregnant women and perinatal outcomes. [ABSTRACT FROM AUTHOR]

In order to cape with counter the smallpox epidemics that frequently occured the vast Ottoman geography, the Vaccine Administration was established in 1840 in the Mekteb-i Tıbbiye-i Şahane (currently Istanbul Faculty of Medicine), and smallpox vaccine production took start (1840). The vaccine strains were imported from Paris, propagated through human passages and provided free of charge to the public and army in the Payitaht (royal capital) Istanbul. The material was contained in glass tubes or vaccination pens and sent to all provinces free of charge Towards the end of the 19th century, smallpox vaccine production took start in smallpox vaccine stations in France, and the Ottoman government switched from importing smallpox strains to smallpox vaccine production in the official Imperial Vaccination Center (1892). However, vaccine tubes and vaccines were sent to the Balkans, remote provinces in Anatolia and especially to the Arab Peninsula through postal service. Delivery by the means of transport of that period took a lot of time, and the vaccines spoiled on the way and would not hold. In order to solve this problem, it was decided to open filigree branches in remote provinces at the beginning of the 1900s, but the planned branches could not be activated due to lack of financial means, and a few opened branches were closed due to inefficiency. The official Ottoman Institute of Vaccination (Telkihhane-i Şahane) produced vaccines during the Second Constitutional period and during the era of Republic under different names. After the foundation of the Republic, while operating under the name of Istanbul Vaccination Institute under the directorate of Dr. Şerafettin Mustafa, it was closed and merged with the Central Hygiene Institute in Ankara. Alongside its director and staff, equipment and two and a half million doses of smallpox vaccine were moved to Ankara (1934). The Central Hygiene Institute's Smallpox Vaccine Branch was found on the experiences in vaccine production acquired in Istanbul after the 1840s. This article is the first to discuss historical accounts on the vaccine production institutions in Turkey as a whole. Production methods, storage of vaccines and supply of vaccine tubes were also evaluated all together for the first time. [ABSTRACT FROM AUTHOR]

* Context.--Before its eradication, the smallpox virus was a significant cause of poor obstetric outcomes, including maternal and fetal morbidity and mortality. The mpox (monkeypox) virus is now the most pathogenic member of the Orthopoxvirus genus infecting humans. The 2022 global mpox outbreak has focused attention on its potential effects during pregnancy. Objective.--To understand the comparative effects of different poxvirus infections on pregnancy, including mpox virus, variola virus, vaccinia virus, and cowpox virus. The impact on the pregnant individual, fetus, and placenta will be examined, with particular attention to the occurrence of intrauterine vertical transmission and congenital infection. Data Sources.--The data are obtained from the authors' cases and from various published sources, including early historical information and contemporary publications. Conclusions.--Smallpox caused maternal and perinatal death, with numerous cases reported of intrauterine transmission. In endemic African countries, mpox has also affected pregnant individuals, with up to a 75% perinatal case fatality rate. Since the start of the 2022 mpox outbreak, increasing numbers of pregnant women have been infected with the virus. A detailed description is given of the congenital mpox syndrome in a stillborn fetus, resulting from maternal-fetal transmission and placental infection, and the potential mechanisms of intrauterine infection are discussed. Other poxviruses, notably vaccinia virus and, in 1 case, cowpox virus, can also cause perinatal infection. Based on the historical evidence of poxvirus infections, mpox remains a threat to the pregnant population, and it can be expected that additional cases will occur in the future. [ABSTRACT FROM AUTHOR]

