View source for Biology:Monkeypox virus

{{Short description|Species of double-stranded DNA virus}}
{{Virusbox
| image = Monkeypox Virus (52103767506).jpg
| image_alt = 
| image_caption = Colorized transmission electron micrograph of monkeypox virus particles (teal) found within an infected cell (brown), cultured in the laboratory.
| image2 = 
| image2_alt = 
| image2_caption = C
| parent = Orthopoxvirus
| species = Monkeypox virus
| synonyms = MPV, MPXV, hMPXV, [ongoing consideration about changing the virus's name]
| synonyms_ref = 
| subdivision_ranks = Clades
| subdivision = * Clade{{nbsp}}I (Congo Basin)
* Clade{{nbsp}}II (West African)
** Clade{{nbsp}}IIa
** Clade{{nbsp}}IIb
}}

The '''''monkeypox virus''''' ('''MPV''', '''MPXV''', or '''hMPXV'''),<ref>{{Cite web |title=Mpox (monkeypox) outbreak 2022 |url=https://www.who.int/emergencies/situations/monkeypox-oubreak-2022 |access-date=2023-01-07 |website=www.who.int |language=en |archive-date=2023-01-07 |archive-url=https://web.archive.org/web/20230107073410/https://www.who.int/emergencies/situations/monkeypox-oubreak-2022 |url-status=live }}</ref>{{efn|The [[Organization:World Health Organization|World Health Organization]] (the authority on disease names) announced the new name "mpox" in November 2022. But virus naming is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV), which is currently reviewing all orthopoxvirus species. As of March 2023, the official name of the virus remains "monkeypox virus".<ref name="Who291122">{{cite press release |title=WHO recommends new name for monkeypox disease |url=https://www.who.int/news/item/28-11-2022-who-recommends-new-name-for-monkeypox-disease |publisher=[[Organization:World Health Organization|World Health Organization]] (WHO) |date=28 November 2022 |access-date=29 November 2022 }}</ref>}} is a species of double-stranded DNA virus that causes [[Medicine:Mpox|mpox disease]] in humans and other mammals. The monkeypox virus is a [[Biology:Zoonosis|zoonotic]] virus belonging to the ''[[Biology:Orthopoxvirus|orthopoxvirus]]'' genus, making it closely related to the variola, [[Medicine:Cowpox|cowpox]], and [[Medicine:Vaccinia|vaccinia]] viruses. MPV is oval-shaped with a lipoprotein outer membrane. The genome is approximately 190 kb.

The [[Medicine:Smallpox|smallpox]] and monkeypox viruses are both orthopoxviruses, and the smallpox vaccine is effective against mpox if given within 3–5 years before contracting the disease.<ref>{{Cite web |vauthors=Hibbert CM |date=2022-08-11 |title=Baby boomer alert: Will your childhood smallpox vaccine protect against monkeypox? |url=https://news.northeastern.edu/2022/08/11/smallpox-vaccine-monkeypox/ |access-date=2022-11-18 |website=News @ Northeastern |language=en-US |archive-date=2022-11-18 |archive-url=https://web.archive.org/web/20221118034035/https://news.northeastern.edu/2022/08/11/smallpox-vaccine-monkeypox/ |url-status=live }}</ref> Symptoms of mpox in humans include a rash that forms [[Medicine:Blister|blister]]s and then crusts over, fever, and [[Medicine:Lymphadenopathy|swollen lymph nodes]].<ref name="WHOfact2023">{{cite web |date=18 April 2023 |title=WHO Factsheet{{snd}}Mpox (Monkeypox) |url=https://www.who.int/news-room/fact-sheets/detail/monkeypox |access-date=21 May 2023 |publisher=[[Organization:World Health Organization|World Health Organization]] (WHO)}}</ref> The virus is transmissible between animals and humans by direct contact to the lesions or bodily fluids.<ref>{{Cite web |last=CDC |date=2022-10-18 |title=Monkeypox in the U.S. |url=https://www.cdc.gov/poxvirus/monkeypox/if-sick/transmission.html |access-date=2022-10-26 |website=Centers for Disease Control and Prevention |language=en-us |archive-date=2022-10-26 |archive-url=https://web.archive.org/web/20221026022148/https://www.cdc.gov/poxvirus/monkeypox/if-sick/transmission.html |url-status=live }}</ref> The virus was given the name ''monkeypox virus'' after being isolated from monkeys, but most of the carriers of this virus are small mammals.<ref name="WHOfact2023" />

The virus is endemic in [[Place:Central Africa|Central Africa]], where infections in humans are relatively frequent.<ref name="WHOfact2023" /><ref name="Bunge2022">{{cite journal |last1=Bunge |first1=Eveline M. |last2=Hoet |first2=Bernard |last3=Chen |first3=Liddy |last4=Lienert |first4=Florian |last5=Weidenthaler |first5=Heinz |last6=Baer |first6=Lorraine R. |last7=Steffen |first7=Robert |date=11 February 2022 |title=The changing epidemiology of human monkeypox{{snd}}A potential threat? A systematic review |journal=PLOS Neglected Tropical Diseases |volume=16 |issue=2 |pages=e0010141 |doi=10.1371/journal.pntd.0010141 |pmc=8870502 |pmid=35148313 |doi-access=free }}</ref> Though there are many natural hosts for the monkeypox virus, the exact [[Biology:Natural reservoir|reservoirs]] and how the virus is circulated in nature needs to be studied further.<ref>{{Cite web |date=2023-04-27 |title=Mpox in Animals {{!}} Mpox {{!}} Poxvirus {{!}} CDC |url=https://www.cdc.gov/poxvirus/mpox/veterinarian/mpox-in-animals.html |access-date=2023-06-08 |website=www.cdc.gov |language=en-us}}</ref>

== Virology ==

=== Classification ===
MPV is part of the genus ''[[Biology:Orthopoxvirus|Orthopoxvirus]],'' belonging to the ''[[Biology:Poxviridae|Poxviridae]]'' family, which have been listed by the WHO as diseases with epidemic or pandemic potential.<ref name="Lansiaux_2022">{{cite journal |vauthors=Lansiaux E, Jain N, Laivacuma S, Reinis A |date=December 2022 |title=The virology of human monkeypox virus (hMPXV): A brief overview |journal=Virus Research |volume=322 |pages=198932 |doi=10.1016/j.virusres.2022.198932 |pmc=9534104 |pmid=36165924}}</ref> There are two subtypes, Clade{{nbsp}}I historically associated with the Congo Basin and Clade{{nbsp}}II historically associated with West Africa. A global outbreak during 2022–2023 was caused by Clade II.<ref name="WHOfact2023" />

MPV is 96.3% identical to the [[Medicine:Smallpox|variola virus]] in regards to its coding region, but it does differ in parts of the genome which encode for virulence and host range.<ref name="Shchelkunov_2001">{{cite journal | vauthors = Shchelkunov SN, Totmenin AV, Babkin IV, Safronov PF, Ryazankina OI, Petrov NA, Gutorov VV, Uvarova EA, Mikheev MV, Sisler JR, Esposito JJ, Jahrling PB, Moss B, Sandakhchiev LS | display-authors = 6 | title = Human monkeypox and smallpox viruses: genomic comparison | journal = FEBS Letters | volume = 509 | issue = 1 | pages = 66–70 | date = November 2001 | pmid = 11734207 | doi = 10.1016/S0014-5793(01)03144-1 | pmc = 9533818 }}</ref> Through phylogenetic analysis, it was found that MPV is not a direct descendant of the variola virus.<ref name="Shchelkunov_2001" />

=== Structure and genome ===
The monkeypox virus, like other poxviruses, is oval shaped, with a lipoprotein outer membrane. The outer membrane protects the enzymes, DNA, and transcription factors of the virus.<ref>{{cite journal | vauthors = Alakunle E, Moens U, Nchinda G, Okeke MI | title = Monkeypox Virus in Nigeria: Infection Biology, Epidemiology, and Evolution | journal = Viruses | volume = 12 | issue = 11 | pages = 1257 | date = November 2020 | pmid = 33167496 | pmc = 7694534 | doi = 10.3390/v12111257 | doi-access = free }}</ref> Typical DNA viruses replicate and express their genome in the nucleus of [[Biology:Eukaryote|eukaryotic]] cells, relying heavily on the host cell's machinery. However, the monkeypox viruses rely mostly on the protein encoded in their genome that allows them to replicate in the cytoplasm.<ref name="Monkeypox: A Comprehensive Review o">{{cite journal | vauthors = Kaler J, Hussain A, Flores G, Kheiri S, Desrosiers D | title = Monkeypox: A Comprehensive Review of Transmission, Pathogenesis, and Manifestation | journal = Cureus | volume = 14 | issue = 7 | page = e26531 | date = July 2022 | pmid = 35928395 | pmc = 9345383 | doi = 10.7759/cureus.26531 | doi-access = free }}</ref>