An enveloped double-stranded DNA monkeypox virus (MPXV) is a causative agent of the zoonotic viral disease, human monkeypox (HMPX). MPXV belongs to the genus Orthopoxviridae, a family of notorious smallpox viruses, and so it shares similar clinical pathophysiological features. The recent multicountry HMPX outbreak (May 2022 onwards) is recognized as an emerging global public health emergency by the World Health Organization, shunting its endemic status as opined over the past few decades. Re-emergence of HMPX raises concern to reassess the present clinical strategy and therapeutics as its outbreak evolves further. Keeping a check on these developments, here we provide insights into the HMPX epidemiology, pathophysiology, and clinical representation. Weighing on its early prevention, we reviewed the strategies that are being enrolled for HMPX diagnosis. In the line of expanded MPXV prevalence, we further reviewed its clinical management and the diverse employed preventive/therapeutic strategies, including vaccines (JYNNEOS, ACAM2000, VIGIV) and antiviral drugs/inhibitors (Tecovirimat, Cidofovir, Brincidofovir). Taken together, with a revised perspective of HMPX re-emergence, the present report summarizes new knowledge on its prevalence, pathology, and prevention strategies. [ABSTRACT FROM AUTHOR]

Vaccination for monkeypox prevention in persons with high-risk sexual behaviours to control on-going outbreak of monkeypox virus clade 3. It is important to consider patients as infectious from the beginning of the prodrome or rash until the scabs fall off.[[8]] The preferred diagnostic test for identifying a person with suspected active Mpox infection is to examine samples taken from a skin lesion using molecular tests such as polymerase chain reaction.[[8], [10]] To effectively treat Mpox, it is necessary to develop medications with specific viral targets.[6] Antiviral medications for Mpox treatment have not yet received official approval.[11] Considering the number of reported Mpox mortalities and the severity of Mpox in some patients, immunocompromised individuals, and pregnant women, the study of antiviral therapies should continue to be an option.[11] This review attempts to summarize the preventive approaches and current applicable treatment options against Mpox infection. Keywords: drug interactions; monkeypox; prevention; treatment; viral infection EN drug interactions monkeypox prevention treatment viral infection 659 666 8 07/04/23 20230701 NES 230701 Monkeypox (Mpox) virus was first observed in cynomolgus monkeys kept for research in Denmark in 1958,[1] and Mpox in humans was first determined in Central Africa in 1970 with clinical similarities and different epidemiology to smallpox.[2] Throughout history, the Mpox virus has caused several outbreaks, the most recent of which occurred in endemic and nonendemic regions around the world in 2022.[[3]] Mpox virus, with a double-stranded DNA genome, belongs to the Poxviridae family, the Chordopoxvirinae subfamily, and the genus I Orthopoxvirus i (OPXV).[5] Two genetically different Mpox viral strains (clades) have been discovered, one in Central Africa and the other in West Africa. Anti-Monkeypox Infection Approaches: From Prevention to Therapeutic Lines. [Extracted from the article]

MPOX (monkeypox) is a zoonotic viral disease, endemic in some Central and West African countries. However, in May 2022, cases began to be reported in non-endemic countries, demonstrating community transmission. Since the beginning of the outbreak, different epidemiological and clinical behaviors have been observed. We conducted an observational study at a secondary hospital in Madrid to characterize suspected and confirmed cases of MPOX epidemiologically and clinically. Besides the general descriptive analysis, we compared data between HIV-positive and HIV-negative subjects; 133 patients were evaluated with suspected MPOX, of which 100 were confirmed. Regarding positive cases, 71.0% were HIV positive, and 99.0% were men with a mean age of 33. In the previous year, 97.6% reported having sex with men, 53.6% used apps for sexual encounters, 22.9% practiced chemsex, and 16.7% went to saunas. Inguinal adenopathies were significantly higher in MPOX cases (54.0% vs. 12.1%, p < 0.001), as the involvement of genital and perianal area (57.0% vs. 27.3% and 17.0% vs. 1.0%, p = 0.006 and p = 0.082 respectively). Pustules were the most common skin lesion (45.0%). In HIV-positive cases, only 6.9% had a detectable viral load, and the mean CD4 count was 607.0/mm3. No significant differences were observed in the disease course, except for a greater tendency towards the appearance of perianal lesions. In conclusion, the MPOX 2022 outbreak in our area has been related to sexual intercourse among MSM, with no severe clinical cases nor apparent differences in HIV and non-HIV patients. [ABSTRACT FROM AUTHOR]