The genome of the monkeypox virus comprises 200 kb of double stranded DNA coding for 191 proteins.<ref>{{Cite journal |last1=Forni |first1=Diego |last2=Cagliani |first2=Rachele |last3=Molteni |first3=Cristian |last4=Clerici |first4=Mario |last5=Sironi |first5=Manuela |date=November 2022 |title=Monkeypox virus: The changing facets of a zoonotic pathogen |journal=Infection, Genetics and Evolution |language=en |volume=105 |pages=105372 |doi=10.1016/j.meegid.2022.105372 |pmc=9534092 |pmid=36202208}}</ref><ref name="Kugelman_2014">{{cite journal |display-authors=6 |vauthors=Kugelman JR, Johnston SC, Mulembakani PM, Kisalu N, Lee MS, Koroleva G, McCarthy SE, Gestole MC, Wolfe ND, Fair JN, Schneider BS, Wright LL, Huggins J, Whitehouse CA, Wemakoy EO, Muyembe-Tamfum JJ, Hensley LE, Palacios GF, Rimoin AW |date=February 2014 |title=Genomic variability of monkeypox virus among humans, Democratic Republic of the Congo |journal=Emerging Infectious Diseases |language=en-us |volume=20 |issue=2 |pages=232–239 |doi=10.3201/eid2002.130118 |pmc=3901482 |pmid=24457084}}</ref> Similar to other poxviruses, the [[Biology:Virus|virions]] of monkey pox have large oval shaped envelopes. Within each virion there is a core which holds the genome along with the enzymes that assist in dissolving the protein coat and replication.<ref>{{Cite web |title=Monkeypox: What We Do and Don't Know About Recent Outbreaks |url=https://asm.org/Articles/2022/May/Monkeypox-What-We-Do-and-Don-t-Know-About-Recent-O |access-date=2022-10-21 |website=ASM.org |language=en |archive-date=2022-10-21 |archive-url=https://web.archive.org/web/20221021034256/https://asm.org/Articles/2022/May/Monkeypox-What-We-Do-and-Don-t-Know-About-Recent-O |url-status=live }}</ref> The center of the genome codes for genes involved in key functions such as viral transcription and assembly; genes located on the extremities of the viral genome are associated more towards interactions between the virus and the host cell such as spike protein characteristics.<ref name="Monkeypox: A Comprehensive Review o"/>

Monkeypox virus is relatively large compared to other viruses. This makes it harder for the virus to breach the host defenses, such as crossing past gap junctions. Furthermore, the large size makes it harder for the virus to quickly replicate and evade immune response.<ref name="Monkeypox: A Comprehensive Review o" /> To evade host immune systems, and buy more time for replication, the monkeypox and other orthopox viruses have evolved mechanisms to evade host immune cells.<ref>{{Cite journal |last1=Zandi |first1=Milad |last2=Shafaati |first2=Maryam |last3=Hosseini |first3=Fatemeh |date=2023-02-01 |title=Mechanisms of immune evasion of monkeypox virus |journal=Frontiers in Microbiology |volume=14 |doi=10.3389/fmicb.2023.1106247 |issn=1664-302X |pmc=9928851 |pmid=36819041 |doi-access=free }}</ref>[[File:Monkeypox viruses scale.png|thumb|Monkeypox virus size and structure in comparison to HIV, SARS-COV-2 and Poliovirus. Membranes and membrane-bound proteins are in purple, capsids are in dark blue, and genomes and nucleoid-associated proteins are in turquoise.|center|736x736px]]  [[File:Colorized transmission electron micrograph of monkeypox virus particles (green).jpg|thumb|Colorized transmission electron micrograph of monkeypox virus particles (green)]]

=== Replication and life cycle ===
As an ''Orthopoxvirus'', MPV replication occurs entirely in the cell cytoplasm within 'factories' – created from the host rough endoplasmic reticulum (ER) – where viral mRNA transcription and translation also take place.<ref name="ASM.org">{{Cite web |title=Monkeypox: What We Do and Don't Know About Recent Outbreaks |url=https://asm.org/Articles/2022/May/Monkeypox-What-We-Do-and-Don-t-Know-About-Recent-O |access-date=2022-10-26 |website=ASM.org |language=en |archive-date=2022-10-21 |archive-url=https://web.archive.org/web/20221021034256/https://asm.org/Articles/2022/May/Monkeypox-What-We-Do-and-Don-t-Know-About-Recent-O |url-status=live }}</ref><ref>{{cite journal | vauthors = Moss B | title = Poxvirus DNA replication | journal = Cold Spring Harbor Perspectives in Biology | volume = 5 | issue = 9 | pages = a010199 | date = September 2013 | pmid = 23838441 | pmc = 3753712 | doi = 10.1101/cshperspect.a010199 }}</ref> The factories are also where DNA replication, gene expression, and mature virions (MV) are created.<ref name="Realegeno_2017">{{cite journal | vauthors = Realegeno S, Puschnik AS, Kumar A, Goldsmith C, Burgado J, Sambhara S, Olson VA, Carroll D, Damon I, Hirata T, Kinoshita T, Carette JE, Satheshkumar PS | display-authors = 6 | title = Monkeypox Virus Host Factor Screen Using Haploid Cells Identifies Essential Role of GARP Complex in Extracellular Virus Formation | journal = Journal of Virology | volume = 91 | issue = 11 | pages = e00011–17 | date = June 2017 | pmid = 28331092 | pmc = 5432867 | doi = 10.1128/JVI.00011-17 }}</ref>

MVs are able to bind to the cell surface with the help of viral proteins.<ref name="Moss_2016">{{cite journal | vauthors = Moss B | title = Membrane fusion during poxvirus entry | journal = Seminars in Cell & Developmental Biology | volume = 60 | issue = | pages = 89–96 | date = December 2016 | pmid = 27423915 | pmc = 5161597 | doi = 10.1016/j.semcdb.2016.07.015 }}</ref> Virus entry into the host cell plasma membrane is dependent on a neutral pH, otherwise entry occurs via a low-pH dependent endocytic route.<ref name="Moss_2016" /> The MV of the monkeypox virus has an Entry Fusion Complex (EFC), allowing it to enter the host cell after attachment.<ref name="Moss_2016" />

Translation of mRNA into structural virions occurs using the host ribosomes.<ref name="ASM.org" /> Gene expression begins when MPV releases viral proteins and enzymatic factors that disable the cell.<ref name="Alkhalil_2010">{{cite journal | vauthors = Alkhalil A, Hammamieh R, Hardick J, Ichou MA, Jett M, Ibrahim S | title = Gene expression profiling of monkeypox virus-infected cells reveals novel interfaces for host-virus interactions | journal = Virology Journal | volume = 7 | page = 173 | date = July 2010 | pmid = 20667104 | pmc = 2920256 | doi = 10.1186/1743-422X-7-173 | doi-access = free }}</ref> Mature virions are infectious, however, they will stay inside the cell, until they are transported from the factories to the Golgi/endosomal comportment.<ref name="Realegeno_2017" /> Protein synthesis allows for the ER membrane of the factory to dismantle, while small two lipid bilayer membranes will appear to encapsulate the genomes of new virions, now extracellular viruses (EVs).<ref name="Alkhalil_2010" /><ref name="ASM.org" /><ref name="Realegeno_2017" /> The VPS52 and VPS54 genes of the GARP complex, which is important for transport, are necessary for wrapping the virus, and formation of EVs.<ref name="Realegeno_2017" /> DNA concatemers process the genomes, which appear in new virions, along with other enzymes, and genetic information needed for the replication cycle to occur.<ref name="Alkhalil_2010" /> EVs are necessary for the spread of the virus from cell-to-cell and its long-distance spread.<ref name="Realegeno_2017" />