The complex relationship between the history of infectious diseases and social inequalities has recently attracted renewed attention. Smallpox has so far largely escaped this revived scholarly scrutiny, despite its century-long status as one of the deadliest and widespread of all infectious diseases. Literature has demonstrated important differences between rural and urban communities, and between cities, but has so far failed to address intra-urban disparities due to varying living conditions and disease environments. This article examines the last nationwide upsurge of smallpox in the Netherlands through the lens of Amsterdam's 50 neighborhoods in the period 1870–72. We use a mixed methods approach combining qualitative spatial analysis and OLS regression to investigate which part of the population was affected most by this epidemic in terms of age and sex, geographic distribution across the city, and underlying sociodemographic neighborhood characteristics such as relative wealth, housing density, crude death rate, and birth rate. Our analyses reveal a significant spatial patterning of smallpox mortality that can largely be explained by the existing social environment. Lacking universal vaccination, the smallpox epidemic was not socially neutral, but laid bare some of the deep-seated social and health inequalities across the city. [ABSTRACT FROM AUTHOR]

Despite being healed from smallpox in 1903, William Seymour incurred scarring in his left eye and lived with monocular vision. He wore a glass eye that somewhat concealed his disability, and few photographs reveal his deformity. Pentecostal scholars have reflected deeply on Seymour's race and class but have devoted little discussion to his disability. Seymour himself seemingly attributed his blindness to his own sin, but his theology assumed that healing was available to everyone, and that God aimed to cure all sick and disabled persons. The disjuncture between Seymour's theology and his personal experience of disability gives Pentecostals an opportunity to reflect anew on how the movement has unknowingly misunderstood and harmed many persons living with disabilities. [ABSTRACT FROM AUTHOR]

This article explores a poorly understood smallpox vaccination campaign targeting Native Americans in the 1830s. While previous scholars have addressed the motivations of U.S. officials in launching the campaign, the author focuses on Indigenous people's interest in disease prevention and their reception of American physicians and vaccine technology across a broad swath of North America. Resistance to vaccination was not uncommon among Native people, yet many were open to the new form of preventive medicine, including some who sought it out and others who demanded it from the government. Departing from a scholarly consensus, the author argues, first, that the federal vaccination program should be viewed as a successful public health intervention in Indian Country and, second, that this success owed to Indigenous nations' desire for protection against a singularly destructive pathogen. [ABSTRACT FROM AUTHOR]

Grandmother presence can improve the number and survival of their grandchildren, but what grandmothers protect against and how they achieve it remains poorly known. Before modern medical care, infections were leading causes of childhood mortality, alleviated from the nineteenth century onwards by vaccinations, among other things. Here, we combine two individual-based datasets on the genealogy, cause-specific mortality and vaccination status of eighteenth- and nineteenth-century Finns to investigate two questions. First, we tested whether there were cause-specific benefits of grandmother presence on grandchild survival from highly lethal infections (smallpox, measles, pulmonary and diarrhoeal infections) and/or accidents. We show that grandmothers decreased all-cause mortality, an effect which was mediated through smallpox, pulmonary and diarrhoeal infections, but not via measles or accidents. Second, since grandmothers have been suggested to increase vaccination coverage, we tested whether the grandmother effect on smallpox survival was mediated through increased or earlier vaccination, but we found no evidence for such effects. Our findings that the beneficial effects of grandmothers are in part driven by increased survival from some (but not all) childhood infections, and are not mediated via vaccination, have implications for public health, societal development and human life-history evolution. [ABSTRACT FROM AUTHOR]

The article discusses the effectiveness of the JYNNEOS vaccine in preventing monkeypox (mpox) among gay, bisexual, and other men who have sex with men (MSM) and transgender individuals. Topics discussed include the approval of the JYNNEOS vaccine by the Food and Drug Administration (FDA) for the prevention of smallpox and monkeypox, the results of a matched case-control study conducted in 12 U.S. jurisdictions to evaluate the vaccine's effectiveness against monkeypox.