==Transmission==

=== Animal to human ===
Zoonotic transmission can occur from direct contact with the blood, bodily fluids, wounds, or mucosal lesions of infected animals whether they are dead or alive. The virus is thought to have originated in Africa where evidence of the virus has been observed in multiple animals including rope squirrels, tree squirrels, Gambian pouched rats, dormice, and different species of monkeys. Though the natural reservoir of the monkeypox virus has not yet been established, rodents are speculated to be the most likely reservoir. Eating meat that has not been properly cooked and consuming other products of infected animals proves to be a major risk factor in the spread of infection.<ref name="www.who.int-2">{{Cite web |title=Monkeypox |url=https://www.who.int/news-room/fact-sheets/detail/monkeypox |url-status=live |archive-url=https://web.archive.org/web/20220421083742/https://www.who.int/news-room/fact-sheets/detail/monkeypox |archive-date=2022-04-21 |access-date=2022-11-18 |website=www.who.int |language=en}}</ref>

=== Human to human ===
[[File:Monkeypox virus transmission.jpg|thumb|250x250px|Transmission scheme of the monkeypox virus<ref>{{Cite journal |last1=Kaler |first1=Jasndeep |last2=Hussain |first2=Azhar |last3=Flores |first3=Gina |last4=Kheiri |first4=Shehreen |last5=Desrosiers |first5=Dara |year=2022 |title=Monkeypox: A Comprehensive Review of Transmission, Pathogenesis, and Manifestation |journal=Cureus |volume=14 |issue=7 |pages=e26531 |doi=10.7759/cureus.26531 |doi-access=free |issn=2168-8184 |pmc=9345383 |pmid=35928395}}</ref>]]
Mpox can be transmitted from one person to another through contact with infectious lesion material or fluid on the skin, in the mouth or on the genitals; this includes touching, close contact and during sex. It may also spread by means of respiratory droplets from talking, coughing or sneezing.<ref name="WHOfact2023" /><ref name="CDC_Transmission">{{Cite web |date=2 February 2023 |title=Mpox - How It Spreads |url=https://www.cdc.gov/poxvirus/mpox/if-sick/transmission.html |url-status=live |archive-url=https://web.archive.org/web/20230521160406/https://www.cdc.gov/poxvirus/mpox/if-sick/transmission.html |archive-date=21 May 2023 |access-date=23 May 2023 |website=Centers for Disease Control and Prevention |language=en-us}}</ref> During the 2022-2023 outbreak, transmission between people was almost exclusively via sexual contact.<ref>{{Cite web |date=28 April 2023 |title=Safer Sex, Social Gatherings, and Mpox |url=https://www.cdc.gov/poxvirus/mpox/prevention/sexual-health.html |url-status=live |archive-url=https://web.archive.org/web/20230529200408/https://www.cdc.gov/poxvirus/mpox/prevention/sexual-health.html |archive-date=29 May 2023 |access-date=26 May 2023 |website=Centers for Disease Control and Prevention |language=en-us}}</ref> There is a lower risk of infection from [[Medicine:Fomite|fomite]]s (objects which can become infectious after being touched by an infected person) such as clothing or bedding, but precautions should be taken.<ref name="WHOfact2023" />

The virus then enters the body through broken skin, or mucosal surfaces such as the mouth, respiratory tract, or genitals.<ref name="WHOfact20232">{{cite web |date=18 April 2023 |title=WHO Factsheet{{snd}}Mpox (Monkeypox) |url=https://www.who.int/news-room/fact-sheets/detail/monkeypox |url-status=live |archive-url=https://web.archive.org/web/20220421083742/https://www.who.int/news-room/fact-sheets/detail/monkeypox |archive-date=21 April 2022 |access-date=21 May 2023 |publisher=[[Organization:World Health Organization|World Health Organization]] (WHO)}}</ref><ref name="Desk">{{Cite web |date=2022-08-30 |title=Brazil: Domestic puppy in Minas Gerais contracts monkeypox, Lived with confirmed human case |url=http://outbreaknewstoday.com/brazil-domestic-puppy-in-minas-gerais-contracts-monkeypox-lived-with-confirmed-human-case-31948/ |access-date=2023-06-10 |website=Outbreak News Today |language=en-US}}</ref>

=== Human to animal ===
There are two recorded instances of human to animal transmission. Both occurred during the 2022–2023 global mpox outbreak. In both cases, the owners of a pet dog first became infected with mpox and transmitted the infection to the pet.<ref>{{Cite journal |last1=Seang |first1=Sophie |last2=Burrel |first2=Sonia |last3=Todesco |first3=Eve |last4=Leducq |first4=Valentin |last5=Monsel |first5=Gentiane |last6=Le Pluart |first6=Diane |last7=Cordevant |first7=Christophe |last8=Pourcher |first8=Valérie |last9=Palich |first9=Romain |date=August 2022 |title=Evidence of human-to-dog transmission of monkeypox virus |url=https://doi.org/10.1016/S0140-6736(22)01487-8 |journal=The Lancet |volume=400 |issue=10353 |pages=658–659 |doi=10.1016/s0140-6736(22)01487-8 |issn=0140-6736 |pmc=9536767 |pmid=35963267}}</ref><ref name="Desk"/>

== Mpox Disease ==
{{Main|Medicine:Mpox}}

=== Human ===
{{Excerpt|Mpox|Signs and symptoms|paragraphs=1,2|files=0}}

=== Animal ===
{{Excerpt|Mpox|In other animals|paragraphs=1}}

=== Prevention ===
{{Excerpt|Mpox|Prevention|paragraphs=1,3}}

=== Treatment ===
{{Excerpt|Mpox|Treatment|paragraphs=1}}

== Immune system interaction ==
Pox viruses have mechanisms to evade the hosts' innate and adaptive immune systems. Viral proteins, expressed by infected cells, employ multiple approaches to limit immune system activity; including binding to, and preventing activation of proteins within the host's immune system, and preventing infected cells from dying to enable them to continue replicating the monkey pox virus.<ref>{{Cite journal |last1=Lum |first1=Fok-Moon |last2=Torres-Ruesta |first2=Anthony |last3=Tay |first3=Matthew Z. |last4=Lin |first4=Raymond T. P. |last5=Lye |first5=David C. |last6=Rénia |first6=Laurent |last7=Ng |first7=Lisa F. P. |date=September 2022 |title=Monkeypox: disease epidemiology, host immunity and clinical interventions |journal=Nature Reviews Immunology |language=en |volume=22 |issue=10 |pages=597–613 |doi=10.1038/s41577-022-00775-4 |pmid=36064780 |pmc=9443635 |issn=1474-1741}}</ref>

==Variants and clades==
The virus is subclassified into two clades, Clade{{nbsp}}I and Clade{{nbsp}}II.<ref name="WHOfact2023" /> At the protein level, the clades share 170 orthologs, and their transcriptional regulatory sequences show no significant differences.<ref name="Lansiaux_2022" /> Both clades have 53 common virulence genes, which contain different types of amino acid changes. 121 of the amino acid changes in the virulence genes are silent, while 61 are conservative, and 93 are non-conservative.<ref name="Lansiaux_2022" />

Historically, the [[Medicine:Case fatality rate|case fatality rate]] (CFR) of past outbreaks was estimated at between 1% and 10%, with Clade I considered to be more severe than Clade II.<ref name="Death_Rates">{{Cite journal |last=Vogel |first=Lauren |date=2022-08-15 |title=Making sense of monkeypox death rates |url=https://www.cmaj.ca/content/194/31/E1097 |url-status=live |journal=CMAJ |language=en |volume=194 |issue=31 |pages=E1097 |doi=10.1503/cmaj.1096012 |issn=0820-3946 |pmid=35970550 |pmc=9377567 |archive-url=https://web.archive.org/web/20230531173637/https://www.cmaj.ca/content/194/31/E1097 |archive-date=31 May 2023 |access-date=31 May 2023}}</ref> The CFR of the 2022-2023 global outbreak (caused by Clade IIb) has been very low - estimated at 0.16%, with the majority of deaths in individuals who were already immunocompromised.<ref>{{Cite web |title=Mpox (monkeypox) - Prognosis |url=https://bestpractice.bmj.com/topics/en-gb/1611/prognosis |url-status=live |archive-url=https://web.archive.org/web/20230531173630/https://bestpractice.bmj.com/topics/en-gb/1611/prognosis |archive-date=31 May 2023 |access-date=2023-05-31 |website=BMJ Best Practice}}</ref>