The word "pox" indicated, during the late 15th century, a disease characterized by eruptive sores. When an outbreak of syphilis began in Europe during that time, it was called by many names, including the French term "la grosse verole" ("the great pox"), to distinguish it from smallpox, which was termed "la petite verole" ("the small pox"). Chickenpox was initially confused with smallpox until 1767, when the English physician William Heberden (1710-1801) provided a detailed description of chickenpox, differentiating it from smallpox. The cowpox virus was used by Edward Jenner (1749-1823) to develop a successful vaccine against smallpox. He devised the term "variolae vaccinae" ("smallpox of the cow") to denote cowpox. Jenner's pioneering work on a smallpox vaccine has led to the eradication of this disease and opened the way to preventing other infectious diseases, such as monkeypox, a poxvirus that is closely related to smallpox and that is currently infecting persons around the world. This contribution tells the stories behind the names of the various "poxes" that have infected humans: the great pox (syphilis), smallpox, chickenpox, cowpox, and monkeypox. These infectious diseases not only share a common "pox" nomenclature, but are also closely interconnected in medical history. [ABSTRACT FROM AUTHOR]

Variola virus, the causing agent of smallpox, was eradicated in 1980s and today no new cases are reported. The first human infectious illness to be eliminated globally is variola. On the contrary to Variola, monkeypox, which is a zoonotic and variola-like disease, has nowadays turned to be a major health problem worldwide. VZV is a neurotropic virus and the cause of varicella (chickenpox) and herpes zoster (shingles), which is also a highly infectious disease, especially prevalent in children. These three skin diseases—monkeypox, smallpox, and chickenpox—are frequently mistaken with one another due to similar manifestations including fever, rash, myalgia, chills and headache, but they can all be distinguished by their distinctive symptoms. Although these rash-causing disorders might present different skin lesions; diagnostic tests can be extremely useful in their differentiation. We searched for these concepts on a search engine like Google Scholar, scanning the results for alternative words and phrases, and examined relevant abstracts or articles for alternative words. The clinical diagnosis of monkeypox infection is commonly made based on the occurrence pattern of its skin rash. It is possible in varicella to concurrently identify lesions in their various stages including macular, papular, vesicular, pustular, and crusts; however, monkeypox lesions are all in the same stage and evolve with the same rate. In this review, we have tried to provide a holistic and comprehensive comparison between these three skin infections with a focus on the newly epidemic monkeypox, bringing about the most recent knowledge about its features and its diagnosis. [ABSTRACT FROM AUTHOR]

Human mpox is caused by the Monkeypox virus, a microorganism closely related to the Variola virus, both belonging to the Orthopoxvirus genus. Mpox had been considered a rare disease until a global outbreak occurred in 2022. People infected with the virus present similar symptoms to patients suffering smallpox and other rash illnesses, hindering diagnosis. The WHO indicated that no commercial PCR or serology kits are currently widely available. In the present study, the MPXV MONODOSE dtec-qPCR kit was validated following guidelines of the UNE/EN ISO/IEC 17025:2005. The parameters evaluated for the acceptance of the assay were in silico and in vitro specificity, quantitative phase analysis, reliability, and sensitivity. The assay passed validation criteria and yielded an efficiency of 95.8%, high repeatability, reproducibility, and a Limit of Detection and Quantification of at least 10 copies. Results from the validation of the MPXV dtec-qPCR kit were satisfactory. The use of the MONODOSE format (dehydrated single PCR-tubes, ready to use) provided considerable advantages allowing the detection of the Monkeypox virus to be accurately achieved. This detection kit may be considered a reliable, fast, simple, and universally available option. [ABSTRACT FROM AUTHOR]