{| class="wikitable"
|+Clades and subclades of ''Monkeypox virus''
! colspan="2" |Name<ref name="www.who.int">{{Cite web |title=Monkeypox: experts give virus variants new names |url=https://www.who.int/news/item/12-08-2022-monkeypox--experts-give-virus-variants-new-names |url-status=live |archive-url=https://web.archive.org/web/20220819020026/https://www.who.int/news/item/12-08-2022-monkeypox--experts-give-virus-variants-new-names |archive-date=2022-08-19 |access-date=2022-08-19 |website=www.who.int |language=en}}</ref>
!Former names<ref name="www.who.int"/>
!Nations<ref>{{Cite web |title=Monkeypox |url=https://www.who.int/news-room/fact-sheets/detail/monkeypox |access-date=2022-08-19 |website=www.who.int |language=en |archive-date=2022-04-21 |archive-url=https://web.archive.org/web/20220421083742/https://www.who.int/news-room/fact-sheets/detail/monkeypox |url-status=live }}</ref><ref>{{cite journal | vauthors = Likos AM, Sammons SA, Olson VA, Frace AM, Li Y, Olsen-Rasmussen M, Davidson W, Galloway R, Khristova ML, Reynolds MG, Zhao H, Carroll DS, Curns A, Formenty P, Esposito JJ, Regnery RL, Damon IK | display-authors = 6 | title = A tale of two clades: monkeypox viruses | journal = The Journal of General Virology | volume = 86 | issue = Pt 10 | pages = 2661–2672 | date = October 2005 | pmid = 16186219 | doi = 10.1099/vir.0.81215-0 | doi-access = free }}</ref>
|-
| colspan="2" |Clade&nbsp;I
|Congo Basin
Central African
|{{unbulleted list
|{{Flag|Cameroon}}
|{{Flag|Central African Republic}}
|{{Flag|Democratic Republic of the Congo}}
|{{Flag|Gabon}}
|{{Flag|Republic of the Congo}}
|{{Flag|South Sudan}}
}}
|-
| rowspan="2" |Clade&nbsp;II
|Clade&nbsp;IIa
| rowspan="2" |West African
|{{unbulleted list
|{{Flag|Benin}}
|{{Flag|Cameroon}}
|{{Flag|Cote d'Ivoire}}
|{{Flag|Liberia}}
|{{Flag|Nigeria}}
|{{Flag|Sierra Leone}}
}}
|-
|Clade&nbsp;IIb
|''Widespread globally - See {{Section link|2022–2023 mpox outbreak|Cases per country and territory}}''
|}

==History==
[[File:Monkeypox By Country.svg|thumb|A map of the spread of the monkeypox virus globally. {{legend|#ff8888|Endemic Clade II}}{{legend|#8888ff|Endemic Clade I}}{{legend|#aa44aa|Both clades recorded}}{{legend|#aa0000|Clade IIb outbreak in 2022–2023}}|250x250px]]
Monkeypox virus was first identified by [[Biography:Preben von Magnus|Preben von Magnus]] in Copenhagen, Denmark, in 1958 in [[Biology:Crab-eating macaque|crab-eating macaque]] monkeys (''Macaca fascicularis'') being used as [[Biology:Animal testing|laboratory animals]].<ref name="Information1978">{{cite journal | title = Monkeypox | journal = New Scientist | url = https://books.google.com/books?id=pO-YdZjojHEC&pg=PA682 | volume = 80 | date = 30 November 1978 | publisher = Reed Business Information | pages = 682– | issn = 0262-4079 | access-date = 3 November 2016 | archive-date = 13 January 2023 | archive-url = https://web.archive.org/web/20230113014032/https://books.google.com/books?id=pO-YdZjojHEC&pg=PA682 | url-status = live }}</ref> The virus was originally given the name ''monkeypox virus'' because it had been isolated from monkeys; subsequent research reveals that monkeys are not the main host. Other small mammals in the tropical forests of Central and West Africa.<ref name="Igiebor_2022">{{cite journal |vauthors=Igiebor FA, Agbontaen OJ, Egharevba PA, Amengialue OO, Ehiaghe JI, Ovwero E, Ehiaghe FA |date=May 2022 |title=Monkeypox: Emerging and Re-Emerging Threats in Nigeria |url=https://scholar.google.com/citations?view_op=view_citation&hl=en&user=VjFa7yoAAAAJ&sortby=pubdate&authuser=1&citation_for_view=VjFa7yoAAAAJ:roLk4NBRz8UC |url-status=live |journal=Journal of Basic and Applied Sciences |location=Benin City, Nigeria |publisher=Faculty of Science, Benson Idahosa University |volume=7 |issue=1 |pages=119–132 |archive-url=https://web.archive.org/web/20220607134452/https://scholar.google.com/citations?view_op=view_citation&hl=en&user=VjFa7yoAAAAJ&sortby=pubdate&authuser=1&citation_for_view=VjFa7yoAAAAJ:roLk4NBRz8UC |archive-date=2022-06-07 |access-date=2022-06-07}}</ref> are suspected to form a natural reservoir.<ref name="Lansiaux_2022" />

The first human infection was diagnosed 1970, in the Democratic Republic of Congo.<ref name="WHOfact2023" /> Small viral outbreaks with secondary human-to-human infection occur routinely in endemic areas of Central Africa; the primary route of infection is thought to be contact with the infected animals or their bodily fluids.<ref name="Meyer2002">{{cite journal |display-authors=6 |vauthors=Meyer H, Perrichot M, Stemmler M, Emmerich P, Schmitz H, Varaine F, Shungu R, Tshioko F, Formenty P |date=August 2002 |title=Outbreaks of disease suspected of being due to human monkeypox virus infection in the Democratic Republic of Congo in 2001 |journal=Journal of Clinical Microbiology |volume=40 |issue=8 |pages=2919–2921 |doi=10.1128/JCM.40.8.2919-2921.2002 |pmc=120683 |pmid=12149352}}</ref> The first reported outbreak in humans outside of Africa occurred in [[Medicine:2003 Midwest monkeypox outbreak|2003 in the United States]]; it was traced to [[Biology:Gambian pouched rat|Gambian pouched rat]]s which had been imported as exotic pets.<ref name="CDC2015Out">{{cite web |date=11 May 2015 |title=2003 U.S. Outbreak Monkeypox |url=https://www.cdc.gov/poxvirus/monkeypox/outbreak.html |url-status=live |archive-url=https://web.archive.org/web/20171015202731/https://www.cdc.gov/poxvirus/monkeypox/outbreak.html |archive-date=15 October 2017 |access-date=15 October 2017 |website=CDC |language=en-us}}</ref>  There have subsequently been a [[Medicine:Mpox#Outbreaks|number of outbreaks]] to regions outside of the endemic areas in Central Africa.

== Notes ==
{{Notelist}}

== References ==
{{Reflist}}

== External links ==
* [https://www.cdc.gov/ncidod/monkeypox/qa.htm CDC Questions and Answers About Monkeypox]
* [http://wonder.cdc.gov/wonder/prevguid/m0048673/m0048673.asp CDC – Human Monkeypox – Kasai Oriental, Zaire, 1996–1997]
* [https://www.cdc.gov/ncidod/eid/vol7no3/hutin.htm CDC – Outbreak of Human Monkeypox, Democratic Republic of Congo, 1996 to 1997]
* [https://www.cdc.gov/ncidod/monkeypox/report060903.htm CDC Preliminary Report: Multistate Outbreak of Monkeypox in Persons Exposed to Pet Prairie Dogs]
* [https://www.nlm.nih.gov/cgi/mesh/2002/MB_cgi?term=MONKEYPOX+VIRUS National Library of Medicine – Monkeypox virus]
* [http://www.virology.net/Big_Virology/BVDNApox.html Virology.net Picturebook: Monkeypox]
* [http://www.expasy.org/viralzone/all_by_species/149.html Viralzone: Orthopoxvirus]
* [http://www.viprbrc.org/brc/home.do?decorator=pox Virus Pathogen Database and Analysis Resource (ViPR): Poxviridae]
* [https://time.com/6187445/monkeypox-who-rename-stigma/ World Health Organization to rename the Monkeypox Virus]

{{Viral cutaneous conditions}}
{{Taxonbar|from=Q6900886}}

[[Category:Chordopoxvirinae]]

{{Sourceattribution|Monkeypox virus}}